High-Intensity Interval Exercise in Type 1 Diabetes: Stronger Protection Against Exercise-Related Glycaemic Decline in the Postabsorptive Than Postprandial State
A 2026 randomized crossover trial by Melin and colleagues shows that high-intensity interval exercise (HIIE) causes a smaller fall in blood glucose than iso-mechanical moderate continuous exercise (CONT) in adults with type 1 diabetes, with the greatest protection observed in the postabsorptive state.
The study extends prior work suggesting that intermittent or sprint-containing exercise can blunt exercise-associated glycaemic decline by amplifying counterregulatory responses, but also shows that insulin-on-board materially modifies this effect.
Across the broader literature, glycaemic outcomes during exercise in type 1 diabetes are determined not only by exercise modality, but also by timing relative to meals, circulating insulin levels, pre-exercise glucose, carbohydrate supplementation, and technology use.
Clinically, the new findings support a more individualized exercise prescription: for adults at high risk of exercise-induced hypoglycaemia, HIIE performed in a lower-insulin, postabsorptive window may be a practical strategy when medically appropriate.
