Guidance published on using automated insulin delivery systems during exercise

A new resource is published for people living with type 1 diabetes to empower them in safer active lives.

A first of its kind resource aimed at helping people with type 1 diabetes use their prescribed automated insulin delivery (AID) systems during physical exercise has been published.

The guidance includes evidence-based insights on managing exercise and glucose levels while using AID systems for people living with type 1 diabetes.

The report was recently published in Diabetologia and was launched at the European Association for the Study of Diabetes (EASD) conference.

The report features a comprehensive review of current AID technologies, with specific recommendations for children, adolescents, and adults.

In addition, the recommendations include strategies for maintaining glucose levels within target ranges during both planned and unplanned exercise and guidance on overcoming barriers to physical activity, such as hypoglycaemia (low blood glucose levels) and access challenges.

The guide was developed in collaboration with academics, healthcare professionals, and researchers from around the world, including Professor Richard Bracken, Vice-Chair of the Exercise and Physical Activity study group (ExPAS), Senior Academic in Exercise, Physiology and Biochemistry and Co-lead of the Health Technology Solutions Interdisciplinary Research Institute at Swansea University.

Professor Bracken said: “I am delighted to have been a part of the writing group for this joint EASD/International Society for Pediatric and Adolescent Diabetes (ISPAD) position statement, which serves as a great starting point for individuals with type 1 diabetes and their healthcare professionals to safely manage physical activity.

“AID systems are increasingly prescribed as therapeutic options for blood glucose management however, there has been a lack of practical and well-informed clinical advice on integrating these devices into the active lifestyle of people with type 1 diabetes – until now.”

While AID systems have improved glucose management, individuals using this technology continue to face obstacles due to the fluctuations in blood sugar that physical activity and exercise can cause.

Professor Bracken said: “For people with type 1 diabetes and their healthcare providers, it is crucial to enhance communication around how to use modern AID systems while encouraging physical activity to harness the many health benefits being active can bring.”

Professor Othmar Moser, EASD lead of the writing group for this position statement and Lead of the Division of Exercise Physiology and Metabolism at Bayreuth University in Germany, said: "While several consensus reports and position statements address insulin therapy during exercise and the use of AID systems in type 1 diabetes, these are the first recommendations specifically focused on using AID systems during physical activity – a key challenge in type 1 diabetes management.

“What sets this position statement apart is its hands-on guidance tailored to each AID system, making it an invaluable resource not only for individuals living with type 1 diabetes but also for caregivers and AID system manufacturers."

Professor Sabine Hofer, co-author of the paper and ISPAD Treasurer, said: “As paediatricians, we strongly support physical activity and sports in all age groups, and this new position statement provides crucial guidance for managing type 1 diabetes in children, adolescents and young adults during physical activity.

“By offering strategies and practical advice for both planned and unplanned exercise, this statement empowers children, adolescents and their caregivers to safely engage in physical activity while effectively managing their diabetes with AID systems.”

Read the report in Diabetologia

Read the DRWF diabetes information leaflet Exercise and diabetes

Read more about type 1 diabetes