Canadian journal of diabetes最新文献

{"title":"\"Why do they say manage?\" A Mixed Method Exploration of Lifestyle-Driven Remission in Type 2 Diabetes.","authors":"Tahmina Rahman, Alexis Marcotte-Chénard, Margherita Cameranesi, Barbara Olivera, Rebecca Mollard, Jonathan Little, Dylan MacKay","doi":"10.1016/j.jcjd.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.jcjd.2026.09.001","url":null,"abstract":"<p><strong>Objective: </strong>Type 2 diabetes (T2D) remission might be achievable through sustained lifestyle modifications, yet lived experience of remission is understudied. This study explored the barriers and facilitators to lifestyle-based remission in Canadians.</p><p><strong>Methods: </strong>In this two-phase mixed methods study, quantitative data from 21 adults (57±8 years) who had achieved T2D remission were collected through questionnaires, HbA1c, and continuous glucose monitoring (CGM). A purposive sub-sample of 7 participants also completed semi-structured interviews. Qualitative data underwent inductive thematic analysis and were integrated using meta-inference with joint display approach.</p><p><strong>Results: </strong>Quantitative results showed strong glycemic regulation (24hr median CGM glucose: 5.0 [4.8-5.6] mmol/L; 92.2 [85-97] % time in range), consistent physical activity, and good perceived health. Qualitative analysis identified seven themes: i) sustainable lifestyle strategies; ii) self-reliance: iii) commitment to Remission; iv) individualized and supportive Care; v) healthcare, not medical care; vi) barriers inside and out; and vii) I'd rather be healthy.</p><p><strong>Conclusion: </strong>Integration highlighted informed decision-making, alongside psychosocial and educational factors as central to sustaining T2D remission in naturalistic settings.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Finding a Regular Primary Care Provider for Unattached Patients at the Primary Care Diabetes Support Program in London, Ontario, Canada.","authors":"Rhiannon Lyons, Lindsay Hedden, Stewart Harris, Yun-Hee Choi, Bridget L Ryan, Sonja Reichert, Leslie Meredith, Maria Mathews","doi":"10.1016/j.jcjd.2026.09.004","DOIUrl":"10.1016/j.jcjd.2026.09.004","url":null,"abstract":"<p><strong>Objective: </strong>The Primary Care Diabetes Support Program (PCDSP) at St. Joseph's Health Care in London, Ontario, focuses on managing diabetes in high-risk adults (e.g. those who are socially and medically complex) and works to attach patients to a regular primary care provider. We describe the characteristics of the unattached patient population enrolled in the PCDSP and identify the time to and predictors of attachment (i.e. finding a regular provider).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using electronic medical record data of patients enrolled in the PCDSP between April 1, 2011, and March 31, 2018 and followed patients for 5 years. We used descriptive statistics to assess characteristics of patients and time-to-event analyses to assess time to attachment.</p><p><strong>Results: </strong>Among a final cohort of 726 patients with 5-year follow-up data, 401 individuals (55.2%) became attached. The estimated median time to attachment was 998 days (95% confidence interval [CI]: 748-1,248). Individuals who were both socially and medically complex (hazard ratio=1.44; 95% CI: 1.01-2.06) and joined the PCDSP in fiscal 2012 (hazard ratio=1.40; 95% CI: 1.01-1.95) were more likely to be attached compared with those who were non-complex and joined the program in fiscal 2011, respectively.</p><p><strong>Conclusions: </strong>The PCDSP prioritises high-risk patients, particularly those who are both medically and socially complex, to attach them to a regular primary care provider. Our findings may relate to the social support workers in the program who play a crucial role in documenting social risk indicators, prioritising high-risk patients, and advocating for their attachment to primary care.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Carbohydrate Management in Type 1 Diabetes.","authors":"Aastha Relan, Robyn Houlden","doi":"10.1016/j.jcjd.2026.09.003","DOIUrl":"10.1016/j.jcjd.2026.09.003","url":null,"abstract":"","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Virtual Care Experiences for Gestational Diabetes in Adults: A Qualitative Descriptive Study.","authors":"Sharon Brudnyi, Stacy Kozak, Alan Santinele Martino, Erin A Brennand, Simren Trehin, Doreen M Rabi, Jamie L Benham","doi":"10.1016/j.jcjd.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.jcjd.2026.09.002","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) care is increasingly provided virtually, yet a gap exists in evaluating virtual GDM care from a patient perspective. This study's objective is to explore the experience of receiving virtual care for GDM management to inform care optimization.