Exercise interventions for patients with type 1 diabetes mellitus: A narrative review with practical recommendations

Abstract

Type 1 diabetes mellitus (T1DM) is a chronic endocrine disease that results from autoimmune destruction of pancreatic insulin-producing β cells, which can lead to microvascular (e.g., retinopathy, neuropathy, and nephropathy) and macro-vascular complications (e.g., coronary arterial disease, peripheral artery disease, stroke, and heart failure) as a consequence of chronic hyperglycemia. Despite the widely available and compelling evidence that regular exercise is an efficient strategy to prevent cardiovascular disease and to improve functional capacity and psychological well-being in people with T1DM, over 60% of individuals with T1DM do not exercise regularly. It is, therefore, crucial to devise approaches to motivate patients with T1DM to exercise, to adhere to a training program, and to inform them of its specific characteristics (e.g., exercise mode, intensity, volume, and frequency). Moreover, given the metabolic alterations that occur during acute bouts of exercise in T1DM patients, exercise prescription in this population should be carefully analyzed to maximize its benefits and to reduce its potential risks.

Keywords: Type 1 diabetes mellitus, Exercise, Resistance training, High-intensity interval training, Aerobic training, Quality of life

Core Tip: Our manuscript analyzed the benefits of physical exercise for patients with type 1 diabetes mellitus. Benefits of different types of physical exercise (e.g., aerobic training, resistance training, and high-intensity interval training) and the possibilities of application for each were analyzed. We discussed the level of physical and physiological fitness as well as the implications of exercise on quality of life, quality of sleep, enjoyment of exercise, and motivation towards physical exercise. Finally, a practical proposal of a physical exercise program for patients with type 1 diabetes mellitus was created.