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Aim: To compare time spent in pre-specified glycemic ranges in day and night-time during intensive training in professional cyclists with type 1 diabetes (T1D). Methods: Fifteen male professional cyclists with T1D on multiple daily injections (age 27±4 years, duration T1D 11±5 years, BMI 21.6±1.5 kg·min-2, HbA1c 7.2±0.7%, O2max 73±4 ml·kg·min-1) performed road cycle sessions (50-90% of the anaerobic threshold, duration 1-6 hours) over 9 consecutive days. Time spent in pre-specified glycemic ranges was compared between day and night time using paired t-test and Wilcoxon matched-pairs signed rank test, P≤0.05. Results: Overall glycemia is shown in Figure 1. More time was spent in level 1 (54-70 mg·dl-1) (6±5% vs. 4±3%, P=0.05) and level 2 hypoglycemia (<54 mg·dL-1) (3±5% vs. 1±4%, P=0.002) during night vs. day periods. During daytime, more time was spent in level 2 hyperglycemia (>299 mg dL-1) (night 0.2±0.4% vs. day 1.4±2.3%, P=0.02). Conclusion: Professional cyclists with T1D spent more time in hypoglycemia during the night compared to day-time during intensified training. Long-lasting insulin-sensitizing effects of endurance exercise may suggest a greater need for additional pre-bed carbohydrates and/or insulin dose reductions. Disclosure O. Moser: Research Support; Self; Abbott, Dexcom, Inc., Novo Nordisk A/S. M.L. Eckstein: Research Support; Self; Novo Nordisk A/S. O. McCarthy: None. M. Riddell: Advisory Panel; Self; Xeris Pharmaceuticals, Inc. Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc., Insulet Corporation, Novo Nordisk Inc., Sanofi. Speaker’s Bureau; Self; Medtronic MiniMed, Inc., OmniPod. Stock/Shareholder; Self; Zucara Therapeutics Inc. F.Y. Fontana: None. K. Skroce: None. L. Festa: None. P.H. Lagrou: None. P. Southerland: Other Relationship; Self; Novo Nordisk Inc. M.P. Christiansen: Research Support; Self; Abbott, Biolinq, Dexcom, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Medtronic MiniMed, Inc., Novo Nordisk A/S, Sanofi-Aventis, Xeris Pharmaceuticals, Inc. B.W. Bode: Consultant; Self; ADOCIA, Lexicon Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; Becton, Dickinson and Company, Dexcom, Inc., Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Eyenuk Inc., Insulet Corporation, National Institutes of Health, Novo Nordisk Inc., Sanofi Research & Development, Senseonics, Xeris Pharmaceuticals, Inc. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi US, Senseonics. Stock/Shareholder; Self; AgaMatrix, Glytec, LLC. C. Stettler: None. S.N. Scott: None. M. Fisher: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Mylan, NAPP Pharmaceuticals Limited, Novo Nordisk A/S. Speaker’s Bureau; Self; Eli Lilly and Company, Sanofi. C.A. Hayes: Other Relationship; Self; Novo Nordisk A/S. R.M. Bracken: None. Funding Novo Nordisk A/S

Several clinical trials (1) have demonstrated that vitamin E does not reduce future major cardiovascular (CV) events. However, these trials could not rule out the potential benefit for highrisk subgroups. Diabetic individuals who are homozygous for the haptoglobin 2 allele (Hp 2-2) are at high risk for CV events (2-4); moreover, the Hp 2-2 protein product is an inferior antioxidant compared with the Hp 1 allele (5). We therefore hypothesized that vitamin E may reduce CV events in Hp 2-2 diabetic individuals.Hp type was measured in 3,167 participants (1,078 with diabetes) of the Heart Outcomes Prevention Evaluation (HOPE) trial, which evaluated the 4.5-year effects of 400 IU vitamin E daily on the primary composite of CV death, myocardial infarction, and stroke (1). No significant benefit of vitamin E supplementation was detected in either the entire group or in the diabetic subset, consistent with what was previously reported for the entire HOPE cohort (1). In Hp 2-2 diabetic participants, there was a trend toward a reduced primary composite outcome (relative risk 0.70 [95% CI 0.45-1.10]) and a statistically significant reduction in the risk of CV death (0.45 [0.23-0.90]) and nonfatal myocardial infarction (0.57 [0.33-0.97]). However, this trend was not observed for strokes (1.15 [0.47-2.82]), and there was no statistical interaction between vitamin E use and haptoglobin type for either the composite outcome or any of its components.In conclusion, the absence of any statistical interaction indicates that these data do not support the hypothesis that the effects of vitamin E differed by Hp phenotype. Therefore, the results noted above in Hp 2-2 diabetic individuals demonstrating a significant reduction in CV death and myocardial infarction could be spurious and clearly require prospective testing in future trials. Acknowledgments -This study was funded by the Kennedy-Leigh Trust and the Israel Science Foundation. ANDREW P. LEVY, MD• Recently, several studies have reported a high prevalence of QT prolongation and increased QT dispersion (QTd) in patients with diabetes. These abnormalities have been shown to be associated with sudden death and poor survival in both type 1 (1) and type 2 (2) diabetes. QTd, i.e., the difference between the maximum and minimum QT intervals on the 12-lead electrocardiogram (ECG) (QTd ϭ QT max Ϫ QT min), is claimed to reflect the degree of inhomogeneity of myocardial repolarization. The role of hyperglycemia in causing QT abnormalities in people with diabetes is not clear. The present study was therefore undertaken to assess the effect of controlling hyperglycemia on QT intervals and dispersion.A total of 26 newly diagnosed type 2 diabetic patients with no coronary artery disease or autonomic dysfunction were recruited. Each was examined and had three ECGs recorded before and after 8 weeks of dietary intervention. All ECGs were analyzed automatically by the previously validated Glasgow program (3). The Hodges formula [corrected QT (QTc) ϭ QT ϩ 1.75 (rate Ϫ 60)] was used to correct QT i...

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