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)

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Moser, Othmar ; Zaharieva, Dessi P. ; Adolfsson, Peter ; Battelino, Tadej ; Bracken, Richard M. ; Buckingham, Bruce A. ; Danne, Thomas ; Davis, Elizabeth A. ; Dovč, Klemen ; Forlenza, Gregory P. ; Gillard, Pieter ; Hofer, Sabine E. ; Hovorka, Roman ; Jacobs, Peter G. ; Mader, Julia K. ; Mathieu, Chantal ; Nørgaard, Kirsten ; Oliver, Nick S. ; O’Neal, David N. ; Pemberton, John ; Rabasa-Lhoret, Rémi ; Sherr, Jennifer L. ; Sourij, Harald ; Tauschmann, Martin ; Yardley, Jane E. ; Riddell, Michael C.:
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).
In: Diabetologia. Bd. 68 (2025) Heft 2 . - S. 255-280.
ISSN 0012-186X
DOI: https://doi.org/10.1007/s00125-024-06308-z

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Abstract

Regular physical activity and exercise (PA) are cornerstones of diabetes care for individuals with type 1 diabetes. In recent years, the availability of automated insulin delivery (AID) systems has improved the ability of people with type 1 diabetes to achieve the recommended glucose target ranges. PA provide additional health benefits but can cause glucose fluctuations, which challenges current AID systems. While an increasing number of clinical trials and reviews are being published on different AID systems and PA, it seems prudent at this time to collate this information and develop a position statement on the topic. This joint European Association for the Study of Diabetes (EASD)/International Society for Pediatric and Adolescent Diabetes (ISPAD) position statement reviews current evidence on AID systems and provides detailed clinical practice points for managing PA in children, adolescents and adults with type 1 diabetes using AID technology. It discusses each commercially available AID system individually and provides guidance on their use in PA. Additionally, it addresses different glucose responses to PA and provides stratified therapy options to maintain glucose levels within the target ranges for these age groups.