Effects of Postprandial Exercise on Glycaemia and Metabolism in People With Type 1 Diabetes
Condition: Type 1 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      A cornerstone in the management and treatment of people living with type 1 diabetes (T1D) is
      to engage in regular physical exercise for a variety of health and fitness reasons. Despite
      these well-established benefits, many people with T1D experience their challenging glycaemic
      condition as a high barrier to exercise. The challenge of managing glycaemia around exercise
      together with fear of hypoglycaemia (FOH) remain major barriers to exercise in T1D patients,
      meaning that many are discouraged from exercise. If people with T1D wish to engage in
      exercise in a safe manner, a certain level of pre-planning before exercise is required in
      terms of insulin dosing and target glucose concentration.

      Numerous research projects have been performed in the morning where participants exercise in
      the fasted state, for logistical reasons, because of easier insulin management in fasting
      conditions and a lower risk of hypoglycaemia during or after the exercise bout. However, in
      reality, advanced planning of exercise is not always possible, and many patients may also
      wish to exercise after their meal.

      Hence, it is important to take into account the impact of prandial state on blood glucose
      responses to exercise in patients with T1D. While evidence on the importance of timing of
      exercise and on the benefits of postprandial exercise for improving glucose control is
      available in patients with type 2 diabetes, less studies have been conducted in T1D despite
      this being of high clinical importance.

      Therefore, more insight is needed into the glycaemic and metabolic effects of different
      postprandial exercise modalities aiming to reduce the risk of hypoglycaemia and improve
      glucose control, both during and after exercise. Postprandial exercise can be a useful
      strategy to improve glycaemic control but research in T1DM is very scarce, with only few
      studies that have been conducted and optimal exercise regimens remaining unknown.

      Summarizing, prandial state is an important factor to take into account in exercise in people
      with T1D, with glycaemic responses that substantially vary between fasted or postprandial
      exercise. Performing exercise in the postprandial period is of high clinical relevance
      however there is a scarcity of research in this area. Therefore, more studies that examine
      the glycaemic and metabolic effects of different modalities of postprandial exercise in
      people with T1D are needed. All of this aiming to simplify exercise-associated
      countermeasures and improve (postprandial) glucose control, and thereby reduce barriers to PA
      in this population.
    


Intervention name(s): Postprandial exercise of different modalities
Intervention type(s): Other
Intervention description(s): Physical exercise performed 60 minutes after a standardized meal, of different modalities (4 different modalities will be examined, as described in the Arms)
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment