Physical exercise is an important component in the management of type 1 diabetes across the lifespan. Yet, acute exercise increases the risk of dysglycaemia, and the direction of glycaemic excursions depends, to some extent, on the intensity and duration of the type of exercise. Understandably, fear of hypoglycaemia is one of the strongest barriers to incorporating exercise into daily life. Risk of hypoglycaemia during and after exercise can be lowered when insulin-dose adjustments are made and/or additional carbohydrates are consumed. Glycaemic management during exercise has been made easier with continuous glucose monitoring (CGM) and intermittently scanned continuous glucose monitoring (isCGM) systems; however, because of the complexity of CGM and isCGM systems, both individuals with type 1 diabetes and their healthcare professionals may struggle with the interpretation of given information to maximise the technological potential for effective use around exercise (i.e. before, during and after). This position statement highlights the recent advancements in CGM and isCGM technology, with a focus on the evidence base for their efficacy to sense glucose around exercise and adaptations in the use of these emerging tools, and updates the guidance for exercise in adults, children and adolescents with type 1 diabetes. Graphical abstract

Russell, M, Sparkes, W, Northeast, J, Cook, CJ, Love, TD, Bracken, RM, and Kilduff, LP. Changes in acceleration and deceleration capacity throughout professional soccer match-play. J Strength Cond Res 30(10): 2839–2844, 2016—As the acceleration and deceleration demands of soccer are currently not well understood, this study aimed to profile markers of acceleration and deceleration capacity during professional soccer match-play. This within-player observational study required reserve team players from a Premier League club to wear 10-Hz Global Positioning System units throughout competitive matches played in the 2013–14 competitive season. Data are presented for players who completed 4 or more games during the season (n = 11), and variables are presented according to six 15-minute intervals (I1–6: 00:00–14:59 minutes, 15:00–29:59 minutes, 30:00–44:59 minutes, 45:00–59:59 minutes, 60:00–74:59 minutes, and 75:00–89:59 minutes, respectively). During I6, the distance covered (total, per minute, and at high intensity), number of sprints, accelerations (total and high intensity), decelerations (total and high intensity), and impacts were reduced compared with I1 (all p ≤ 0.05). The number of high-intensity impacts remained unchanged throughout match-play (p > 0.05). These findings indicate that high-intensity actions and markers of acceleration and deceleration capacity are reduced in the last 15 minutes of the normal duration of match-play. Such information can be used to increase the specificity of training programs designed for soccer players while also giving further insight in to the effects of 90 minutes of soccer-specific exercise. Interventions that seek to maintain the acceleration and deceleration capacity of players throughout the full duration of a soccer match warrant investigation.

25(11): 3070–3075, 2011—There is considerable conflict within the literature regarding the relevance of isometric testing for the assessment of neuromuscular function within dynamic sports. The aim of this study was to determine the relationship between isometric measures of force development and dynamic performance. Thirty-nine professional rugby league players participated in this study. Forty-eight hours after trial familiarization, participants performed a maximal isometric midthigh pull, with ∼120–130° bend at the knee, countermovement jump (CMJ), and a 10-m sprint. Force–time data were processed for peak force (PF), force at 100 milliseconds (F100ms), and peak rate of force development (PRFD). Analysis was carried out using Pearson's product moment correlation with significance set at p < 0.05. The PF was not related to dynamic performance; however, when expressed relative to body weight, it was significantly correlated with both 10-m time and CMJ height (r = −0.37 and 0.45, respectively, p < 0.05). The F100ms was inversely related to 10-m time (r = −0.54, p < 0.01); moreover, when expressed relative to body weight, it was significantly related to both 10-m time and CMJ height (r = −0.68 and 0.43, p < 0.01). In addition, significant correlations were found between PRFD and 10-m time (r = −0.66, p < 0.01) and CMJ height (r = 0.387, p < 0.01). In conclusion, this study provides evidence that measures of maximal strength and explosiveness from isometric force–time curves are related to jump and sprint acceleration performance in professional rugby league players....