</p><p><strong>Methods: </strong>We conducted a pragmatic qualitative descriptive study guided by Oben's patient experience framework and feedback from a person with lived experience. Eligible participants (≥18 years) had GDM within the past 2 years and received virtual GDM care in Alberta, Canada. We collected data from April to August 2025 through virtual semi-structured interviews and moderated focus group discussions that were coded inductively in NVivo using Reflexive Thematic Analysis.</p><p><strong>Results: </strong>Of the 35 participants (20 metropolitan, 15 rural), the median age was 34 years, 16 (46%) identified as part of a racialized group, 17 (49%) experienced their first pregnancy, and 9 (26%) experienced GDM in previous pregnancies. Four themes were developed to describe patient experiences of virtual GDM care: 1) tension between convenience and drawbacks of virtual care; 2) aligning virtual care to the evolving needs of patients; 3) supporting a virtual therapeutic relationship; and 4) improving access with virtual care.</p><p><strong>Interpretation: </strong>Generally, participants appreciated virtual care for its ability to help them fit GDM care into their everyday lives, especially when faced with competing demands during pregnancy. Virtual care can be optimized to better address patient needs, including by improving access to GDM care rurally.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum Asprosin With Blood Pressure in Patients With Type 2 Diabetes Mellitus in the Community: A Cross-Sectional Study.","authors":"Yiwei Zhang, Hui Jing, Chunfan Niu, Lijing Ma, Xiaofeng Qu, Jing Yang, Linxin Xu, Shirun Wu","doi":"10.1016/j.jcjd.2026.08.184","DOIUrl":"10.1016/j.jcjd.2026.08.184","url":null,"abstract":"<p><strong>Objective: </strong>To probe the serum asprosin levels in community-dwelling individuals diagnosed with type 2 diabetes mellitus (T2DM) and to verify their association with blood pressure.</p><p><strong>Methods: </strong>From November 2019 to July 2021, detailed information was systematically collected from 498 patients diagnosed with T2DM at a community health service station located in southeastern Shanxi Province. Blood pressure measurements taken on the same day, laboratory indices, and serum asprosin concentrations were recorded. The participants were categorized into 2 groups based on their blood pressure measurements: normotensive and hypertensive. The variance in indices between these 2 groups was analyzed through the application of t tests, chi-square tests, and non-parametric tests. The association between asprosin and elevated blood pressure was subsequently examined via logistic regression analysis.</p><p><strong>Results: </strong>The group with elevated blood pressure demonstrated significantly higher levels of asprosin compared to the normotensive group (p<0.01). Multivariate logistic regression analysis indicated that, after tertile stratification and using the T1 group as the reference, the risk of hypertension was significantly higher in both the T2 and T3 groups in the unadjusted model (Model 1: p<0.003). Following stepwise adjustment for age, gender, body mass index, metabolic parameters, and the use of antihypertension and antidiabetes medications, the associations remained statistically significant in Model 2 (p<0.009) and Model 3 (p<0.015).</p><p><strong>Conclusions: </strong>Elevated serum asprosin levels are correlated with a heightened risk of hypertension among community-dwelling individuals living with T2DM.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Glucose Monitoring Reduces Severe Diabetes Distress Independently of Glycemic Improvement in Adults With Type 1 Diabetes: A Prospective Study in a Public Health-Care Setting.","authors":"Nathalia Costa Monteiro, Laís Prado Smith Lima, João Paulo Almeida Freitas, Maria de Lourdes Passos Machado, Fernanda Gonçalves Gama, Victória Dayane Santos Silva, Leonardo Machado Martins, Sophia de Santana Ferreira Lemos, Gutemberg Lemos Torres, Danielle Góes da Silva, Mariana Garcez Varela, Talita Letícia Trevisan, Mônica Sueli Vilela da Mota Silveira, Bruno Fernandes de Oliveira Santos, Nathalie Oliveira de Santana","doi":"10.1016/j.jcjd.2026.08.187","DOIUrl":"10.1016/j.jcjd.2026.08.187","url":null,"abstract":"<p><strong>Objective: </strong>Although technology improves glycemic management, its psychological impact in resource-limited settings is less well explored. This study evaluated the impact of continuous glucose monitoring (CGM) on diabetes distress and glycemic outcomes in adults with type 1 diabetes (T1D) within a public health-care system.</p><p><strong>Methods: </strong>This prospective study enrolled 35 adults with T1D at a public centre in northeastern Brazil. Participants initiated CGM with monthly follow-ups. Diabetes distress was assessed at baseline and at 6 months using the Brazilian Type 1 Diabetes Distress Scale (T1DDS).