Exerciții pentru diabet zaharat tip 1 — monitorizare glicemie, gestionare insulină, prevenire hipo

The 2017 ADA position by Riddell et al. and ISPAD guidelines establish the framework for T1D + exercise: pre-exercise blood glucose check with a target of 90-180 mg/dL in most cases. Below 90 → 15-30 g CHO + recheck. Above 250 with ketones → DO NOT EXERCISE (DKA risk); without ketones, light exercise OK with caution. Critically, aerobic exercise drops glucose (insulin-sensitivity rises) while anaerobic + resistance can RAISE glucose (catecholamine surge) — mixed sessions intermediate. Insulin-on-board (IOB) from a bolus within 90 min of exercise significantly raises hypo risk; common adjustments are mealtime bolus reduction 25-75% or temp basal 30-50% reduction 60-90 min pre-exercise on pumps (Riddell + JDRF). Post-exercise hypoglycaemia risk extends 6-24h (late-onset hypo). The exercise priorities + safety are therefore: glucose tabs + glucagon kit ALWAYS carry, CGM alert thresholds adjusted for exercise, gradual progression, and consistent monitoring habits. AVOID exercise when BG <90 without carb intake; AVOID exercise with ketones present.

Volya's catalogue carries the foundation moves: wall-push-up for upper-body strength scaling, supported-glute-bridge for posterior chain, scapular-retraction for posture, cat-cow for spinal mobility, supine-knee-to-chest for low-back release, calf-raise-rehab for posterior-chain strength + foot health (T1D adjacent neuropathy concern), ankle-pump for venous return + foot health, diaphragmatic-breathing for parasympathetic regulation, standing-march for cardio. The AI coach also knows the nutrition side — pre-exercise BG check + carb adjustment, aerobic vs anaerobic opposite glucose effects, insulin-on-board management (reduce mealtime bolus 25-75% per Riddell + JDRF; temp basal 30-50% pre-exercise on pumps), carb during exercise 15-30 g every 30-60 min for sustained >45-60 min sessions, post-exercise late-onset hypo 6-24h (bedtime BG check + lower basal overnight if evening exercise), protein 1.4-1.8 g/kg/day, alcohol AVOID excess (delayed hypo risk 6-24h post — alcohol blocks hepatic gluconeogenesis; if drinking, eat substantial carb), hypo treatment carry (glucose tabs + glucagon kit nasal Baqsimi; medical ID jewelry), iron + vitamin D + B12 monitoring annually (T1D autoimmune associations — celiac + thyroid + B12 deficiency). CRITICAL: endocrinologist + CDCES (certified diabetes care + education specialist) + JDRF + ADA + DiabetesSisters + College Diabetes Network. CGM + insulin pump optimization for athletes is specialty care. Annual A1c + eye + foot + kidney + lipid screening per ADA. This is NEVER a replacement for diabetes care team.