Assuming that glycaemic management has been optimised for non-exercise days, the exercise type (aerobic, anaerobic, mixed) and duration will largely dictate the strategies employed for active days [
16]. In general, prolonged predominantly aerobic exercise promotes a drop in blood glucose concentration, while more intensive aerobic and anaerobic events promote a glucose rise [
16]. The rise in blood glucose during intensive exercise in the fasted state is reproducible and tends to be associated with a rise in lactate [
53]. For endurance events, such as marathons and road cycling, athletes often have elevated glucose levels prior to the event, sometimes because of psycho-physiological stress responses [
54] or as a purposeful coping strategy to limit the likelihood of developing hypoglycaemia during the event [
55]. Typically, carbohydrate consumption is needed to maintain performance and prevent hypoglycaemia in endurance events lasting ≥60 min [
16]. More aerobically fit individuals may have higher hypoglycaemic risk during exercise than those who are less fit [
56], potentially due to higher absolute power outputs and greater rates of carbohydrate oxidation. Conversely, having insulin at near basal levels or lower typically causes a rise in glucose during burst events, like pole vaulting, power lifting, sprinting or wrestling [
57].