A Case Study on Managing Glucose and Nutritional Needs in a Physically Active Person Using an Insulin Pump

A Case Study on Managing Glucose and Nutritional Needs in a Physically Active Person Using an Insulin Pump

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Released: 10/27/2021
Expires: 10/25/2023
Max Credits: 0.5
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Aaron J. Kowalski, PhD
President and CEO
New York, NY 

Joseph Henske, MD, FACE 
Associate Professor 
Director of the Diabetes Program 
Division of Diabetes, Endocrinology, and Metabolism 
University of Arkansas for Medical Sciences 
Little Rock, AR 

Lori Laffel, MD, MPH 
Professor, Pediatrics 
Harvard Medical School 
Chief, Pediatric, Adolescent and Young Adult Section 
Head, Section on Clinical, Behavioral and Outcomes Research 
Joslin Diabetes Center 
Boston, MA 

Activity Planners
Ian Gallen, MD, CBE
Consultant Physician 
Royal Berkshire FT and Community Diabetes Specialist
Berkshire West CCGs
United Kingdom

Michael Riddell, PhD
School of Kinesiology and Health Science
Muscle Health Research Centre
York University
Toronto, Canada

Iñigo San Millán, PhD
Associate Research Professor
Department of Human Physiology and Nutrition
University of Colorado, Colorado Springs
Division of Endocrinology, Metabolism and Diabetes
Division of Sports Medicine
University of Colorado School of Medicine
Aurora, CO

Becky Sulik, RD, LD, CDE
Director of Education
Rocky Mountain Diabetes & Osteoporosis Center
Idaho Falls, ID

Eric Tozer
Co-founder & President, Diabetes Sports Project
San Marcos, CA

Sydney Yovic
AVP, Research Operations and Mission
New York, NY

Jaime Symowicz, PhD
Manager, Educational Strategy and Content
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Kathryn Schaefer, MSN, RN, CPHRM, CHCP
Associate Director, Education Quality and Compliance
East Lansing, MI

Learning Objectives
Upon completion, participants should be able to:
  • Describe a common outcome associated with fear of hypoglycemia among physically active patients with T1D
  • Describe modifications to insulin pump settings to avoid hypoglycemia in patients with T1D beginning exercise programs

Target Audience
This activity is intended for the healthcare team caring for those living with type 1 diabetes, including diabetologists, adult and pediatric endocrinologists, primary care physicians, endocrinology advanced practice providers, pharmacists, nurses, dietitians, certified diabetes care and education specialists, and other healthcare professionals.

Statement of Need
Type 1 diabetes (T1D) is a challenging condition to manage for a number of physiologic and behavioral reasons. Regular exercise is important to help people with T1D improve health and well-being, achieve target lipid profiles, improve body composition, and reach personal goals related to fitness and glycemic control. Integrating physical activity into daily life is challenging for anyone, but those with T1D face additional barriers related to the management of blood glucose levels before, during, and after exercise, including a fear of hypoglycemia, which prevents many from starting exercise programs. People with T1D tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass and not achieving the minimum recommended weekly amount of moderate to vigorous aerobic activity. The American Diabetes Association Standards of Care recommend that people with diabetes receive care from a coordinated interdisciplinary team consisting of certified diabetes care and education specialists (CDCES), pharmacists, and primary care and specialty providers, including physicians, nurse practitioners, physician assistants, and nurses. The PEAK Program addresses the need for education among all members of the diabetes care team on safely and successfully planning for and managing different types of activity in individuals with T1D.

Collaboration Statement


Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Med-IQ is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation..
This nursing activity has been approved for up to 0.5 contact hour.

ACPEMed-IQ is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 0.5 contact hour (0.05 CEU) of credit for pharmacists. ACPE #0476-0000-21-010-H01-P. This knowledge-based activity is designed for all pharmacists.

Physician assistants and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Instructions to Receive Credit
To receive credit, read the introductory CE material, watch the webcast, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: October 27, 2021
Expiration Date: October 25, 2023
Estimated Time to Complete This Activity: 30 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 24 months that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.  

Ian Gallen, MD, CBE, has indicated no real or apparent conflicts.

Aaron J. Kowalski, PhD, has indicated no real or apparent conflicts.

Lori Laffel, MD, MPH
Consulting fees/advisory boards: Boehringer Ingelheim Pharmaceuticals, Inc., ConvaTec Group, Dexcom, Inc., Dompé, F. Hoffmann-La Roche Ltd., Insulet Corporation, Insulogic, Janssen Pharmaceuticals, Inc., Lilly, Medtronic, Inc., Novo Nordisk, Provention Bio
Contracted research: Boehringer Ingelheim Pharmaceuticals, Inc., Dexcom, Inc., Lilly

Michael Riddell, PhD
Consulting fees/advisory boards: Indigo Diabetes, Insulet Corporation, Novo Nordisk, Supersapiens, Zealand Pharma, Zucara Therapeutics
Fees received for promotional/non-CE activities: Lilly, Insulet Corporation, Medtronic, Inc., Novo Nordisk, Sanofi-aventis U.S. Inc.
Ownership interest (stocks/stock options – excluding mutual funds): Supersapiens, Zucara Therapeutics

Becky Sulik, RD, LD, CDE
Consulting fees/advisory boards: Lilly
Other: Insulet Corporation, Medtronic, Inc., Tandem Diabetes Care, Inc.

Eric Tozer
Fees received for promotional/non-CE activities: Dexcom, Inc., Tandem Diabetes Care, Inc.

The peer reviewers and other activity planners have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email


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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CE
This activity is available free of charge to participants.

Acknowledgement of Support
This activity is funded in part by JDRF and The Leona M. and Harry B. Helmsley Charitable Trust.




Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available by clicking the "Continue" button below.

  • Fear of hypoglycemia may cause people with T1D to start exercising with high glucose levels
  • For individuals who use an insulin pump, adjusting their pump settings can help reduce the risk of hypoglycemia during exercise

Click "Continue" to proceed through this activity and/or receive credit.

By clicking "Continue," you confirm that you have reviewed the CME information.


Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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