Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 3;18(17):9332.
doi: 10.3390/ijerph18179332.

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Sheri R Colberg  1 , Jihan Kannane  2 , Norou Diawara  2
Affiliations

Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey

Sheri R Colberg et al. Int J Environ Res Public Health. .

Abstract

Individuals with type 1 diabetes (T1D) are able to balance their blood glucose levels while engaging in a wide variety of physical activities and sports. However, insulin use forces them to contend with many daily training and performance challenges involved with fine-tuning medication dosing, physical activity levels, and dietary patterns to optimize their participation and performance. The aim of this study was to ascertain which variables related to the diabetes management of physically active individuals with T1D have the greatest impact on overall blood glucose levels (reported as A1C) in a real-world setting. A total of 220 individuals with T1D completed an online survey to self-report information about their glycemic management, physical activity patterns, carbohydrate and dietary intake, use of diabetes technologies, and other variables that impact diabetes management and health. In analyzing many variables affecting glycemic management, the primary significant finding was that A1C values in lower, recommended ranges (<7%) were significantly predicted by a very-low carbohydrate intake dietary pattern, whereas the use of continuous glucose monitoring (CGM) devices had the greatest predictive ability when A1C was above recommended (≥7%). Various aspects of physical activity participation (including type, weekly time, frequency, and intensity) were not significantly associated with A1C for participants in this survey. In conclusion, when individuals with T1D are already physically active, dietary changes and more frequent monitoring of glucose may be most capable of further enhancing glycemic management.

Keywords: A1C; CGM; athletes; blood glucose; diet; exercise; physical activity; type 1 diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Histogram plots of A1C (a) and log A1C (b) distributions.
Figure 1
Figure 1
Distribution of participants by age (a) and years living with type 1 diabetes (b).
Figure 2
Figure 2
Distribution of participants by total hours per week spent doing all physical activities.
Figure 3
Figure 3
Total physical activity time by recommended amount and association with log A1C values.
Figure 4
Figure 4
Number of days of physical activity per week and association with log A1C values.
Figure 5
Figure 5
Intensity of physical activity and association with log A1C values.
Figure 6
Figure 6
Participation in fitness activities, endurance sports, and endurance-power sports and association with log A1C values.
Figure 7
Figure 7
Participation in power sports and outdoor activities and ingestion of carbohydrates for physical activity and association with log A1C values.
Figure 8
Figure 8
Use of CGM and physical activity-related low and high glucose and association with log A1C values.
Figure 9
Figure 9
Usual daily carbohydrate intake and association with log A1C values.
Figure 10
Figure 10
Percentages of usual daily carbohydrate intake by category.
See this image and copyright information in PMC

References

    1. Gerstein H.C., Rutty C.J. Insulin Therapy: The Discovery That Shaped a Century. Can. J. Diabetes. 2021:S1499-2671(21)00066-6. doi: 10.1016/j.jcjd.2021.03.002. - DOI - PubMed
    1. American Diabetes Association Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(Suppl. 1):S15–S33. doi: 10.2337/dc21-S002. - DOI - PubMed
    1. Colom C., Rull A., Sanchez-Quesada J., Pérez A. Cardiovascular Disease in Type 1 Diabetes Mellitus: Epidemiology and Management of Cardiovascular Risk. J. Clin. Med. 2021;10:1798. doi: 10.3390/jcm10081798. - DOI - PMC - PubMed
    1. Chimen M., Kennedy A., Nirantharakumar K., Pang T.T., Andrews R., Narendran P. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia. 2012;55:542–551. doi: 10.1007/s00125-011-2403-2. - DOI - PubMed
    1. Brazeau A.S., Leroux C., Mircescu H., Rabasa-Lhoret R. Physical activity level and body composition among adults with Type 1 diabetes. Diabet. Med. 2012;29:e402–e408. doi: 10.1111/j.1464-5491.2012.03757.x. - DOI - PubMed