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Quality in Sport

The Role of Modern Technologies in Managing Glycemia During Physical Activity in Patients with Type 1 Diabetes – A Literature Review
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The Role of Modern Technologies in Managing Glycemia During Physical Activity in Patients with Type 1 Diabetes – A Literature Review

Authors

  • Emilia Bolesta-Okuniewska Independent Researcher, Warsaw, Poland https://orcid.org/0009-0008-4086-5232
  • Konrad Borowski Independent Researcher, Warsaw, Poland https://orcid.org/0000-0002-7835-3960
  • Julia Ceryn Independent Researcher, Warsaw, Poland https://orcid.org/0009-0000-6586-0763
  • Katarzyna Kopeć Independent Researcher, Warsaw, Poland https://orcid.org/0009-0001-4448-9341
  • Aleksandra Marchwińska-Pancer Independent Researcher, Warsaw, Poland https://orcid.org/0009-0002-3459-281X
  • Paweł Michalak Independent Researcher, Warsaw, Poland https://orcid.org/0009-0009-5487-5180
  • Oskar Pastuszek Independent Researcher, Wroclaw, Poland https://orcid.org/0009-0007-6646-2418
  • Maja Radziwon Independent Researcher, Wroclaw, Poland https://orcid.org/0009-0002-8983-5989

DOI:

https://doi.org/10.12775/QS.2026.49.67252

Keywords

Type 1 Diabetes, Physical Activity, continuous glucose monitoring, Hybrid Closed Loop, Hypoglycemia, Exercise Physiology

Abstract

Introduction. Regular physical activity is a fundamental component of therapy for type 1 diabetes (T1D), offering multidimensional benefits: from improved insulin sensitivity and weight control to reduced cardiovascular risk and enhanced psychological well-being. Despite these proven advantages, the fear of hypoglycemia remains the primary barrier preventing patients from engaging in regular exercise.

Aim. The aim of this study is to provide a comprehensive review of current literature regarding the use of modern diabetes technologies - specifically Continuous Glucose Monitoring (CGM/FGM) systems and Advanced Hybrid Closed Loop (AHCL) insulin delivery systems - in the context of various forms of physical activity.

Methods. A systematic search of the literature was conducted using PubMed, Google Scholar and Web of Science databases. The review prioritized clinical trials, meta-analyses, and consensus guidelines published between 2007 and 2024, with a special focus on the rapid technological advancements observed in the 2020–2024.

Results. The analysis indicates that modern technologies have revolutionized the approach to exercise in T1D. CGM systems allow for proactive trend-based decision-making, while AHCL systems effectively mitigate hypoglycemia risk through automated insulin suspension. However, the efficacy of these tools is dependent on the type of exercise (aerobic vs. anaerobic) and requires specific patient education regarding "exercise modes" and nutritional strategies.

Conclusion. While modern technology significantly reduces the cognitive burden of diabetes management during sports, it does not eliminate physiological challenges entirely. Future research should focus on dual-hormone systems and algorithms dedicated to high-intensity interval sports.

References

Adolfsson, P., et al. (2022). ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes. Pediatric Diabetes, 23(8), pp. 1341-1372. https://doi.org/10.1111/pedi.13412

Aronson, R., et al. (2023). Efficacy and Safety of the MiniMed 780G System in Adult Patients with Type 1 Diabetes and High Sports Activity. Diabetes Technology & Therapeutics, 25(S1). https://doi.org/10.1089/dia.2023.2502

Battelino, T., et al. (2019). Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care, 42(8). https://doi.org/10.2337/dci19-0028

Brazeau, A. S., et al. (2008). Barriers to physical activity among patients with type 1 diabetes. Diabetes Care, 31(11). https://doi.org/10.2337/dc08-0952

Campbell, M. D., et al. (2013). Low-glycemic index meal and bedtime snack prevents postprandial hyperglycemia and late-onset hypoglycemia in adults with type 1 diabetes. Diabetes Care, 37(7). https://doi.org/10.2337/dc13-1004

Colberg, S. R., et al. (2016). Physical activity/exercise and diabetes: a position statement of the ADA. Diabetes Care, 39(11). https://doi.org/10.2337/dc16-1728

Davey, R. J., et al. (2013). The effect of midday moderate-intensity exercise on postexercise hypoglycemia risk in individuals with type 1 diabetes. JCEM, 98(7). https://doi.org/10.1210/jc.2013-1498

