Type 1 diabetes (T1D) is among the most common chronic illnesses affecting children and adolescents, meaning that all schools regularly include students with T1D. Supporting their well-being requires understanding how they experience middle school to address their specific needs. This qualitative, child-centered study, grounded in principles of grounded theory, explored the school experiences of 25 middle school students aged 11-15 living with T1D in France, using semi-structured interviews. Analysis revealed several key dimensions shaping their experience. A prominent theme was their desire to go through school "like everyone else" despite the constraints of the illness. This aspiration led to two central needs: a well-informed social environment and discreet attentiveness from teachers. Several levers for creating a supportive school environment emerged from the findings: rethinking technological devices to better fit school constraints; providing targeted information and training to school staff; raising awareness among all students to democratize knowledge about the condition; and fostering a professional attitude that combines understanding with discretion.

Abstract Introduction This study investigated the effects of a topical cannabidiol (CBD) gel compared to placebo on muscle function recovery, perceived muscle soreness, and blood marker of muscle damage following strenuous exercise designed to induce muscle damage. Methods Fifteen physically active students (age: 21.4 ± 2.1 years; mass: 78.0 ± 9.5 kg; height: 181.7 ± 5.0 cm) participated in the study. To induce muscle damage, participants completed 10 sets of 10 drop jumps from a 0.6 m box, with 2 min of rest between sets. In a randomized crossover design, 2 g of either CBD gel or placebo gel were applied to the quadriceps and hamstrings immediately after exercise and over the following 72 h. Muscle function recovery was assessed by measuring isometric and concentric isokinetic peak torque of the knee extensors, plasma myoglobin (Myo) concentration, and Delayed Onset Muscle Soreness (DOMS), evaluated using a visual analogue scale (VAS) at baseline, immediately post-exercise, and at 24-, 48-, and 72-h intervals. Results The two-way ANOVA revealed no significant interaction between time and condition for concentric isokinetic peak torque (p > 0.05). No significant differences were observed between the CBD and placebo conditions for plasma Myo concentrations or DOMS scores. A significant interaction was observed for isometric torque (p = 0.02), with moderate effect sizes favoring CBD over placebo from 24 to 72 h post-exercise (ES = 0.85–1.0). Conclusion The topical application of CBD gel does not appear to accelerate the recovery of muscle function or to reduce DOMS following muscle-damaging exercise. Ethical approval number B200-2020–120.

AIMS/HYPOTHESIS:Physical education (PE) in adolescents with type 1 diabetes remains underexplored despite its key role in shaping adolescents' engagement with physical activity. While the only available data about inclusion of individuals with type 1 diabetes in PE lessons are based on interviews with teachers, this study aimed to explore the first-person perspectives of adolescents. METHODS:This was a child-centred qualitative study using grounded theory. We conducted semi-structured interviews with 25 adolescents (11-15 years) with type 1 diabetes recruited from diverse middle schools. RESULTS:Students' experiences in PE are shaped by the balance between equal participation, recognition of diabetes-related needs and discreet support for autonomous glucose management, which together foster a psychologically healthy environment prompting competence, connection and autonomy. Fear of hypoglycaemia was not identified as a barrier to PE participation. Adolescents instead called for greater teacher support and regretted that excessive caution sometimes undermined their engagement and sense of competence. They sought equal participation without discrimination, with minimal adjustments for hypoglycaemic episodes. The practical constraints of insulin pumps further highlight the need for more discreet technological designs. CONCLUSIONS/INTERPRETATION:The study emphasises teachers' central role and the need for education on self-regulating physical effort according to glucose levels, which remains underdeveloped. Practical recommendations are identified to better meet the needs of young people with type 1 diabetes in middle school PE.

The objective of this randomised crossover study was to determine, in adults with type 1 diabetes, whether the glycaemic effects of high-intensity interval exercise (HIIE) vs moderate-intensity continuous exercise (CONT) differ between the postprandial (PP, higher insulin-on-board) and postabsorptive (PA) states. Twenty physically active adults (inclusion criteria: type 1 diabetes for >1 year, 18–55 years old; nine female; mean ± SD age 33.4 ± 9.4 years) completed four iso-mechanical 25 min cycling sessions (HIIE-PA and HIIE-PP including 1’-1’ bouts at 100 https://entrepot.recherche.data.gouv.fr/ platform ( https://doi.org/10.57745/YGYJSH ) with no time limit scheduled. The only restriction on the use of the data will be for commercial purposes.

