Trial reportJournal of diabetes science and technology2015
Effects of performing morning versus afternoon exercise on glycemic control and hypoglycemia frequency in type 1 diabetes patients on sensor-augmented insulin pump therapy.
Trial report in Journal of diabetes science and technology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 4 syntheses or guidelines pooled it, 134 citations in OpenAlex.
- Diabetes Mellitus and Long-Distance Running: A Systematic Review.Sports medicine - open · 2026Pooled it
- Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis.Diabetes care · 2025Pooled it
- Mapping the research trends and hotspots of exercise and nutrition in diabetes: a bibliometric and visual analysis (2005-2025).Frontiers in nutrition · 2025Pooled it
- Guideline
- Trial
- No insulin degludec dose adjustment required after aerobic exercise for people with type 1 diabetes: the ADREM study.Diabetologia · 2023Trial
- A High Protein Diet Is Associated with Improved Glycemic Control Following Exercise among Adolescents with Type 1 Diabetes.Nutrients · 2023Trial
- Management of Glycemia during Acute Aerobic and Resistance Training in Patients with Diabetes Type 1: A Croatian Pilot Study.International journal of environmental research and public health · 2023Trial
- A Randomized Crossover Pilot Study Evaluating Glucose Control During Exercise Initiated 1 or 2 h After a Meal in Adults with Type 1 Diabetes Treated with an Automated Insulin Delivery System.Diabetes technology & therapeutics · 2023Trial
- Trial
- Afternoon exercise is more efficacious than morning exercise at improving blood glucose levels in individuals with type 2 diabetes: a randomised crossover trial.Diabetologia · 2019Trial
- Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial.Diabetes, obesity & metabolism · 2019Trial
- Mini-Dose Glucagon as a Novel Approach to Prevent Exercise-Induced Hypoglycemia in Type 1 Diabetes.Diabetes care · 2018Trial
- Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients.Journal of physical activity & health · 2017Trial
- GlucoseGo: a simple tool to predict hypoglycaemia during exercise in type 1 diabetes.Diabetologia · 2026Observational
- Exercise in type 1 diabetes: real-world data on glucose levels and hypoglycaemia risk from over 420,000 exercise sessions.Diabetologia · 2026Observational
- The effect of timing of physical exercise on glycemia: a systematic review and meta-analysis of human intervention studies.Journal of diabetes and metabolic disorders · 2026Review
- Developmental stages and exercise timing in relation to fear of hypoglycemia and quality of life in type 1 diabetes.Endocrine · 2026Article
- Variation in Hypoglycemia Risk During Real-World Physical Activity in Adults with Type 1 Diabetes: Insights from the Type 1 Diabetes Exercise Initiative.Diabetes technology & therapeutics · 2026Article
- Safety and glycaemic control during exercise with the MiniMed™ 780G: A narrative review of evidence from lab to real world.Diabetes, obesity & metabolism · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough physical exercise (PE) is recommended for individuals with type 1 diabetes (DM1), participation in exercise is challenging because it increases the risk of severe hypoglycemia and the available therapeutic options to prevent it frequently result in hyperglycemia. There is no clear recommendation about the best timing for exercise. The aim of this study was to compare the risk of hypoglycemia after morning or afternoon exercise sessions up to 36 hours postworkout.
methodsThis randomized crossover study enrolled subjects with DM1, older than 18 years of age, on sensor-augmented insulin pump (SAP) therapy. Participants underwent 2 moderate-intensity exercise sessions; 1 in the morning and 1 in the afternoon, separated by a 7 to 14 day wash-out period. Continuous glucose monitoring (CGM) data were collected 24 hours before, during and 36 hours after each session.
resultsThirty-five subjects (mean age 30.31 ± 12.66 years) participated in the study. The rate of hypoglycemia was significantly lower following morning versus afternoon exercise sessions (5.6 vs 10.7 events per patient, incidence rate ratio, 0.52; 95% CI, 0.43-0.63; P < .0001). Most hypoglycemic events occurred 15-24 hours after the session. On days following morning exercise sessions, there were 20% more CGM readings in near-euglycemic range (70-200 mg/dL) than on days prior to morning exercise (P = .003).
conclusionsMorning exercise confers a lower risk of late-onset hypoglycemia than afternoon exercise and improves metabolic control on the subsequent day.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.