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Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults

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Glycemic Responses to Two Different Exercise Modalities in Adolescents with Type 1 Diabetes Using Automated Insulin

Emilie B Lindkvist^1,2, Olivia M McCarthy^1,3, Sandra Tawfik¹

¹Clinical Translational Research, Diabetes Technology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.

Diabetes Technology & Therapeutics

|June 9, 2026

Summary

High-intensity interval exercise and moderate-intensity continuous exercise showed similar glycemic control in adolescents with type 1 diabetes using automated insulin delivery systems. However, hypoglycemia remains a concern, indicating automated insulin delivery systems need improvement for exercise safety.

Keywords:

CGM Tandem Control-IQ and Minimed 780G aerobic anaerobic hybrid closed loop physical activity sensor glucose

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Evaluation of Blood Lactate and Plasma Insulin During High-intensity Exercise by Antecubital Vein Catheterization

Published on: May 18, 2018

Area of Science:

Endocrinology
Exercise Physiology
Pediatric Diabetes Management

Background:

Adolescents with type 1 diabetes (T1D) using automated insulin delivery (AID) systems face challenges in managing glycemic responses during exercise.
Understanding the impact of different exercise modalities on glucose control is crucial for safe and effective physical activity in this population.

Purpose of the Study:

To compare the glycemic responses to high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in adolescents with T1D using AID systems.
To evaluate the effectiveness of consensus guideline pre-exercise preparatory measures in mitigating glycemic excursions during exercise.

Main Methods:

A two-period crossover trial involving 24 adolescents with T1D using either MiniMed™ 780G or Tandem Control-IQ™ AID systems.
Participants underwent both HIIE and MICE sessions, with continuous glucose monitoring (CGM) and plasma glucose measurements.
Pre-exercise protocols were applied 60 minutes before MICE, but not HIIE.

Main Results:

No significant difference in CGM-derived time in range (TIR_CGM) between HIIE (91.7%) and MICE (83.3%).
Hypoglycemia occurred during both exercise modalities (HIIE: 8 instances, MICE: 11 instances).
The MiniMed™ 780G group showed higher plasma glucose time in range (TIR_PG) during MICE compared to HIIE, with no difference in hypoglycemia incidence.

Conclusions:

Both HIIE and MICE, when preceded by guideline recommendations, resulted in generally stable glycemic outcomes in adolescents with T1D on AID systems.
Hypoglycemia persists as a challenge during exercise, suggesting current AID systems may not fully ensure safe glycemic control during physical activity.
Further advancements in AID technology are needed to optimize glucose management during exercise in this population.