Insulin-based strategies to prevent ...
Document type :
Article dans une revue scientifique
DOI :
PMID :
Permalink :
Title :
Insulin-based strategies to prevent hypoglycaemia during and after exercise in adult patients with type 1 diabetes on pump therapy: the DIABRASPORT randomized study
Author(s) :
Franc, S. [Auteur]
Daoudi, A. [Auteur]
Pochat, A. [Auteur]
Petit, M. -H. [Auteur]
Randazzo, C. [Auteur]
Petit, C. [Auteur]
Duclos, Martine [Auteur]
Penfornis, A. [Auteur]
Pussard, E. [Auteur]
Not, D. [Auteur]
Heyman, Elsa [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Koukoui, F. [Auteur]
Simon, Chantal [Auteur]
Charpentier, G. [Auteur]
Daoudi, A. [Auteur]
Pochat, A. [Auteur]
Petit, M. -H. [Auteur]
Randazzo, C. [Auteur]
Petit, C. [Auteur]
Duclos, Martine [Auteur]
Penfornis, A. [Auteur]
Pussard, E. [Auteur]
Not, D. [Auteur]
Heyman, Elsa [Auteur]
Unité de Recherche Pluridisciplinaire Sport, Santé, Société (URePSSS) - ULR 7369 - ULR 4488 [URePSSS]
Koukoui, F. [Auteur]
Simon, Chantal [Auteur]
Charpentier, G. [Auteur]
Journal title :
Diabetes, obesity & metabolism
Abbreviated title :
Diabetes Obes. Metab.
Volume number :
17
Pages :
1150-1157
Publication date :
2015-12-01
ISSN :
1462-8902
English keyword(s) :
continuous subcutaneous insulin infusion
type 1 diabetes
insulin pump therapy
glycaemic control
exercise
type 1 diabetes
insulin pump therapy
glycaemic control
exercise
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
OBJECTIVE: To validate strategies to prevent exercise-induced hypoglycaemia via insulin-dose adjustment in adult patients with type 1 diabetes (T1D) on pump therapy.
METHODS: A total of 20 patients randomly performed four ...
Show more >OBJECTIVE: To validate strategies to prevent exercise-induced hypoglycaemia via insulin-dose adjustment in adult patients with type 1 diabetes (T1D) on pump therapy. METHODS: A total of 20 patients randomly performed four 30-min late post-lunch (3 h after lunch) exercise sessions and a rest session: two moderate sessions [50% maximum oxygen consumption (VO2 max)] with 50 or 80% basal rate (BR) reduction during exercise + 2 h and two intense sessions (75% VO2 max) with 80% BR reduction or with their pump stopped. Two additional early post-lunch sessions (90 min after lunch) were analysed to compare hypoglycaemia incidence for BR reduction versus bolus reduction. RESULTS: In all, 100 late post-lunch sessions were analysed. Regardless of exercise type and BR reduction, no more hypoglycaemic events occurred in the period until the next morning than occurred after the rest sessions. In the afternoon, no more hypoglycaemic events occurred with 80% BR reduction/moderate exercise or with pump discontinuation/intense exercise than for the rest session, whereas more hypoglycaemic events occurred with 50% BR reduction/moderate exercise and 80% BR reduction/intense exercise. After early post-lunch exercise (n = 37), a trend towards fewer hypoglycaemic episodes was observed with bolus reduction versus BR reduction (p = 0.07). Mean blood glucose fell by ∼3.3 mmol/l after 30 min of exercise, irrespective of dose reduction, remaining stable until the next morning with no rebound hyperglycaemia. CONCLUSIONS: In adults with T1D, to limit the hypoglycaemic risk associated with 30 min of exercise 3 h after lunch, without carbohydrate supplements, the best options seem to be to reduce BR by 80% or to stop the pump for moderate or intense exercise, or for moderate exercise 90 min after lunch, to reduce the prandial bolus rather than the BR.Show less >
Show more >OBJECTIVE: To validate strategies to prevent exercise-induced hypoglycaemia via insulin-dose adjustment in adult patients with type 1 diabetes (T1D) on pump therapy. METHODS: A total of 20 patients randomly performed four 30-min late post-lunch (3 h after lunch) exercise sessions and a rest session: two moderate sessions [50% maximum oxygen consumption (VO2 max)] with 50 or 80% basal rate (BR) reduction during exercise + 2 h and two intense sessions (75% VO2 max) with 80% BR reduction or with their pump stopped. Two additional early post-lunch sessions (90 min after lunch) were analysed to compare hypoglycaemia incidence for BR reduction versus bolus reduction. RESULTS: In all, 100 late post-lunch sessions were analysed. Regardless of exercise type and BR reduction, no more hypoglycaemic events occurred in the period until the next morning than occurred after the rest sessions. In the afternoon, no more hypoglycaemic events occurred with 80% BR reduction/moderate exercise or with pump discontinuation/intense exercise than for the rest session, whereas more hypoglycaemic events occurred with 50% BR reduction/moderate exercise and 80% BR reduction/intense exercise. After early post-lunch exercise (n = 37), a trend towards fewer hypoglycaemic episodes was observed with bolus reduction versus BR reduction (p = 0.07). Mean blood glucose fell by ∼3.3 mmol/l after 30 min of exercise, irrespective of dose reduction, remaining stable until the next morning with no rebound hyperglycaemia. CONCLUSIONS: In adults with T1D, to limit the hypoglycaemic risk associated with 30 min of exercise 3 h after lunch, without carbohydrate supplements, the best options seem to be to reduce BR by 80% or to stop the pump for moderate or intense exercise, or for moderate exercise 90 min after lunch, to reduce the prandial bolus rather than the BR.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Univ. Littoral Côte d’Opale
Univ. Artois
Université de Lille
Univ. Artois
Université de Lille
Research team(s) :
Activité Physique, Muscle, Santé (APMS)
Submission date :
2019-09-24T10:01:44Z