Physical activity in children with type 1 diabetes

To discuss the practical aspects of safe physical activity and sports participation in children and adolescents with type 1 diabetes mellitus. A literature search was conducted using national (SciELO) and international (PubMed/MEDLINE) databases and the reference lists of the articles found, adopting the following limits: articles on physical activity published in the last 10 years, preferably conducted in children and adolescents with type 1 diabetes. Most studies had an experimental design or were meta-analyses. Skeletal muscle glucose uptake is greater during aerobic metabolism in order to generate energy for muscle contraction, which suppresses hepatic gluconeogenesis and thus promotes a decrease in blood glucose levels and increased risk of hypoglycemia. Adequate carbohydrate replacement before, during, and after exercise and reduction of preprandial rapid-acting insulin doses are the main allies in avoiding severe hypoglycemic events among diabetic children and adolescents. Type, duration, and intensity of physical activity must be considered when planning carbohydrate replacement and insulin dose reduction, as must the timing of exercise. Nonetheless, physical activity and participation in many individual and team sports is possible and highly recommended in the treatment of type 1 diabetes in children and adolescents.