دورية أكاديمية
Extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin adjustments in individuals with type 1 diabetes
| العنوان: | Extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin adjustments in individuals with type 1 diabetes |
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| المؤلفون: | McCarthy, Olivia, Deere, Rachel, Churm, Rachel, Dunseath, Gareth J., Jones, Charlotte, Eckstein, Max L., Williams, David M., Hayes, Jennifer, Pitt, Jason, Bain, Stephen C., Moser, Othmar, Bracken, Richard M. |
| المصدر: | McCarthy , O , Deere , R , Churm , R , Dunseath , G J , Jones , C , Eckstein , M L , Williams , D M , Hayes , J , Pitt , J , Bain , S C , Moser , O & Bracken , R M 2021 , ' Extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin adjustments in individuals with type 1 diabetes ' , Nutrition, Metabolism and Cardiovascular Diseases , vol. 31 , no. 1 , pp. 227-236 . https://doi.org/10.1016/j.numecd.2020.07.043Test |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Exercise, Hypoglycemia, Insulin aspart, Insulin degludec, Type 1 diabetes, /dk/atira/pure/subjectarea/asjc/2700/2701, name=Medicine (miscellaneous), /dk/atira/pure/subjectarea/asjc/2700/2712, name=Endocrinology, Diabetes and Metabolism, /dk/atira/pure/subjectarea/asjc/2900/2916, name=Nutrition and Dietetics, /dk/atira/pure/subjectarea/asjc/2700/2705, name=Cardiology and Cardiovascular Medicine, /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being, name=SDG 3 - Good Health and Well-being |
| الوصف: | Aim: 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). Methods and results: 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% V̇O 2max . 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. Conclusions: 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. Clinical trials register: DRKS00013509. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://researchportal.bath.ac.uk/en/publications/d31f0c45-0ec1-4354-bfb1-c28e1d338bbbTest |
| DOI: | 10.1016/j.numecd.2020.07.043 |
| الإتاحة: | https://doi.org/10.1016/j.numecd.2020.07.043Test https://researchportal.bath.ac.uk/en/publications/d31f0c45-0ec1-4354-bfb1-c28e1d338bbbTest http://www.scopus.com/inward/record.url?scp=85092014349&partnerID=8YFLogxKTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.2479EEAF |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.numecd.2020.07.043 |
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