Definition:
An autoimmune disease which occurs when the body’s immune system mistakenly attacks the cells in the pancreas that produce insulin. It more commonly presents during childhood and adolescence, but a person can develop it at any age.
Cause and scope for prevention:
The exact cause is unknown, however there can be a genetic component so having a family member with type 1 diabetes will increase the chances of someone developing it. There is no scope for prevention.
Diagnosis:
The person usually presents with an acute episode of weight loss, fatigue, thirst and increased urination. Blood glucose tests will then be performed to confirm diagnosis.
Standard medical therapy:
Insulin via injection or pump, plus digital self monitoring of blood glucose levels.
Type and benefit of exercise therapy:
Both diagnosis and living with the condition often cause depression and exercise is a very effective treatment for mild to moderate depression. People with severe depression may need medication, but once that starts to work exercise will also help.
There is often also significant anger in response to having type 1 diabetes, especially amongst young people. This can lead to destructive behaviours such as substance abuse, eating disorders, and self harm. Purposefully not taking enough insulin—known as diabulimia—is common and classed as an eating disorder, however the motivation is often not related to weight but to having a sense of control. Exercise can serve as a good outlet for anger and also help manage weight if that is a concern. After the initial adjustment period working out the changes to insulin dose and carbohydrate intake, there will be an increased sense of autonomy and overall reduction in blood glucose levels.
Faculty of Sport and Exercise Medicine Guidelines on the balance of risks and benefits of activity for people with dysglycaemia (abnormal blood glucose levels)
The benefits of physical activity outweigh the risks in both Type 1 and Type 2 diabetes. There is a risk of short-term dysglycaemia with physical activity.
Hypoglycaemia is the most common adverse event associated with physical activity in Type 1 & 2 diabetes, and other forms of diabetes treated with insulin or insulin secretagogues. This can be recurrent if not managed appropriately. Guidelines are available to help reduce the risk of hypoglycaemia, and evidence suggests that the overall risk of severe hypoglycaemia is not increased in those who are more physically active. People with diabetes should be made aware
that high intensity physical activity can cause a rise in blood glucose and offered strategies to combat this.
Key references:
Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis
https://pubmed.ncbi.nlm.nih.gov/29223408/
Effects of Long-Term exercise Interventions on Glycaemic Control in Type 1 and Type 2 Diabetes: a systematic review.
https://pubmed.ncbi.nlm.nih.gov/27437921/
Key organisations:
Diabetes UK
JDRF
American Diabetes Association