</p><p><strong>Results: </strong>Participants had a mean T1D duration of 13±9.9 years and a baseline A1C of 9.13±1.87%. After 6 months, mean A1C decreased to 7.94±1.28% (mean difference = -1.19%; p=0.007). Time in range reached 54.4% within the first month and remained consistent throughout the follow-up. The total diabetes distress score decreased significantly from 2.86±0.88 at baseline to 2.32±0.85 at 6 months (mean difference = -0.28; p<0.001; Cohen's dz=0.76). The proportion of participants with severe distress dropped from 34.3% (n=12) to 14.3% (n=5) (p=0.002). Major improvements were observed in the management and family/social domains. Psychosocial benefits were observed regardless of the magnitude of A1C reduction (r=-0.182, p=0.384).</p><p><strong>Conclusions: </strong>CGM implementation reduced diabetes distress, particularly in severe cases, and improved glycemic parameters in a resource-limited setting. The improvement in well-being independent of glycemic drop suggests that CGM is a valuable tool for both the clinical and psychosocial management of adults with T1D in public health systems.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical Gaps in Kidney and Cardiovascular Risk Assessment Among Patients With Diabetes and Hypertension: A Real-World Primary Care Study.","authors":"Jian Roushani, Sachin V Pasricha, Lisa Dubrofsky, Bailey Goldman, Laura O'Driscoll, Shane Golden, Brad Millson, Sheldon W Tobe","doi":"10.1016/j.jcjd.2026.08.185","DOIUrl":"10.1016/j.jcjd.2026.08.185","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with both diabetes and hypertension are at high risk for micro- and macrovascular complications, underscoring the importance of regular monitoring of glycated hemoglobin (A1C), cholesterol, urine albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR).</p><p><strong>Methods: </strong>We analyzed laboratory tests from 4,456 adults from primary care practices with diabetes and hypertension, each with at least 2 blood pressure measurements between January 1, 2013, and December 31, 2017, and at least 1 test (A1C, UACR, eGFR, and low-density lipoprotein cholesterol [LDL-C]) within 2 years. Test completion rates and results were reported across 3 blood pressure categories: controlled (<130 mmHg/<80 mmHg), stage 1 hypertension (130-139 mmHg/80-89 mmHg), and stage 2 hypertension (≥140 mmHg/≥90 mmHg).</p><p><strong>Results: </strong>Of the 4,456 individuals, 86% had A1C tested, 32% had UACR tested, 76% had eGFR tested, and 83% had LDL-C tested. Among those tested, 43% had A1C >7.0%, 11% had macroalbuminuria (UACR >20 mg/mmol), 20% had chronic kidney disease (CKD) (eGFR <60 mL/min/1.73 m²), and 54% had dyslipidemia (LDL-C ≥2.0 mmol/L). Those with stage 2 hypertension had higher rates of albuminuria, CKD, and dyslipidemia than those with controlled or stage 1 hypertension.</p><p><strong>Conclusions: </strong>Our study has 3 key findings. UACR testing was underutilized among patients with diabetes and hypertension. Consistent screening could identify individuals who would benefit from guideline-directed antiproteinuric therapies. Uncontrolled blood pressure was associated with higher rates of albuminuria and dyslipidemia. Achievement of LDL-C <2.0 mmol/L was suboptimal in over 50% of patients, necessitating improved cardiovascular risk management in this high-risk group.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Disparities in Diabetes Prevalence in Ontario, Canada Between 2015 and 2021.","authors":"Christina Hanna, Deva Thiruchelvam, Chris Kenaszchuk, Lorraine L Lipscombe, Baiju R Shah, Calvin Ke, Gillian L Booth, Laura C Rosella, Fatema M Ali, Aimen Zehra, Ghazal S Fazli","doi":"10.1016/j.jcjd.2026.08.186","DOIUrl":"10.1016/j.jcjd.2026.08.186","url":null,"abstract":"<p><strong>Objective: </strong>The rising prevalence of diabetes disproportionately affects socially disadvantaged communities. We aimed to determine whether trends in diabetes prevalence vary by age, sex, and neighbourhood socioeconomic status (SES).</p><p><strong>Methods: </strong>We conducted a population-based cross-sectional time-series analysis using health administrative data for adults aged ≥20 years (>90% type 2 diabetes) from 2015 (N=10,935,448) to 2021 (N=11,885,060). Annual crude and age-sex-standardized prevalence rates were estimated using a validated administrative case definition. Neighbourhood SES was measured using the Material Deprivation Domain of the Ontario Marginalization Index and was categorized into quintiles (Q1 [least deprived] to Q5 [most deprived]).</p><p><strong>Results: </strong>The age-sex-standardized prevalence of diabetes increased by nearly 6%, from 10.8% in 2015 to 11.4% in 2021. Increases were consistent across all age and sex groups, with the largest relative increases among adults aged 20 to 34 years (males: +17.1%, females: +11.3%). Diabetes prevalence rose across all neighbourhood deprivation quintiles, remaining highest in the most deprived areas from 2015 to 2021 (13.3% to 14.1%). Relative increases ranged from 5.8% in the most deprived areas to 7.1% in the least deprived areas. A clear socioeconomic gradient was observed, with diabetes prevalence 42% higher in the most deprived neighbourhoods (Q5, rate ratio: 1.42, 95% CI: 1.41-1.44; all p<0.0001) compared to the least deprived (Q1) neighbourhoods, underscoring the structural nature of diabetes inequities.