Desjardins, K., et al. (2021). Identification of Exercise Barriers and Strategies in Adults with Type 1 Diabetes Using Closed-Loop Systems. Journal of Diabetes Science and Technology, 15(6). https://doi.org/10.1177/1932296820965561

Forlenza, G. P., et al. (2021). Real-World Evidence of Control-IQ Technology in Youth with Type 1 Diabetes and High Physical Activity. Diabetes Technology & Therapeutics, 23(S1). https://doi.org/10.1089/dia.2020.0573

Gomez, A. M., et al. (2015). Effects of performing morning versus afternoon exercise on glycemic control and hypoglycemia risk in type 1 diabetes. JDST, 9(3). https://doi.org/10.1177/1932296814566233

Guelfi, K. J., et al. (2007). The decline in blood glucose levels is less with intermittent high-intensity compared with moderate exercise in individuals with type 1 diabetes. Diabetes Care, 28(10). https://doi.org/10.2337/dc05-0968

McCarthy, O., et al. (2023). Rescue carbohydrate requirements for hypoglycemia treatment in type 1 diabetes managed with automated insulin delivery. Diabetic Medicine, 40(5). https://doi.org/10.1111/dme.15065

Moser, O., et al. (2020). Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the EASD/ISPAD. Diabetologia, 63(12). https://doi.org/10.1007/s00125-020-05263-9

Moser, O., et al. (2021). Nutritional supplementation and physical exercise in type 1 diabetes. Nutrients, 13(4). https://doi.org/10.3390/nu13041286

Paldus, B., et al. (2022). Management of physical activity with automated insulin delivery systems. Diabetes, Obesity and Metabolism, 24(S1). https://doi.org/10.1111/dom.14652

Riddell, M. C., et al. (2017). Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol, 5(5). https://doi.org/10.1016/S2213-8587(17)30014-1

Romine, W., et al. (2023). Psychometric analysis of barriers to exercise in adults with type 1 diabetes. Journal of Health Psychology, 28(2). https://doi.org/10.1177/13591053221124843

Sherr, J. L., et al. (2022). Safety and Effectiveness of the Omnipod 5 Hybrid Closed-Loop System. Diabetes Care, 45(8). https://doi.org/10.2337/dc21-2550

Sherr, J. L., et al. (2016). Safety and effectiveness of the MiniMed 670G hybrid closed-loop system. Diabetes Care, 39(7). https://doi.org/10.2337/dc16-0683

Tagougui, S., et al. (2020). Hybrid closed-loop systems for glycemic control during physical exercise in adults with type 1 diabetes: A systematic review. Diabetes, Obesity and Metabolism, 22(8). https://doi.org/10.1111/dom.14059

Taleb, N., et al. (2022). Future challenges in the field of automated insulin delivery. Diabetes & Metabolism, 48(2). https://doi.org/10.1016/j.diabet.2021.10.007

Vigers, T., et al. (2022). Accuracy of Factory-Calibrated Continuous Glucose Monitors During Exercise in Youth with Type 1 Diabetes. Diabetes Technology & Therapeutics, 24(2). https://doi.org/10.1089/dia.2021.0374

Yardley, J. E., et al. (2013). Resistance exercise in type 1 diabetes. Canadian Journal of Diabetes, 37(6). https://doi.org/10.1016/j.jcjd.2013.04.008

Zhu, Y., et al. (2022). Effects of high-intensity interval training on glycemic control in type 1 diabetes: A meta-analysis. Diabetes Research and Clinical Practice, 190. https://doi.org/10.1016/j.diabres.2022.110006

Quality in Sport

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Published

2026-01-03

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1.
BOLESTA-OKUNIEWSKA, Emilia, BOROWSKI, Konrad, CERYN, Julia, KOPEĆ, Katarzyna, MARCHWIŃSKA-PANCER, Aleksandra, MICHALAK, Paweł, PASTUSZEK, Oskar and RADZIWON, Maja. The Role of Modern Technologies in Managing Glycemia During Physical Activity in Patients with Type 1 Diabetes – A Literature Review. Quality in Sport. Online. 3 January 2026. Vol. 49, p. 67252. [Accessed 10 January 2026]. DOI 10.12775/QS.2026.49.67252.
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Vol. 49 (2026)

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Medical Sciences

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Copyright (c) 2026 Emilia Bolesta-Okuniewska, Konrad Borowski, Julia Ceryn, Katarzyna Kopeć, Aleksandra Marchwińska-Pancer, Paweł Michalak, Oskar Pastuszek, Maja Radziwon

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