Systematic Review and Meta-Analysis of Blood glucose Response to High Intensity Interval Exercise in Adults with Type 1 Diabetes

Published:November 24, 2022DOI:
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      Exercise-induced hyperglycemia is recognized in type 1 diabetes (T1D) clinical guidelines, but its association with high intensity intermittent exercise (HIIE) in acute studies is inconsistent. This meta-analysis examined the available evidence of blood glucose responses to HIIE in adults with T1D. The secondary aim was to examine predictors of blood glucose responses to HIIE. We hypothesized that there would be no consistent effect on blood glucose from HIIE, unless examined in the context of participant prandial status.


      We conducted a literature search using keywords related to T1D and HIIE. Studies were required to include at least 6 participants with T1D with mean age >18 years, involve a HIIE intervention, and contain pre- and post-exercise measures of blood glucose. Analyses of extracted data were performed using a general inverse variance statistical method with a random effects model and a weighted multiple regression.


      Nineteen interventions from 15 reports were included in the analysis. A mean overall blood glucose change of -1.3 mmol/L (95% confidence interval [-2.3, -0.2]) was found during exercise albeit with high heterogeneity (I2= 84%). When performed following an overnight fast, exercise increased blood glucose by +1.7 mmol/L [0.4, 3.0], while post-prandial exercise decreased blood glucose by -2.1 mmol/L [-2.8, -1.4], with a statistically significant difference between groups (p<0.0001). No associations with fitness (p=0.4), sex (p=0.4), age (p=0.9), exercise duration (p=0.9), or interval duration (p=0.2) were found.


      The effect of HIIE on blood glucose is inconsistent, but partially explained by prandial status.


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