ObjectiveThis study aimed to evaluate the effect of a 50% reduction in preprandial bolus insulin (50%-B) on plasma glucose (PG) responses during postprandial exercise of continuous moderate intensity (CONT) and intermittent high intensity (INT) in individuals with type 1 diabetes (T1D).MethodsSixteen adults with T1D (31% male), treated with multiple daily insulin injections (MDI), participated in a randomized crossover study comprising four experimental conditions, separated by a washout period of at least 48 hours. Participants performed two 30-minute, preceded by a 3-minute warm-up without weights:• CONT: continuous cycling at 60% of maximal aerobic power (MAP).• INT: 2-minute intervals alternating between 40% and 80% of MAP, repeated for 7 intervals, with the last interval adjusted so that the total exercise time is exactly 30 minutes. Each exercise modality was performed under two insulin conditions: a full preprandial bolus (100%-B) and a 50% reduction (50%-B). Plasma glucose, insulin, and cortisol were measured before, during, and after exercise. Linear mixed models were used to analyze temporal changes and condition effects.ResultsBlood glucose decreased significantly over time for both exercise types (p < 0.001). During CONT, the decline in PG was similar between doses (Δ100%-B: –3.01 ± 2.96 vs. Δ50%-B: –2.82 ± 2.28 mmol/L; p = 0.18), However, the nadir PG was higher with 50%-B compared to 100%-B (8.59 ± 4.07 vs. 5.69 ± 3.06 mmol/L, respectively; β = +2.91 mmol/L; p = 0.026), and hypoglycemia was less frequent (2 vs. 18 episodes; p = 0.028). During INT, PG decreased less with 50%-B than with 100%-B (Δ: –2.03 ± 1.63 vs. –3.62 ± 2.76 mmol/L; p = 0.022), with no hypoglycemic episodes under 50%-B compared to six with 100%-B. Mean PG remained higher with 50%-B across both exercise types (p < 0.01). Plasma insulin decreased over time (p = 0.038) regardless of bolus condition, while cortisol increased more during INT with 100%-B than with 50%-B (p = 0.02).ConclusionsReducing the preprandial bolus insulin by 50% effectively attenuates exercise-induced declines in plasma glucose and substantially reduces hypoglycemia risk, particularly during intermittent high-intensity exercise. These results emphasize the clinical relevance of personalized insulin adjustments to enhance metabolic safety during exercise in individuals with T1D.

OBJECTIVE:This study aimed to compare 2 post-exercise glucose management approaches in type 1 diabetes patients using continuous subcutaneous insulin infusion. METHODS:A group of 46 adults and adolescents underwent a 60-minute ergocycling session at 60% of their VO2peak at 4 pm After the exercise, participants were randomly assigned to post-exercise glucose management strategies: The first strategy involved a 20% reduction in basal insulin infusion rate for 10 h, along with a 20% reduction in the dinner insulin bolus. The second strategy consisted of consuming a post-exercise snack with 50% of their usual insulin bolus, followed by an evening snack without insulin bolus. RESULTS:During the 13-hours of recovery (5 PM to 6 AM post-exercise), there were no significant differences between the 2 strategies in terms of time spent within blood glucose levels of 4.0-10.0 mmol/l (54.4 ± 26.2 vs 57.7 ± 25.9%) and time spent below 4.0 mmol/l (1.8 ± 5.9 vs 5.5 ± 9.2%), this difference did not reach statistical significance, likely due to high interindividual variability as reflected by the large standard deviations. However, the time to first hypoglycemic event (eg, time from exercise end to first interstitial glucose <4.0 mmol/L) was significantly longer with the basal insulin reduction strategy (140 vs 83 min, P= .04), indicating a clinically meaningful advantage in delaying post-exercise hypoglycemia. CONCLUSIONS:Both strategies were comparably effective in maintaining similar blood glucose stability during the 13-hours recovery period post-exercise. However, the basal insulin reduction strategy significantly delayed the onset of the first hypoglycemic episode, suggesting a potential advantage for post-exercise hypoglycemia management.

