Women and Older Adults Are Largely Missing From Type 1 Diabetes Exercise Research

For decades, exercise has been recognized as an important part of Type 1 diabetes management. Yet a new review of clinical exercise studies reveals that research has not equally included all people with Type 1 diabetes. Scientists analyzed 315 exercise studies published between 1985 and 2025 and found stark imbalances in who participates.

The numbers tell a clear story: men make up 57% of study participants while women represent 43%. This male skew becomes even more pronounced when looking at studies focused on a single sex. Since 1985, researchers conducted 54 studies exclusively in men with Type 1 diabetes, but only 6 exclusively in women—a nine-fold difference. The total number of female participants in those single-sex women's studies (99 people) was less than one-seventh the number of male participants in men-only studies (671 people).

Women and men with Type 1 diabetes may experience exercise differently due to biological factors. The menstrual cycle can influence blood sugar patterns, energy levels, and how the body responds to physical activity. Yet this critical detail has been largely overlooked in research.

When researchers reviewed whether studies tracked menstrual cycle information in female participants, they found it documented in only 30 of 315 studies. Of those 30, none met the highest standards for thoroughness—which would include verifying menstrual cycle details and measuring hormone levels. This means scientists have limited data on how the menstrual cycle affects exercise and blood sugar management in women with Type 1 diabetes.

The research gap extends beyond sex. Across all 315 studies reviewed, the average participant age was 29 years. This narrow focus on younger adults means very little is known about how exercise affects older people with Type 1 diabetes—a population that faces unique health considerations.

Only one study in the entire 40-year period examined exercise in post-menopausal women with Type 1 diabetes. This is a striking absence, given that older adults often need evidence-based guidance on physical activity to maintain overall health and manage their diabetes effectively.

Researchers who conducted this review are calling for a significant shift in how exercise studies are designed and who is invited to participate. More research that specifically includes women—with careful attention to menstrual cycle status—is needed. Studies focused on older adults with Type 1 diabetes are equally overdue.

Until research catches up, women and older people with Type 1 diabetes may have less evidence to guide their exercise choices. By including more diverse participants in future studies, scientists can build a fuller picture of how exercise affects all people living with Type 1 diabetes.

Source: Diabetic medicine : a journal of the British Diabetic Association. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.