Simulated games activity vs continuous running exercise: A novel comparison of the glycemic and metabolic responses in T1DM patients

To compare the glycemic and metabolic responses to simulated intermittent games activity and continuous running exercise in type 1 diabetes. Nine patients (seven male, two female; 35 ± 4 years; HbA1c 8.1 ± 0.2%/65 ± 2 mmol/mol) treated on a basal‐bolus regimen completed two main trials, a continuous treadmill run ( CON ) or an intermittent running protocol ( INT ). Patients arrived to the laboratory fasted at ∼ 08:00 h, replicating their usual pre‐exercise meal and administering a 50% reduced dose of rapid‐acting insulin before exercising. Blood glucose ( BG ), K + , Na ++ , pH , triglycerides, serum cortisol and NEFA were measured at baseline and for 60 min post‐exercise. Interstitial glucose was measured for a further 23 h under free‐living conditions. Following exercise, BG declined under both conditions but was less under INT ( INT −1.1 ± 1.4 vs CON −5.3 ± 0.4 mmol/L, P  = 0.037), meaning more patients experienced hypoglycemia ( BG  ≤ 3.5 mmol/L; CON   n  = 3 vs INT   n  = 2) but less hyperglycemia ( BG  ≥ 10.9 mmol/L; CON   n  = 0 vs INT   n  = 6) under CON . Blood lactate was significantly greater, and pH lower, with a temporal delay in K + under INT ( P  < 0.05). No conditional differences were observed in other measures during this time, or in interstitial glucose concentrations during the remaining 23 h after exercise. Simulated games activity carries a lower risk of early, but not late‐onset hypoglycemia than continuous running exercise in type 1 diabetes.