Glycemic control in endurance athletes with type 1 diabetes - a literature review
DOI:
https://doi.org/10.12775/QS.2026.60.72921Keywords
type 1 diabetes, endurance sports, continuous glucose monitoring (CGM), exercise-induced hypoglycemia, automated insulin deliveryAbstract
Background: Physical activity is vital for type 1 diabetes management, yet endurance sports carry a high risk of rapid blood glucose fluctuations. Fear of hypoglycemia remains a primary barrier to regular training. Modern technologies, including continuous glucose monitoring (CGM) and automated insulin delivery (AID), significantly improve standards of care, athletic performance, and quality of life.
Aim: This study analyzes scientific literature on glycemic control strategies for endurance athletes with type 1 diabetes, emphasizing the impact of modern technologies and nutritional interventions on exercise safety.
Materials and methods: A literature review of 48 publications was conducted. The analysis included guidelines from international societies (ADA, EASD, ISPAD), clinical trials, and systematic reviews evaluating CGM, insulin pumps, closed-loop systems, and nutritional interventions.
Results: Safe endurance exercise requires proactive basal insulin adjustment and precisely planned carbohydrate intake. CGM allows real-time tracking of glycemic trends, though sensor lag time during exercise must be considered. AID, including hybrid closed-loop systems, optimizes metabolic control during and after training. Supported by education, these tools effectively reduce the fear of hypoglycemia and improve athletes' quality of life.
Conclusions: With proper glycemic control, type 1 diabetes is no longer an obstacle to competitive endurance sports, including ultramarathons. Integrating diabetes technologies with personalized nutritional strategies ensures athlete safety. Future developments should focus on refining closed-loop algorithms for variable exercise workloads.
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