Automated insulin delivery (AID) systems improve glycemic control in type 1 diabetes (T1D), but maintaining glucose stability during PA remains challenging. The RAPPID study, presented at the European Association for the Study of Diabetes (EASD) 2025, evaluated real-life PA management and hypoglycemia risk in adults with T1D using AID systems.

This 4-week, prospective, multicenter study included 86 adults with T1D using various AID systems (Medtronic 780G, Tandem CIQ, CamAPS Fx). Participants performed at least two PA sessions per week and logged session characteristics, carbohydrate (CHO) intake, and hypoglycemia events.

Among 954 PA sessions, 20% were associated with hypoglycemia, mostly during or after aerobic activity. Only 15% of sessions fully adhered to guideline-based exercise management. The exercise mode was activated in 73% of sessions, often less than one hour before activity, and pre-PA CHO intake was reported in 36%.

Despite AID use, hypoglycemia occurred frequently during PA and recovery phases. The findings emphasize the need for improved insulin algorithms and enhanced patient education to ensure safe exercise participation and reduce glucose variability in T1D.