New Position Statement on Automated Insulin Delivery Systems and Physical Acticity in Type 1 Diabetes

Sports and other forms of physical activity are beneficial for health and overall well-being. However, for people with diabetes, exercise or regular physical activity can significantly affect glucose levels. Even for those using automated insulin delivery (AID) systems, managing these glucose fluctuations can be challenging, as the device needs to be adjusted according to the type of activity planned.

This is why the European Association for the Study of Diabetes (EASD) and the International Society for Paediatric and Adolescent Diabetes (ISPAD) published a joint position statement with recommendations on physical activity and the use of AID systems in type 1 diabetes in the journal Diabetologia earlier this year.

In their recommendations, the experts differentiate between planned and unplanned physical activities and discuss the effects of exercising before or after a meal. While the authors provide a general overview of glucose trends, insulin delivery, and carbohydrate intake during various forms of activity, they emphasise that responses to exercise are multifactorial and highly individual in people with type 1 diabetes.

The position statement gives an overview about how to generally manage AID systems during physical activity and discusses the use of exercise modes in different exercise settings. It also includes a section dedicated to specific examples of AID devices and corresponding device-specific recommendations.

Understanding the relationship between physical activity, glucose dynamics, and AID system functionality is also crucial for the development of the MuSiC4Diabetes device. Besides glucose, it also measures ketone and lactate levels in the human blood to ensure a precise insulin dosage especially during physical activity. The algorithmic metabolite data processing of this device aims to determine the appropriate insulin dosage for everyday challenges such as exercise, while a personalised strategy adjusts the algorithm to the individual needs of each person with type 1 diabetes.

Read the full article here:

Othmar Moser et al. 2025. 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 68. 255-280. https://doi.org/10.1007/s00125-024-06308-z