AIMS:Some studies have explored associations between physical activity (PA) and hypoglycaemia in real-life in type 1 diabetes (T1D) but without fully accounting for two major confounders, diet and insulin. We aimed to identify thresholds of PA characteristics, insulin, and carbohydrates associated with dysglycaemia across the exercise-recovery cycle in children with T1D. MATERIALS AND METHODS:Continuous glucose monitoring and accelerometry data, self-reported PA sessions (timing, duration and perceived intensity), diet (timing, type and quantity; optional photographs) and insulin data (doses and timing; corrective/meal boluses and basal insulin) were collected in 36 children with T1D (11.9 ± 3.3 years, injections or open-loop pumps) over seven free-living days. Accelerometer data were analysed for periods corresponding to self-reported PA sessions. Ensemble machine-learning models classified hypoglycaemia (< 70 mg/dL) and hyperglycaemia (> 180 mg/dL) during three phases: PA, 2-h post-exercise (early recovery), overnight. Shapley analysis identified risk and protection thresholds of features with high importance. RESULTS:Models achieved moderate to strong performance (AUC: 0.65-0.99; F1-score: 0.62-0.95) across outcomes and phases. Insulin boluses > 11% of total daily dose within 4-h pre-exercise and > 17% during early recovery were associated with hypoglycaemia risk during PA and early recovery respectively. Carbohydrate intake showed collinearity with insulin, resulting in complex associations with glycaemia. Self-reported PA > 80 min was associated with hypoglycaemia risk during PA, while accumulating > 15 min of accelerometer-derived vigorous PA was actually protective against early recovery hypoglycaemia. Multiple daily sessions were associated with nocturnal hyperglycaemia protection. CONCLUSIONS:Phase-specific thresholds across exercise and insulin domains associated with exercise-related dysglycaemia were identified.

OBJECTIVES:In type 1 diabetes, glycemia management is rendered complex through the confounding influence of spontaneous physical activity (PA), particularly frequent in children. We aim to understand the glycemic effects of self-reported PA and cumulative spontaneous PA in their everyday life, controlling for carbohydrate intake and insulin. METHODS:In this 7-d observational study, 45 children/adolescents (21 females, 11.7 ± 3.4 yr) wore a continuous glucose monitoring system and accelerometer, completing diaries about PA, diet, and insulin. Types of PA included (i) self-reported PA and its characteristics (duration, subjective intensity) and conditions (previous sessions, timing and pre-exercise carbohydrate intake, insulin-on-board, glycemia), and (ii) spontaneous cumulative PA (accelerometry) adjusted for sedentary time. Linear mixed models were used with results expressed as the estimated coefficient " e ." In cases of skewed continuous dependent outcomes containing a preponderance of zero % values, random-intercept binary logistic regressions were used with results expressed as odds ratios (OR). RESULTS:Accumulating moderate-to-vigorous PA during the late afternoon ( e = -0.32, P = 0.039) was associated with decreased concomitant time spent >13.9 mmol·L -1 . Time spent >10.0 mmol·L -1 during self-reported PA was lower when children consumed less high-glycemic-index carbohydrates the previous hour ( e = +0.49, P = 0.034; albeit found only in one model out of two) or were physically active before the session (tendency: e = -11.58, P < 0.07). PA conditions were not significantly associated with hypoglycemia. Risk of spending some time <3.9 mmol·L -1 during sessions was higher in the case of longer PA duration (OR = 1.02, P = 0.008). Risk of nocturnal time <3.0 mmol·L -1 was greater when children performed longer duration structured PA (OR = 1.02, P = 0.054) or accumulated more afternoon vigorous-intensity PA (OR = 1.06, P = 0.04). CONCLUSIONS:Increasing spontaneous active behavior during the late afternoon could help reduce daytime spent >13.9 mmol·L -1 . There is a possibility that hyperglycemia during exercise could be limited by multiplying daily PA sessions or avoiding excessive pre-exercise carbohydrate intake. However, as only sessions characteristics, especially duration, predicted time <3.9 mmol·L -1 during PA and <3.0 mmol·L -1 the following night, simplified guidelines (not considering PA conditions) on hypoglycemic risk could be developed.

The benefits of exercise and physical activity (PA) for people living with diabetes are clear. However, current exercise recommendations do not take into consideration the potential impact of female-specific hormonal changes across the lifespan on the glycemic response to exercise. Moreover, the impact of life phases on barriers to participation in exercise and PA for women compared to men with diabetes is not well described. In this narrative review we have synthesized the literature to date regarding the interaction of female sex hormone variations (menarche and the menstrual cycle, pregnancy, and the menopausal transition) with glycemic management in the context of exercise for females with type 1 and type 2 diabetes. We also evaluated PA behaviours and barriers to participation in exercise and PA among individuals with diabetes identifying as women. We observed a lack of evidence regarding the impact of female-specific hormonal changes on the glycemic response to exercise among females with diabetes, with a particular paucity of studies during pregnancy and postpartum and for the menopausal transition. In this study we demonstrate that additional research is required to understand the influence of exercise on glucose management for females with diabetes across the lifespan, with the aim to provide safe and effective exercise recommendations and to encourage equitable participation in exercise and PA for females and women with diabetes throughout life.

