{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:05:23Z","timestamp":1784574323209,"version":"3.55.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To identify modifiable factors associated with postexercise nocturnal hypoglycemia in the Type 1 Diabetes and Exercise Initiative (T1DEXI) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In this real-world prospective cohort study, overnight continuous glucose monitoring data following exercise days versus sedentary days were assessed in adults with type 1 diabetes. Nocturnal hypoglycemia was defined as a continuous glucose monitoring level of 54\u201369 mg\/dL (level 1) or &amp;lt;54 mg\/dL (level 2) for \u226515 min between midnight and 6:00 a.m.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 496 adults across 12,340 nights, exercise days were associated with more frequent level 1 nocturnal hypoglycemia relative to sedentary days (15.6% vs. 13.1%, P = 0.001). Factors associated with reduced risk included lower preexercise time below range, higher preexercise and bedtime glucose, absence of hypoglycemia during or within 4 h after exercise, and hybrid closed-loop delivery. Time below range \u22654% in the 24 h preceding exercise was associated with substantially higher nocturnal hypoglycemia risk relative to &amp;lt;4% for level 1 (22.9% vs. 11.7%) and level 2 (10.2% vs. 3.3%) (both P &amp;lt; 0.001). Hybrid closed-loop users experienced approximately half the rate of nocturnal hypoglycemia compared with participants using standard pumps or multiple daily injections (level 1: 9.7% vs. 20.3% vs. 17.3%, respectively; level 2: 3.2% vs. 7.2% vs. 5.8%, respectively) (both P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In the T1DEXI study, exercise was associated with increased nocturnal hypoglycemia risk in adults with type 1 diabetes. Targeting modifiable factors may reduce risk and address a critical barrier to safe physical activity in type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc26-0381","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T16:10:06Z","timestamp":1780675806000},"page":"1404-1413","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Nocturnal Hypoglycemia After Exercise in the Type 1 Diabetes and Exercise Initiative (T1DEXI)"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4440-7366","authenticated-orcid":false,"given":"Daniel I.","family":"Bisno","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, and Institute for Diabetes, Obesity and Metabolism, Perelman School of Medicine, University of Pennsylvania 1 , Philadelphia, 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