Abstract: Fear of hypoglycemia is a common barrier to exercise and physical activity for individuals with type 1 diabetes. While some of the earliest studies in this area involved only one or two participants, the link between exercise, exogenous insulin, and hypoglycemia was already clear, with the only suggested management strategies being to decrease insulin dosage and/or consume carbohydrates before and after exercise. Over the past 50 years, a great deal of knowledge has been developed around the impact of different types and intensities of exercise on blood glucose levels in this population. Recent decades have also seen the development of technologies such as continuous glucose monitors, faster-acting insulins and commercially available insulin pumps to allow for the real-time observation of interstitial glucose levels, and more precise adjustments to insulin dosage before, during and after activity. As such, there are now evidence-based exercise and physical activity guidelines for individuals with type 1 diabetes. While the risk of hypoglycemia has not been completely eliminated, therapy recommendations have evolved considerably. This review discusses the evolution of the knowledge and the technology related to type 1 diabetes and exercise that have allowed this evolution to take place.

Keywords: exercise, physical activity, blood glucose, insulin, carbohydrate, continuous glucose monitoring


中文翻译：

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1型糖尿病运动员：从病例报告到一般治疗建议的过渡

摘要：恐惧低血糖是1型糖尿病患者锻炼和身体活动的常见障碍。尽管该领域的一些早期研究仅涉及一个或两个参与者，但运动，外源胰岛素和低血糖之间的联系已经很清楚，唯一建议的管理策略是减少运动前后的胰岛素剂量和/或消耗碳水化合物。在过去的50年中，围绕不同类型和强度的运动对该人群血糖水平的影响，已经积累了很多知识。最近几十年来，还出现了诸如连续血糖监测仪，作用更快的胰岛素和市售胰岛素泵等技术的发展，这些技术可以实时观察组织间葡萄糖水平，以及在运动前，运动中和运动后对胰岛素剂量进行更精确的调整。因此，现在有针对1型糖尿病患者的循证锻炼和身体活动指南。尽管尚未完全消除低血糖的风险，但治疗建议已发生了很大变化。这篇综述讨论了与1型糖尿病和运动有关的知识和技术的发展，这些知识和技术使这种发展得以发生。

关键词：运动，体育锻炼，血糖，胰岛素，碳水化合物，连续血糖监测