AIMS:Implementing exercise programs in individuals with type 1 diabetes may precipitate glycemic fluctuations. A better understanding of these fluctuations is essential for developing appropriate glucose management strategies. We aimed to assess glycemic excursions and their progression during a 2-month training program, comparing fluctuations around exercise sessions with those of non-exercising days. METHODS:Nineteen (13 female) adults with type 1 diabetes participated in two to three supervised 90-min combined (aerobic/strength) exercise sessions per week, over 2 months. Glycemic excursions (continuous glucose monitoring) were measured during specific periods (24-h, nocturnal; periods before, during, after exercise sessions) and compared between exercise and non-exercise days (linear mixed models, logistic regressions). RESULTS:Nights following exercise sessions showed a reduced risk of hyperglycemia (>10.0 mmol·L -1 ) versus non-exercise nights. This difference diminished over the weeks of training, alongside a progressive increase in the risk of time >16.7 mmol·L -1 during the early and late recovery phases of exercise. Overall, regardless of exercise session occurrence, the risk of spending time < 70 or 54 mg/dL increased as the training program progressed. CONCLUSIONS:Initially, acute exercise sessions reduced nocturnal hyperglycemia without increasing hypoglycemia. However, over time, the risk of nocturnal hypoglycemia increased, highlighting the need for vigilant glycemic supervision, particularly at night, even on non-exercise days.

Cognitive decline is a significant complication of type 1 diabetes (T1D) that substantially affects patients' quality of life. Although previous studies suggest that Neutral Protamine Hagedorn (NPH) insulin may mitigate certain effects of streptozotocin-induced type 1 diabetes (T1DSTZ), the impact of NPH on diabetes-related cognitive decline remains unclear. This study evaluated the efficacy of NPH insulin in attenuating spatial, short-term, and long-term memory deficits in T1DSTZ rats, assessing their progression at 10, 20, and 30 days following diabetes induction and treatment initiation. Sixteen adult male Wistar rats were randomly assigned into diabetic and non-diabetic groups; T1D was induced using streptozotocin (STZ). Diabetic rats received twice-daily injections of NPH insulin and underwent cognitive assessments using the Novel Object Recognition and Spatial Object Recognition tasks. NPH insulin treatment delayed the progression of memory deficits in T1DSTZ rats over the 30-day period. Although memory function was not fully restored, insulin treatment effectively delayed deficits across spatial, short-term, and long-term memory domains. However, despite treatment, T1DSTZ rats still exhibited memory impairments, highlighting the complexity of diabetes-associated cognitive decline. These findings suggest that NPH insulin offers partial neuroprotection in T1DSTZ rats, underscoring the importance of early and consistent diabetes management to preserve cognitive function. Future research should focus on refining insulin therapy strategies to enhance their effectiveness in preventing and reducing diabetes-associated cognitive impairments.

AIMS:In the general population, individuals who self-identify as girls and women are typically less active and report more barriers to physical activity (PA), often influenced by gender stereotypes and sociocultural norms. These barriers may be accentuated in individuals with type 1 diabetes (T1D), who face additional diabetes-related barriers to engaging in PA. METHODS:In this narrative review, electronic databases were searched using keywords related to PA barriers and T1D. Titles, abstracts and full texts were screened to select articles analysing gender effects or reporting specific data on girls/women with T1D versus peers without diabetes. RESULTS:While many studies have examined gender effects on PA levels in T1D (consistently reporting lower overall and vigorous-intensity PA in girls/women), few have explored gender effects on barriers to PA. Among the ten barrier-related studies, some (but not all) suggest that girls/women report higher overall PA barrier scores and diabetes-related concerns, such as fear of hypoglycaemia, hyperglycaemia or losing control over diabetes management, compared with boys/men. The interactions between PA barriers and PA levels appear complex and may vary between adults and children. However, these interactions remain understudied from a gender perspective. CONCLUSIONS:Fear of glycaemic challenges related to PA appears to be a greater barrier for girls/women with T1D versus boys/men. However, further research is needed to examine universal barriers to PA. Interactions between diabetes-related or universal barriers with lower habitual PA also require exploration as a first step towards developing appropriate PA promotion initiatives, whether focused on glycaemic management education or social factors.

