Recovery for the endurance athlete with Type 1 Diabetes

Many people living with type 1 diabetes live an active lifestyle, and there are numerous examples of individuals achieving incredible feats of physical endurance while living with the condition. Recently we published a detailed review on this topic in the Lancet Diabetes and Endocrinology. Below is the summary.

In contrast to athletes without diabetes, research specifically examining a post-exercise recovery routine is scarce, with most of the focus being placed on insulin or nutritional strategies to manage glycaemia before or during the exercise bout. A recent blog addressed some of this. The lack of research in this area is unfortunate because the post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the rest of the day and overnight.

To highlight this, a consensus statement on the post exercise recovery period for the endurance athlete living with type 1 diabetes has now been published (1). This blog will not discuss the entire document, but will highlight some key topics covered. The paper highlights three main topics:

  1. The principles and time course of post-exercise recovery, highlighting the implications and challenges for endurance athletes living with type 1 diabetes;

  2. Potential strategies for post-exercise recovery that could be used by athletes with type 1 diabetes to optimise recovery and adaptation, alongside improved glycaemic monitoring and management;

  3. Technology and its potential to ease the burden of managing glycaemia in the post-exercise recovery period.

Strategies to maximise and facilitate post-exercise glycogen synthesis in athletes with type 1 diabetes

For the athlete with type 1 diabetes, maintaining blood glucose concentration within target range (4–10 mmol/l) adds an additional complexity that requires vigilance, frequent glucose monitoring, preferably by continuous glucose monitoring (CGM), and often insulin dose titration.

The potential for technology to aid post-exercise recovery

Self-adjusted insulin dosing is complex. Physical activity presents additional challenges, with most decision making b