Titre :

A single-blind, randomised, crossover study to reduce hypoglycaemia risk during postprandial exercise with closed-loop insulin delivery in adults with type 1 diabetes: announced (with or without bolus reduction) vs unannounced exercise strategies.

Auteur(s) :

Tagougui, Sémah [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Taleb, Nadine [Auteur]
Université du Québec à Montréal = University of Québec in Montréal [UQAM]
Legault, Laurent [Auteur]
Montreal Children's Hospital
Suppère, Corinne [Auteur]
Institut de Recherches Cliniques de Montréal [IRCM]
Messier, Virginie [Auteur]
Montreal Heart Institute - Institut de Cardiologie de Montréal
Boukabous, Inès [Auteur]
Montreal Heart Institute - Institut de Cardiologie de Montréal
Shohoudi, Azadeh [Auteur]
Université du Québec à Montréal = University of Québec in Montréal [UQAM]
Ladouceur, Martin [Auteur]
Centre Hospitalier de l'Université de Montréal [CHUM]
Rabasa-Lhoret, Rémi [Auteur]
Institut de Recherches Cliniques de Montréal [IRCM]

Titre de la revue :

Diabetologia

Nom court de la revue :

Diabetologia

Numéro :

63

Pagination :

2282-2291

Date de publication :

2020-11-01

ISSN :

1432-0428

Mot(s)-clé(s) en anglais :

Closed-loop insulin delivery
Hypoglycaemia
Postprandial exercise
Type 1 diabetes

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

For individuals living with type 1 diabetes, closed-loop insulin delivery improves glycaemic control. Nonetheless, maintenance of glycaemic control during exercise while a prandial insulin bolus remains active is a challenge ...
Lire la suite >For individuals living with type 1 diabetes, closed-loop insulin delivery improves glycaemic control. Nonetheless, maintenance of glycaemic control during exercise while a prandial insulin bolus remains active is a challenge even to closed-loop systems. We investigated the effect of exercise announcement on the efficacy of a closed-loop system, to reduce hypoglycaemia during postprandial exercise. A single-blind randomised, crossover open-label trial was carried out to compare three strategies applied to a closed-loop system at mealtime in preparation for exercise taken 90 min after eating at a research testing centre: (1) announced exercise to the closed-loop system (increases target glucose levels) in addition to a 33% reduction in meal bolus (A-RB); (2) announced exercise to the closed-loop system and a full meal bolus (A-FB); (3) unannounced exercise and a full meal bolus (U-FB). Participants performed 60 min of exercise at 60% [Formula: see text] 90 min after eating breakfast. The investigators were not blinded to the interventions. However, the participants were blinded to the sensor glucose readings and to the insulin infusion rates throughout the intervention visits. The trial was completed by 37 adults with type 1 diabetes, all using insulin pumps: mean±SD, 40.0 ± 15.0 years of age, HbA 57.1 ± 10.8 mmol/mol (7.3 ± 1.0%). Reported results were based on plasma glucose values. During exercise and the following 1 h recovery period, time spent in hypoglycaemia (10 mmol/l) by 21% (p = 0.001). No side effects were reported during the applied strategies. Combining postprandial exercise announcement, which increases closed-loop system glucose target levels, with a 33% meal bolus reduction significantly reduced time spent in hypoglycaemia compared with the other two strategies, yet at the expense of more time spent in hyperglycaemia. ClinicalTrials.gov NCT0285530 FUNDING: JDRF (2-SRA-2016-210-A-N), the Canadian Institutes of Health Research (354024) and the Fondation J.-A. DeSève chair held by RR-L.Lire moins >

Comité de lecture :

Oui

Audience :

Non spécifiée

Établissement(s) :

Université de Lille
Univ. Artois
Univ. Littoral Côte d’Opale

Collections :

• Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369

Équipe(s) de recherche :

Activité Physique, Muscle, Santé (APMS)

Date de dépôt :

2020-12-16T10:02:36Z
2021-01-25T09:50:15Z