Effect of Aerobic and Resistance Exercise on Glycemic Control in Adults With Type 1 Diabetes

Objectives: Physical exercise is recommended for individuals with type 1 diabetes, yet the effects of exercise on glycemic control are not well established. We evaluated the impact of different modes of exercise on glycemic control in people with type 1 diabetes. Methods: In a 3-week randomized crossover trial, 10 adults with type 1 diabetes (4 men and 6 women, aged 33 +/- 6 years; duration of diabetes, 18 +/- 10 years; glycated hemoglobin level, 7.4%+/- 1%) were assigned to 3 weeks of intervention: aerobic exercise (treadmill at 60% of maximum volume of oxygen utilization), resistance training (8 to 12 repetitions of 5 upper and lower body exercises at 60% to 80% of 1 repetition maximum) or no exercise (control). During each exercise week, participants completed 2 monitored 45 min exercise sessions. For each week of the study, we analyzed participants' insulin pump data, sensor glucose data and meal intake using a custom smart-phone application. The primary outcome was the percentage of time in range (glucose >3.9 mmol/L and <= 10 mmol/L) for the 24 h after each bout of exercise or rest during the control week. The study was registered on ClinicalTrials.gov (NCT: 02687893). Results: Aerobic exercise caused a mean glucose reduction during exercise of 3.94 +/- 2.67 mmol/L, whereas the reduction during resistance training was 1.33 +/- 1.78 mmol/L (p = 0.007). The mean percentage time in range for the 24 h after resistance training was significantly greater than that during the control period (70% vs. 56%, p = 0.013) but not after aerobic exercise (60%). Conclusions: The results indicate that when various confounders are considered, resistance training could improve glycemic control in this population. (C) 2018 Canadian Diabetes Association.