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The British Journal of Diabetes & Vascular Disease
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Review: Helping the athlete with type 1 diabetes

Ian W Gallen

Diabetes Centre, Wycombe Hospital, High Wycombe, Buckinghamshire, HP11 2TT, UK, ian.gallen{at}sbucks.nhs.uk

Exercise is a significant physiological challenge with markedly increased cardiac output, respiration and fuel mobilisation. Whilst the cardio-respiratory response to exercise is similar in type 1 diabetes to that seen in non-diabetic subjects, the response to mobilisation of fuel source to support exercise is impaired. This effect, when combined with the difficulties of nutrition and insulin therapy in type 1 diabetes may negatively impact on the performance of the athlete with diabetes. Hypoglycaemia both during and following exercise, is a significant risk. Furthermore, hyperglycaemia prior to and following some types of exercises can also be problematic. The effect on blood glucose of varying sports can be predicted, and therefore, pro-active adjustments of insulin therapy and nutrition can be made. This article outlines the important differences seen with exercise in type 1 diabetes and discusses appropriate strategies to normalise performance and reduce the risk of hypoglycaemia.

Key Words: type 1 diabetes • exercise • sport • insulin therapy • exercise physiology.

The British Journal of Diabetes & Vascular Disease, Vol. 4, No. 2, 87-92 (2004)
DOI: 10.1177/14746514040040020401
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