The Timing of Walking and Post-Meal Blood Sugar Levels in Adults with Type 1 Diabetes

Managing blood glucose excursions following a meal can pose a challenge for individuals with type 1 diabetes (T1D). This thesis examined whether, compared to being sedentary, a 20-minute moderate-intensity walk pre- or post-dinner could reduce postprandial glucose excursions. Eleven adults with T1D using hybrid closed-loop systems (HCLS) participated in this randomized, crossover real-world study. Participants undertook a 20-minute pre- or post-dinner walk for two weeks following a two-week baseline period. Continuous glucose monitoring data were analyzed using generalized estimating equations. In the 2-hours pre- to 4-hours post-dinner, pre-meal walks significantly improved percent time in 3.9-10.0mmol/L (LSM±SE=84.9±1.5%; B=5.58; p=0.01) and decreased percent time in 10.0-13.9mmol/L (LSM±SE=11.1±1.4%; B=-4.70; p=0.02) compared to baseline (LSM±SE=79.3±1.9% and 15.8±1.7%). There were no significant differences in area under the curve, peak, and nadir glucose between conditions (p>0.05). A 20-minute pre-meal walk may be a practical strategy to mitigate postprandial glucose excursions in individuals with T1D using HCLS.