Automated insulin delivery (AID) systems, physical activity and sports in type 1 diabetes mellitus: joint guidelines of the DDG and ÖDG

Kurzfassung

The increased availability and use of automated insulin delivery (AID) systems in recent years have shown that individuals using AID systems can more easily and consistently achieve glycemic targets and that this is associated with improvements in quality of life. Alongside this technological progress, regular physical activity and exercise remain cornerstones of diabetes management for individuals with type 1 diabetes, owing to the numerous well-documented health benefits of an active lifestyle. Despite the clear evidence supporting the positive effects of physical activity and exercise, glucose fluctuations frequently occur around physical activity and exercise, posing challenges for AID systems and simultaneously deterring people with type 1 diabetes from maintaining a physically active lifestyle. Given the growing number of clinical trials and reviews on AID systems in the context of physical activity and exercise, there is a clear need to consolidate this knowledge and develop joint guidelines by the German Diabetes Association (DDG) and the Austrian Diabetes Association (ÖDG). This German-language guideline is based on the current position statements of the European Association for the Study of Diabetes (EASD) and the International Society for Pediatric and Adolescent Diabetes (ISPAD). They summarize the evidence on AID systems and provide practical recommendations for the management of physical activity and exercise in children, adolescents and adults with type 1 diabetes using AID systems. Within the guidelines we detail each AID system available in Germany and Austria and give specific guidance for their use around physical activity and exercise. Furthermore, we discuss glycemic responses to physical activity and exercise and outline therapeutic strategies to maintain glycemia within target ranges.