Type 1 diabetes mellitus (T1DM) is a chronic disease which leads to the destruction of insulin-producing β-cells in the pancreas, leading to absolute insulin deficiency [1], [2]. When T1DM is established, it results in chronic hyperglycemia which is closely associated with oxidative stress, a condition related to several metabolic (i.e. HbA1c) and cardiovascular disorders (i.e. microvascular and macrovascular complications). These in turn can interfere with neuromuscular function and body composition, in addition to increasing the risk of future mortality [3], [4], [5], [6], [7].

On the other hand, regular practice of appropriately oriented physical exercises is highly recommended for people with T1DM due to the numerous health benefits [1], [2], [8]. The benefits may include reduced metabolic changes (i.e. reduction in LDL cholesterol and triglyceride levels), cardiovascular risks (i.e. control of blood pressure), promotion of personal well-being, control of body composition and neuromuscular improvement (i.e. increased strength) [2], [9], [10], [11]. Therefore, in addition to insulin therapy and nutrition, physical exercise should be encouraged as an essential factor in treating T1DM [1], [2].

Specifically regarding the types of physical exercise, strength exercise (SE) should be indicated for adults with T1DM diabetes at a frequency of 2 to 3 sessions/week on non-consecutive days [11], [12]. On the other hand, aerobic exercise (AE) is recommended for adults with diabetes for at least 150 min/week (10–30 min/day) of moderate-intensity [11]. When compared, SE can increase blood glucose during exercise, attenuating the glycemic drop and thereby provide a lower risk of acute post-exercise hypoglycemia [2], [13]. Moreover, it is possible to combine SE and AE as recommended for T1DM patients [2].

The combination of SE and AE in the same session has been referred to in the literature as combined (COMB) or concurrent exercise (CON) [14], [15], [16]; Yardley et al. (2012) [13] suggest anticipating the practice of SE in relation to continuous AE, which appears to be an effective strategy to minimize the risk of hypoglycemia in T1DM patients. A systematic review with meta-analysis (13 studies) proposes greater reductions in HbA1c and insulin dose per day in training with the inclusion of COMB [14]. Furthermore, COMB is associated with metabolic improvement (i.e. glucose stability) when SE is performed before continuous AE [13], [16].

Based on the need for people living with T1DM to exercise and gain a clear understanding of the impact of COMB on metabolic, cardiovascular, neuromuscular, and body composition variables, the objective of this systematic review is to summarize the effects of combined exercise on metabolic, cardiovascular, neuromuscular, and body composition variables in people with T1DM.