Features of glycemic management in children and adolescents with type 1 diabetes mellitus during systematic physical activity

<jats:p> <jats:bold>Introduction.</jats:bold> Achieving and maintaining stable glycemic levels in children with type 1 diabetes (T1D) who are regularly engaged in physical activity (PA) represents a complex clinical challenge that requires a multidisciplinary team approach. </jats:p> <jats:p> <jats:bold>Aim.</jats:bold> To study the characteristics of blood glucose fluctuations in children with T1DM during regular physical activity, and to develop, on this basis, practical personalized recommendations for the prevention of complications and improving the effectiveness of long-term disease management. </jats:p> <jats:p> <jats:bold>Materials and methods.</jats:bold> This retrospective study included 60 children and adolescents aged 6 to 17 years with T1D. The following parameters were assessed: glycated hemoglobin (HbA1c), time in range (TIR), time above range (TAR), and time below range (TBR). Statistical analysis was performed using StatTech software v. 4.5.0. </jats:p> <jats:p> <jats:bold>Results.</jats:bold> No statistically significant differences in HbA1c, TIR, TAR, and TBR were found between patients using insulin pump therapy and those on multiple daily injections. Regular glycemic monitoring during exercise sessions was associated with significantly higher TIR (77.21% vs. 64.33%) and lower TAR. Each additional minute of exercise duration was associated with a 0.111% increase in TIR and a 0.135% decrease in TAR. Impaired hypoglycemia awareness was more common in children under 10 years of age and was associated with HbA1c levels &gt; 6.8%. </jats:p> <jats:p> <jats:bold>Conclusions.</jats:bold> Both insulin delivery methods (pump therapy and multiple daily injections) provide comparable glycemic control in physically active patients with T1DM. The key success factor is regular glucose monitoring. Longer exercise sessions are associated with improved glycemic outcomes. Impaired hypoglycemia awareness requires special attention in younger children. These findings emphasize the importance of a multidisciplinary approach to ensuring safe and effective physical activity in patients with T1D. </jats:p>