ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes

Pediatric Diabetes, Journal Year: 2022, Volume and Issue: 23(8), P. 1341 - 1372

Published: Dec. 1, 2022

Language: Английский

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Youth with type 1 diabetes mellitus are more inactive and sedentary than apparently healthy peers: A systematic review and meta-analysis

Diabetes Research and Clinical Practice, Journal Year: 2023, Volume and Issue: 200, P. 110697 - 110697

Published: May 9, 2023

To conduct a meta-analysis of differences in physical activity, sedentary behaviour, and fitness between children adolescents with type 1 diabetes their healthy peers.The databases EMBASE, PubMed SportsDiscus were searched for studies. Pooled effects calculated using random inverse-variance models the Hartung-Knapp-Sidik-Jonkman adjustment.Thirty-five studies included, comprising total 4,751 youths (53% girls, 2,452 diabetes). Youth less physically active (Cohen's d = -0.23, 95%CI - 0.42 to -0.04), more 0.33, 0.06 0.61), had lower cardiorespiratory -0.52, 0.73 -0.31) than peers. This corresponds -12.72 min/day moderate-to-vigorous 63.3 time (accelerometry) -4.07 ml/kg/min maximum/peak oxygen consumption. In addition, young people likely meet international activity recommendations peers (odds ratio 0.44, 0.31 0.62).Keeping mind heterogeneity design, population assessment, our findings show that seem be active, sedentary, have levels

Language: Английский

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Psychological and Clinical Challenges in the Management of Type 1 Diabetes during Adolescence: A Narrative Review

Children, Journal Year: 2024, Volume and Issue: 11(9), P. 1085 - 1085

Published: Sept. 4, 2024

Adolescence, a critical period of physical and psychological development, presents unique challenges in type 1 diabetes (T1D) management due to endocrinological changes, reduced therapeutic adherence, elevated susceptibility issues such as depression, anxiety, eating disorders. This narrative review explores the impact behavioral factors on glycemic control adolescents with T1D. We examine prevalence influence mental health disorders, lifestyle factors, harmful behaviors, social dynamics outcomes. Strategies for improving metabolic are also reviewed, including cognitive therapy, technological devices, educational interventions. The importance tailored support, family involvement, targeted interventions improve adherence treatment T1D should be emphasized.

Language: Английский

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Exercising Safely with the MiniMed™ 780G Automated Insulin Delivery System

Diabetes Technology & Therapeutics, Journal Year: 2024, Volume and Issue: 26(S3), P. 84 - 96

Published: Feb. 20, 2024

The physical and psychological benefits of exercise are particularly pertinent to people with type 1 diabetes (T1D). variability in subcutaneous insulin absorption the delay offset onset glucose lowering action impose limitations, given rapidly varying requirements exercise. Simultaneously, there challenges monitoring. Consequently, those T1D less likely because concerns regarding instability. While control can be enhanced using automated delivery (AID), all commercially available AID systems remain limited by pharmacokinetics delivery. Although glycemic responses may vary exercises differing intensities durations, principles providing foundation for guidelines include minimization on board before commencement, judicious timely carbohydrate supplementation, when possible, a reduction delivered anticipation planned There is an increasing body evidence support superior over manual dosing who wish MiniMed™ 780G system varies basal superimposed correction boluses. It incorporates temporary (elevated glucose) target 8.3 mmol/L (150 mg/dL) it functioning, autocorrection boluses stopped. As device has recently become available, data assessing under conditions. Importantly, was implemented within consensus guidelines, %time range below targets were met. A practical approach exercising provided illustrative case studies. limitations spontaneity imposed any due associated current formulations, provides excellent option safely if appropriate strategies implemented.

Language: Английский

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International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guidelines 2024 Diabetes Technologies: Glucose Monitoring

Hormone Research in Paediatrics, Journal Year: 2025, Volume and Issue: unknown, P. 571 - 591

Published: Jan. 30, 2025

The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations children, adolescents, young adults living with diabetes worldwide. This chapter builds on 2022 ISPAD guidelines, summarizes recent advances in technology behind glucose monitoring, its role glucose-responsive integrated is feasible use automated insulin delivery (AID) systems children adolescents.

