Exercise and Glycemic Management in Females and Women With Diabetes: The Role of Sex and Gender Across the Lifespan

Abstract

The benefits of exercise and physical activity (PA) for people living with diabetes are clear. However, current exercise recommendations do not take into consideration the potential impact of female-specific hormonal changes across the lifespan on the glycemic response to exercise. Moreover, the impact of life phases on barriers to participation in exercise and PA for women compared to men with diabetes is not well described. In this narrative review we have synthesized the literature to date regarding the interaction of female sex hormone variations (menarche and the menstrual cycle, pregnancy, and the menopausal transition) with glycemic management in the context of exercise for females with type 1 and type 2 diabetes. We also evaluated PA behaviours and barriers to participation in exercise and PA among individuals with diabetes identifying as women. We observed a lack of evidence regarding the impact of female-specific hormonal changes on the glycemic response to exercise among females with diabetes, with a particular paucity of studies during pregnancy and postpartum and for the menopausal transition. In this study we demonstrate that additional research is required to understand the influence of exercise on glucose management for females with diabetes across the lifespan, with the aim to provide safe and effective exercise recommendations and to encourage equitable participation in exercise and PA for females and women with diabetes throughout life.