A literature review published in 2012 evaluated a range of health benefits to patients with type 1 diabetes who were physically active . This review highlighted that aerobic and strength training both resulted in improved insulin resistance or a reduction in insulin sensitivity for patients with type 1 diabetes. 3 studies were cited that reported significant reductions in insulin sensitivity of 20% (p<0.05) , 25-40% (p<0.025) , and 23+5% (p<0.01)  after participants completed structured exercise programmes. These studies were all non-randomised controlled trials with small samples sizes (range: 9-38 participants) and participants completed physical activity programmes over 6-16 weeks or were assigned to a sedentary control group. Hypoglycaemic symptoms and episodes were monitored and no adverse events were reported by any of the studies. Participants included adult males with type 1 diabetes [2, 3, 4], adult females with type 1 diabetes [3, 4], adolescent males and females with type 1 diabetes  and adult males and females without type 1 diabetes to form a control group for comparison . There is currently insufficient evidence of improvements in insulin resistance with regular physical activity in older people with type 1 diabetes.
The literature review concluded that physical activity had beneficial effects on insulin resistance. As insulin resistance is linked to macro- and microvascular complications, physical activity should be recommended to people with type 1 diabetes .
Quality of Evidence
B – Moderate
Strength of Recommendation
1 – Strong recommendation
Aerobic and strength training physical activities are likely to result in an improvement in insulin resistance in people with type 1 diabetes. Exercise intervention can be recommended to most people, in most circumstances, to help improve insulin resistance unless there are compelling reasons to do otherwise.
 Chimen M, Kennedy A, Nirantharakumar K, et al. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 2012;55:542-551. https://doi.org/10.1007/s00125-011-2403-2
 Wallberg-Henriksson H, Gunnarsson R, Henriksson J, et al. Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type I diabetics after physical training. Diabetes 1982;31:1044–1050. https://doi.org/10.2337/diacare.31.12.1044
 Yki-Jarvinen H, DeFronzo RA, Koivisto VA. Normalization of insulin sensitivity in type I diabetic subjects by physical training during insulin pump therapy. Diabetes Care 1984;7:520–527. https://doi.org/10.2337/diacare.7.6.520
 Landt KW, Campaigne BN, James FW, Sperling MA. Effects of exercise training on insulin sensitivity in adolescents with type I diabetes. Diabetes Care 1985;8:461–465. https://doi.org/10.2337/diacare.8.5.461