Sex Differences in Glycemia and Self-management Strategies for Exercise in an Active Adult Cohort With Type 1 Diabetes.

Abstract

To examine potential differences in glucose levels during and after exercise between sexes in adults with type 1 diabetes. The Type 1 Diabetes Exercise Initiative study was a prospective, 4-week free-living observational study in adults with type 1 diabetes. Ninety-one females were matched on age and insulin modality to 91 males. Participants completed exercise study videos and personal exercise sessions. Study-collected food, insulin, exercise, and glucose data surrounding exercise and on sedentary days were compared between sexes to examine how they impact glucose levels during and after exercise. Female participants had higher glucose levels than male participants when starting study exercise (8.5 ± 2.8 vs 8.0 ± 2.8 mmol/L, P = .01) and when starting personal exercise activities (8.4 ± 2.9 vs 7.8 ± 2.7 mmol/L; P = .05). Glucose declines during study exercise were comparable between female and male participants (adjusted mean: -0.8 vs -1.0 mmol/L, respectively; P = .11), but smaller in female participants during personal exercise (adjusted mean: -0.9 vs -1.4 mmol/L; P < .001). Twenty-four-hour mean glucose levels were also higher in female participants on sedentary days (P = .04). Daily macronutrient consumption was similar between sexes after adjusting for weight, as were food, exercise, and insulin habits surrounding exercise. Female participants had higher preexercise glucose levels compared to male participants and smaller glucose declines during personal exercise, but there were no observable differences in food, exercise, and insulin habits.