</p><p><strong>Conclusions: </strong>Diabetes prevalence continues to increase in the lowest-income areas, calling for more tailored and culturally sensitive policy interventions and programs to reduce the future burden of diabetes among populations living with social disadvantage.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disruption and Recovery of Type 2 Diabetes Screening During the Coronavirus Disease 2019 Pandemic: A Population-Based Interrupted Time-Series Analysis in Ontario, Canada.","authors":"Ghazal S Fazli, Rahim Moineddin, Vicki Ling, Gillian L Booth","doi":"10.1016/j.jcjd.2026.08.006","DOIUrl":"10.1016/j.jcjd.2026.08.006","url":null,"abstract":"<p><strong>Objective: </strong>The pandemic disrupted routine health-care services, including preventive screening for diabetes. We examined the impact of the pandemic on diabetes screening rates and recovery patterns in a universal health-care setting.</p><p><strong>Methods: </strong>We conducted a time-series analysis using linked administrative health-care and laboratory data from Ontario, Canada, to compare expected vs observed monthly diabetes screening rates during the period from March 2020 to March 2023 in the non-diabetes population overall and among subgroups defined by age, sex, and neighbourhood socioeconomic status. Monthly expected screening rates were predicted for the same period based on patterns observed from March 2016 to March 2020.</p><p><strong>Results: </strong>Overall, the eligible, non-diabetes population was 9,359,851 in March 2016 and 9,894,353 in March 2023. Diabetes screening rates declined sharply by 70.1% during the initial lockdown period in April 2020 compared to February 2020 (1.55 vs 4.47 per 100, -2.92 per 100), with a gradual increase to pre-pandemic levels. In addition, 24.5% fewer individuals were screened during the pandemic period vs pre-pandemic levels. Although the overall patterns were consistent by sex, the rate of recovery was greater among women (6.42 vs 4.85 per 100, -1.57 per 100) in March 2023. Moreover, screening recovery rates appeared to be 2- to 3-fold higher among adults aged 50 years and above. Findings were consistent across income groups, with slightly higher recovery rates for those living in higher-income communities.</p><p><strong>Conclusions: </strong>The observed sudden decline in diabetes screening may lead to delays in prediabetes and diabetes diagnoses, resulting in missed opportunities for diabetes prevention and early management.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological Impacts of Type 1 Diabetes on Exercise Performance: A Systematic Review and Narrative Synthesis of the Literature.","authors":"Shania N Smee, Angela L Spence, Rhiannon Halse, Leo Ng, Vinutha B Shetty, Elizabeth A Davis, Raymond J Davey","doi":"10.1016/j.jcjd.2026.06.007","DOIUrl":"10.1016/j.jcjd.2026.06.007","url":null,"abstract":"<p><strong>Objective: </strong>Type 1 diabetes (T1D) may influence acute and adaptive responses to exercise training and performance. This systematic review aimed to summarize the evidence comparing exercise performance between individuals with and without T1D and to identify the physiological mechanisms underlying potential differences in exercise performance.</p><p><strong>Methods: </strong>Seven electronic databases were searched for studies comparing exercise performance and underlying physiological mechanisms in individuals with and without T1D. Exercise performance was categorized as aerobic, anaerobic, or skill based, and physiological mechanisms were grouped across cardiorespiratory, neuromuscular, and metabolic domains.</p><p><strong>Results: </strong>Of 6,563 studies, 28 met the inclusion criteria. Most (k=25) evaluated aerobic exercise performance with time-trial, time-to-exhaustion, and V̇O_2peak tests. Five evaluated anaerobic exercise performance with one-repetition maximum, maximum voluntary contraction, and supramaximal time-to-exhaustion tests. Of the aerobic studies, 88% reported lower aerobic performance in individuals with T1D compared with those without, potentially due to cardiovascular or circulatory mechanisms. Similarly, 60% of the anaerobic studies reported lower anaerobic performance in individuals with T1D compared with those without, potentially due to mitochondrial mechanisms and recovery. Certainty of evidence was assessed using the GRADE tool and was found to be very low.</p><p><strong>Conclusion: </strong>Current evidence suggests that aerobic exercise performance may be reduced in individuals with T1D. However, the evidence is weak, and these differences seem to be marginal. Suboptimal glycemic management and longer T1D duration may influence physiological responses to exercise and reduce performance capacity. Further research is required to support these conclusions and to determine the impact of T1D on anaerobic and skill-based exercise performance.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}