Introduction Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glycemia and metabolic parameters following evening exercise in type 1 diabetes. Methods Ten male participants (glycated hemoglobin: 52.4±2.2 mmol/mol), treated with multiple daily injections, completed two randomized study-days, whereby administration of total daily basal insulin dose was unchanged (100%), or reduced by 20% (80%). Participants attended the laboratory at ∼08:00 h for a fasted blood sample, before returning in the evening. On arrival (∼17:00 h), participants consumed a carbohydrate meal and administered a 75% reduced rapid-acting insulin dose and 60 min later performed 45 min of treadmill running. At 60 min postexercise, participants consumed a low glycemic index (LGI) meal and administered a 50% reduced rapid-acting insulin dose, before returning home. At ∼23:00 h, participants consumed a LGI bedtime snack and returned to the laboratory the following morning (∼08:00 h) for a fasted blood sample. Venous blood samples were analyzed for glucose, glucoregulatory hormones, non-esterified fatty acids, β-hydroxybutyrate, interleukin 6, and tumor necrosis factor α. Interstitial glucose was monitored for 24 h pre-exercise and postexercise. Results Glycemia was similar until 6 h postexercise, with no hypoglycemic episodes. Beyond 6 h glucose levels fell during 100%, and nine participants experienced nocturnal hypoglycemia. Conversely, all participants during 80% were protected from nocturnal hypoglycemia, and remained protected for 24 h postexercise. All metabolic parameters were similar. Conclusions Reducing basal insulin dose with reduced prandial bolus insulin and LGI carbohydrate feeding provides protection from hypoglycemia during and for 24 h following evening exercise. This strategy is not associated with hyperglycemia, or adverse metabolic disturbances. Clinical trials number NCT02204839, ClinicalTrials.gov.

Regular exercise is important for health, fitness and longevity in people living with type 1 diabetes, and many individuals seek to train and compete while living with the condition. Muscle, liver and glycogen metabolism can be normal in athletes with diabetes with good overall glucose management, and exercise performance can be facilitated by modifications to insulin dose and nutrition. However, maintaining normal glucose levels during training, travel and competition can be a major challenge for athletes living with type 1 diabetes. Some athletes have low-to-moderate levels of carbohydrate intake during training and rest days but tend to benefit, from both a glucose and performance perspective, from high rates of carbohydrate feeding during long-distance events. This review highlights the unique metabolic responses to various types of exercise in athletes living with type 1 diabetes.

The aim of this study was to investigate the effects of postactivation potentiation (PAP) on swim start performance (time to 15 m) in a group of international sprint swimmers. Nine international sprint swimmers (7 men and 2 women) volunteered and gave informed consent for this study, which was approved by the university ethics committee. Initially, swimmers performed a countermovement jump (CMJ) on a portable force platform (FP) at baseline and at the following time points ∼15 seconds, 4, 8, 12, and 16 minutes after a PAP stimulus (1 set of 3 repetitions at 87% 1 repetition maximum [RM]) to individually determine the recovery time required to observe enhanced muscle performance. On 2 additional days, swimmers performed a swim start to 15 m under 50-m freestyle race conditions, which was preceded by either their individualized race specific warm-up or a PAP stimulus (1 set of 3 repetitions at 87% 1RM). Both trials were recorded on 2 cameras operating at 50 Hz with camera 1 located at the start and camera 2 at the 15-m mark. Peak vertical force (PVF) and peak horizontal force (PHF) were measured during all swim starts from a portable FP placed on top of the swim block. A repeated measures analysis of variance revealed a significant time effect with regard to power output (PO) (F = 20.963, p < 0.01) and jump height (JH) (F = 14.634, p < 0.01) with a paired comparison indicating a significant increase in PO and JH after 8 minutes of recovery from the PAP stimulus. There was a significant increase in both PHF and PVF after the PAP stimulus compared to the swim-specific warm-up during the swim start (PHF 770 ± 228 vs. 814 ± 263 N, p = 0.018; PVF: 1,462 ± 280 vs. 1,518 ± 311 N, p = 0.038); however, time to 15 m was the same when both starts were compared (7.1 ± 0.8 vs. 7.1 ± 0.8 seconds, p = 0.447). The results from this study indicate that muscle performance during a CMJ is enhanced after a PAP stimulus providing adequate recovery (∼8 minutes) is given between the 2 activities. In addition, this study demonstrated that swimmers performed equally well in terms of time to 15 m when a PAP stimulus was compared to their individualized race specific warm-up and indicates that PAP may be a useful addition to a warm-up protocol before races. However, more research is required to fully understand the role PAP plays in swim performance.