Introduction: Physical activity (PA), along with insulin adjustments and food intake for its purpose, can cause dysglycemia for people with type 1 diabetes (PWT1D), acting as a major barrier to activity. It is unclear if automated insulin delivery (AID) systems improve this situation. Methods: Observational study in real-life conditions to assess time in, below or above range (TIR, TBR [< 70mg/dl], TAR [> 180 mg/dl]) and glucose variability (CV%) during PA, 1-h post-, 4-h post-PA compared to non-PA periods with continuous glucose monitors. Participants also completed a PA log for 6 weeks including PA type (continuous, intermittent or resistance) and duration. Data were analyzed using a mixed model with Bonferroni correction for post-hoc comparisons. Results: We enrolled 22 PWT1D using AID (8 males, age: 48.7 ± 13.2 years, A1c: 6.7 ± 0.5%). Participants recorded a total of 339 PA sessions (mean 15 ± 13 [5 - 64]; 251 continuous, 59 intermittent, 29 resistance) lasting 60.9 ± 55.6 min (10 - 430 min). We found no significant effect of PA type on TIR, TBR, TAR or CV during, 1-h post or 4-h post PA. TBR as well as TAR during, 1-h and 4-h PA were comparable to non-PA periods. CV was higher in non-PA periods. All values for TBR, TAR and CV remained within optimal recommended ranges (Table). Conclusion: PWT1D using AID successfully manage PA. Respective roles of AID algorithm and adaptive behaviors need to be investigated on a larger sample size. Disclosure J. Molveau: None. C.L. Russon: None. V. Boudreau: None. E. Nguyen: None. E. Heyman: None. J.E. Yardley: Speaker's Bureau; Dexcom, Inc. Research Support; LifeScan Diabetes Institute. R.P.R. Rabasa-Lhoret: Other Relationship; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Dexcom, Inc. Research Support; Diabetes Canada. Other Relationship; Eli Lilly and Company. Research Support; Cystic Fibrosis Canada, Canadian Institutes of Health Research, FFRD - Fondation Francophone pour la Recherche du Diabète. Other Relationship; Janssen Pharmaceuticals, Inc. Research Support; Juvenile Diabetes Research Foundation (JDRF). Other Relationship; Novo Nordisk, GlaxoSmithKline plc. Consultant; HLS Therapeutics Inc., Insulet Corporation. Speaker's Bureau; CPD Networks. Other Relationship; Medtronic. Consultant; Pfizer Inc. Speaker's Bureau; Tandem Diabetes Care, Inc. Other Relationship; Sanofi. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; SFD - Société Francophone du Diabète. Funding Diabetes Canada (OG-3-21-5586-RR)

Objectives In this study we explore the impact of postprandial exercise timing (morning vs evening) on glycemia in individuals with type 1 diabetes (T1D) during short all-out sprints on a cycle ergometer. Methods Ten healthy physically sedentary male (n=7) and female (n=3) volunteers with type 1 diabetes, 22.8±2.8 years of age, and with a diabetes duration of 9.7±5.5 years and glycated hemoglobin level of 8.6±1.2%, underwent comprehensive screening and assessment of their physical health and fitness status before study participation, under the guidance of a physician. Each participant underwent 2 postprandial exercise sessions on separate days: the first in the morning at 8:00 AM and second in the evening at 8:00 PM, both conducted 60 minutes after a standardized meal. Results Morning exercise showed a less pronounced reduction in plasma glucose (PG) levels compared with evening exercise (−2.01±1.24 vs −3.56±1.6 mmol/L, p=0.03). In addition, higher cortisol levels were observed in the morning vs evening (128.59±34 vs 67.79±26 ng/mL, p<0.001). Conclusions Morning repeated sprint exercise conducted in the postprandial state consistent with the protective effect of higher cortisol levels resulted in a smaller reduction in PG levels compared with evening exercise. This highlights the potential influence of exercise timing on glycemic responses and cortisol secretion in the management of T1D.

