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McCarthy, O; Deere, R; Churm, R; Dunseath, GJ; Jones, C; Eckstein, ML; Williams, DM; Hayes, J; Pitt, J; Bain, SC; Moser, O; Bracken, RM.
Extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin adjustments in individuals with type 1 diabetes.
NUTR METAB CARDIOVAS. 2021; 31(1): 227-236. Doi: 10.1016/j.numecd.2020.07.043 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Eckstein Max Lennart
Moser Othmar
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Abstract:
To detail the extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin dose adjustments in individuals with type 1 diabetes (T1D) using multiple daily injections of insulins aspart (IAsp) and degludec (IDeg). Sixteen individuals with T1D, completed a single-centred, randomised, four-period crossover trial consisting of 23-h inpatient phases. Participants administered either a regular (100%) or reduced (50%) dose (100%; 5.1 ± 2.4, 50%; 2.6 ± 1.2 IU, p < 0.001) of individualised IAsp 1 h before and after 45-min of evening exercise at 60 ± 6% V̇O2max. An unaltered dose of IDeg was administered in the morning. Metabolic, physiological and hormonal responses during exercise, recovery and nocturnal periods were characterised. The primary outcome was the number of trial day occurrences of hypoglycemia (venous blood glucose ≤ 3.9 mmol L -1). Inclusion of a 50% IAsp dose reduction strategy prior to evening exercise reduced the occurrence of in-exercise hypoglycemia (p = 0.023). Mimicking this reductive strategy in the post-exercise period decreased risk of nocturnal hypoglycemia (p = 0.045). Combining this strategy to reflect reductions either side of exercise resulted in higher glucose concentrations in the acute post-exercise (p = 0.034), nocturnal (p = 0.001), and overall (p < 0.001) periods. Depth of hypoglycemia (p = 0.302), as well as ketonic and counter-regulatory hormonal profiles were similar. These findings demonstrate the glycemic safety of peri-exercise bolus dose reduction strategies in minimising the prevalence of acute and nocturnal hypoglycemia following evening exercise in people with T1D on MDI. Use of newer background insulins with current bolus insulins demonstrates efficacy and advances current recommendations for safe performance of exercise. DRKS00013509. Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Biomarkers - blood
Blood Glucose - drug effects
Blood Glucose - metabolism
Circadian Rhythm -
Cross-Over Studies -
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - drug therapy
Drug Administration Schedule -
Exercise -
Female -
Humans -
Hypoglycemia - blood
Hypoglycemia - chemically induced
Hypoglycemia - epidemiology
Hypoglycemia - prevention & control
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - adverse effects
Insulin Aspart - administration & dosage
Insulin Aspart - adverse effects
Insulin, Long-Acting - administration & dosage
Insulin, Long-Acting - adverse effects
Male -
Middle Aged -
Prevalence -
Risk Factors -
Treatment Outcome -
Young Adult -

Find related publications in this database (Keywords)
Type 1 diabetes
Exercise
Insulin aspart
Insulin degludec
Hypoglycemia
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