Physical activity for cardiometabolicrisk reduction in type 1 diabetes

People with Type 1 diabetes face a substantially elevatedrisk of cardiometabolic and cardiovascular disease, driven notonly by chronic hyperglycemia and glycemic variability butalso by a higher prevalence of modifiable risk factors such ashypertension, dyslipidemia, and smoking. Several studies havedocumented an attenuated cardiorespiratory fitness (CRF) inindividuals with Type 1 diabetes, which is clinically relevantas CRF is a strong predictor of cardiovascular outcomes. Exer-cise enhances CRF while reducing inflammatory stress andsupporting long-term metabolic health. Physical activity isa key therapeutic strategy that directly targets these mecha-nisms. Regular aerobic and resistance exercise improvesinsulin sensitivity, lowers daily insulin requirements, andfavorably influences lipid profiles, blood pressure, vascularstiffness, and overall cardiovascular fitness. Although practicalbarriers—such as fear of hypoglycemia or uncertainty aboutinsulin adjustments—may limit engagement, most individualscan achieve safe and sustainable activity with tailored guid-ance. This presentation will summarize the pathophysiologybehind increased cardiovascular risk in Type 1 diabetes andoutline how structured physical activity can meaningfullycounteract these drivers.