Language: Английский

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Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes

Diabetes Spectrum, Journal Year: 2023, Volume and Issue: 36(2), P. 127 - 136

Published: May 1, 2023

Regular exercise is essential to overall cardiovascular health and well-being in people with type 1 diabetes, but can also lead increased glycemic disturbances. Automated insulin delivery (AID) technology has been shown modestly improve time range (TIR) adults diabetes significantly TIR youth diabetes. Available AID systems still require some user-initiated changes the settings and, cases, significant pre-planning for exercise. Many recommendations were developed initially using multiple daily injections or pump therapy. This article highlights practical strategies around

Language: Английский

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A Comparison of Faster Insulin Aspart with Standard Insulin Aspart Using Hybrid Automated Insulin Delivery System in Active Children and Adolescents with Type 1 Diabetes: A Randomized Double-Blind Crossover Trial

Diabetes Technology & Therapeutics, Journal Year: 2023, Volume and Issue: 25(9), P. 612 - 621

Published: July 5, 2023

Objective: To evaluate the use of faster acting (FIA) and standard insulin aspart (SIA) with hybrid automated delivery (AID) in active youth type 1 diabetes. Research Design Methods: In this double-blind multinational randomized crossover trial, 30 children adolescents diabetes (16 females; aged 15.0 ± 1.7 years; baseline HbA1c 7.5% 0.9% [58 9.8 mmol/mol]) underwent two unrestricted 4-week periods using AID either FIA or SIA random order. During both interventions, participants were (investigational version MiniMed™ 780G; Medtronic). Participants encouraged to exercise as frequently possible, capturing physical activity an monitor. The primary outcome was percentage sensor glucose time above range (180 mg/dL [10.0 mmol/L]) measured by continuous monitoring. Results: intention-to-treat analysis, mean 31% 15% at baseline, 19% 6% during use, 20% no difference between treatments: = −0.9%; 95% CI: −2.4% 0.6%; P 0.23. Similarly, there (TIR) (78% 77%) median below (2.5% 2.8%). Glycemic outcomes postprandial comparable for treatment arms. No severe hypoglycemia diabetic ketoacidosis events occurred. Conclusions: not superior system physically Nonetheless, formulations enabled high overall TIR low ranges, even after documented exercise. Trial Registration Clinicaltrials.gov: NCT04853030.

Language: Английский

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The Acute Effects of Real-World Physical Activity on Glycemia in Adolescents With Type 1 Diabetes: The Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) Study

Diabetes Care, Journal Year: 2023, Volume and Issue: 47(1), P. 132 - 139

Published: Nov. 3, 2023

Data from the Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) study were evaluated to understand glucose changes during activity and identify factors that may influence changes.In this real-world observational study, adolescents with type diabetes self-reported physical activity, food intake, insulin dosing (multiple-daily injection users) using a smartphone application. Heart rate continuous monitoring data collected, as well pump downloads.Two hundred fifty-one (age 14 ± 2 years [mean SD]; HbA1c 7.1 1.3% [54 14.2 mmol/mol]; 42% female) logged 3,738 activities over ∼10 days of observation. Preactivity was 163 66 mg/dL (9.1 3.7 mmol/L), dropping 148 (8.2 mmol/L) by end activity; median duration 40 min (20, 75 [interquartile range]) mean peak heart 109 16 bpm 130 21 bpm. Drops in greater those lower baseline levels (P = 0.002), shorter disease 0.02), less hypoglycemia fear 0.04), BMI 0.05). Event-level predictors drops included self-classified "noncompetitive" activities, on board >0.05 units/kg body mass, already prior preactivity >150 (>8.3 time 70-180 >70% 24 h before (all P < 0.001).Participant-level event-level can help predict magnitude drop youth diabetes. A better appreciation these improve decision support tools self-management strategies reduce activity-induced dysglycemia active living disease.

Language: Английский

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Diabetes Management in Detention Facilities: A Statement of the American Diabetes Association

Diabetes Care, Journal Year: 2024, Volume and Issue: 47(4), P. 544 - 555

Published: March 25, 2024

This statement provides guidance for diabetes care in detention facilities. It focuses on areas where the processes delivery of to people with facilities may differ from those community, and key points are made at end each section. Areas emphasis, which inform multiple aspects discussed this statement, include 1) timely identification or diagnosis treatment needs continuity (at reception/intake, during transfers, upon discharge), 2) nutrition physical activity, 3) access management tools (insulin, blood glucose monitoring, tracking data, current technologies, etc.), 4) whole person (self-management education, mental health support, monitoring addressing long-term complications, specialty care, etc.).

Language: Английский

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The use of automated insulin delivery around physical activity and exercise in type 1 diabetes: a position statement of the European Association for the Study of Diabetes (EASD) and the International Society for Pediatric and Adolescent Diabetes (ISPAD)

Diabetologia, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 10, 2024

Language: Английский

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