The relationship between pre-meal insulin type, exercise timing and the risk of postprandial exercise-induced hypoglycaemia in people living with type 1 diabetes is unknown. We aimed to evaluate the effects of exercise timing (60 vs 120 min post meal) and different insulin types (aspart vs ultra-rapid aspart) on hypoglycaemic risk. This was a four-way crossover randomised trial including 40 individuals with type 1 diabetes using multiple daily injections (mean HbA1c 56 mmol/mol [7.4 V̇O_2peak ) after breakfast (60 min [EX60min] or 120 min [EX120min] post meal) with 50

OBJECTIVE:We investigated strategies to mitigate hypoglycemic risk during and after different aerobic exercises in people with type 1 diabetes (pwT1D) using continuous subcutaneous insulin infusion. RESEARCH DESIGN AND METHODS:Thirty-seven pwT1D (21 adults, 16 adolescents; HbA1c = 7.5 ± 1.0 %) participated in two post-absorptive (4-h post-meal) exercise sessions (60-min continuous moderate intensity [CONT] vs. intermittent [INT]). Pre-exercise basal rate reduction (BRR) was either 40 % or 80 %, 90 min before exercise. Post-exercise, participants undertook either a 20 % BRR for 10 h with 20 % reduced dinner bolus (INS) or a 45 g post-exercise carbohydrate (CHO) snack with a 50 % insulin bolus, and a 30 g bedtime CHO snack without bolus (snack). RESULTS:While a similar number of hypoglycemic events (31 vs. 28) were observed between exercise modalities, CONT led to a greater decrease in blood glucose during exercise compared to INT (-3.1 ± 2.3, CONT vs. -2.7 ± 2.2 mmol/l, INT, P = 0.005). Changes in blood glucose during exercise (-3.0 ± 2.4, 40 %BRR vs. -2.8 ± 2.1 mmol/l, 80 %BRR, P = 0.076) and the number of hypoglycemic events (35 vs. 24) were similar between 40 % and 80 %BRR. Time in hyperglycemia was lower with INS compared to snack in the first 30 min after exercise, but no differences were observed for late recovery period or nighttime. CONCLUSION:Compared to INT, CONT led to greater blood glucose decline without increasing hypoglycemia risk. A larger pre-exercise BRR did not further reduce hypoglycemia risk during exercise. Post-exercise INS and snack strategies led to comparable glucose profiles in pwT1D.

Individuals with type 2 diabetes free from micro- and macrovascular complications have normal resting pulmonary function, but their V̇o2peak is impaired due to poor skeletal muscle oxygenation during exercise. Tailoring exercise regimes for this population should prioritize interventions aimed at enhancing muscle oxygenation and blood flow improvement.

AbstractAcute kidneys injuries (AKIs) have been described in marathon and trail running. The currently available data allows assessment of before/after comparisons but does not allow an analysis of what happens during the race. A multidisciplinary assessment protocol was performed during the first trail of Clécy (Normandy France) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26 km, and finally after 24 h of recovery. The race extends over 156 km in hilly terrain and 6000 m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty‐five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a “RIFLE risk” level. After 24 h of rest, only one runner still had a “RIFLE Risk”. The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long‐duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti‐inflammatory drugs) before or during an ultra‐distance race should therefore be prohibited. Attention should be paid to hydration disorders.

Objectives: In this study, we explore the impact of postprandial exercise timing (morning vs evening) on glycemia in individuals with type 1 diabetes (T1D) during short all-out sprints on a cycle ergometer. Methods: Ten healthy, physically sedentary male (n=7) and female (n=3) volunteers with T1D, 22.8 +/- 2.8 years of age, and with a diabetes duration of 9.7 +/- 5.5 years and glycated hemoglobin level of 8.6 +/- 1.2%, underwent comprehensive screening and assessment of their physical health and fitness status before study participation, under the guidance of a physician. Each participant underwent 2 postprandial exercise sessions on separate days: the first in the morning at 8:00 AM and the second in the evening at 8:00 PM, both conducted 60 minutes after a standardized meal. Results: Morning exercise showed a less pronounced reduction in plasma glucose (PG) levels compared with evening exercise (-2.01 +/- 1.24 vs-3.56 +/- 1.6 mmol/L, p=0.03). In addition, higher cortisol levels were observed in the morning vs evening (128.59 +/- 34 vs 67.79 +/- 26 ng/mL, p<0.001). Conclusions: Morning repeated sprint exercise conducted in the postprandial state consistent with the protective effect of higher cortisol levels resulted in a smaller reduction in PG levels compared with evening exercise. This highlights the potential influence of exercise timing on glycemic responses and cortisol secretion in the management of T1D. (c) 2024 The Author(s). Published by Elsevier Inc. on behalf of Canadian Diabetes Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).