Predicting the Unpredictable: Challenges in Applying Exercise Research to Real-World Type 1 Diabetes Care

Dessi Zaharieva, PhD, CEP, CDCES
Instructor - Certified Exercise Physiologist (CEP), and Certified Diabetes Care and Education Specialist
Pediatric Endocrinology
Stanford University – School of Medicine 
Stanford, CA, USA

This conference is hosted by Jane Yardley, PhD, Synapse Development and Plasticity Research Unit. This conference is part of the 2025-2026 IRCM conference calendar.

About the conference
Exercise is a cornerstone of health promotion for youth and adults with type 1 diabetes (T1D), yet it remains one of the most challenging components of daily diabetes management. In this presentation, we will explore the complex intersection of exercise physiology and type T1D management, with a focus on translating findings from controlled research studies into real-world care. Despite the known health benefits of regular physical activity, most youth with T1D do not meet exercise guidelines, often due to fear of hypoglycemia and lack of individualized guidance. Drawing on data from the 4T Exercise Study, recent automated insulin delivery exercise consensus recommendations, and ongoing trials, this session will highlight practical strategies that address the variability and unpredictability of exercise in everyday life with T1D.

About the speaker
Dr. Dessi Zaharieva is an Instructor, Certified Exercise Physiologist, and Certified Diabetes Care and Education Specialist currently working in Pediatric Endocrinology at Stanford University – School of Medicine. Her research focuses on automated insulin delivery (AID) systems and strategies to optimize blood glucose concentrations around exercise in youth and adults with type 1 diabetes.

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