Managing blood glucose during and after exercise in Type 1 diabetes: reproducibility of glucose response and a trial of a structured algorithm adjusting insulin and carbohydrate intake

Kilbride, Lynn; Charlton, Jacqui; Aitken, Gill; Hill, Gordon; Davison, R. C. Richard; McKnight, John

doi:10.1111/j.1365-2702.2011.03771.x

Cited by 16 publications

(17 citation statements)

References 14 publications

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“…Several studies in literature, for example, Harmer et al [13], Braken et al [14], and Kilbride et al [15], have assessed the impact on glucose levels caused by a range of acute exercise protocols, including different physical activity types. However, there is limited literature comparing these glycemic effects from a quantitative perspective.…”

Section: Introduction 2 Methodsmentioning

confidence: 99%

Quantifying the Acute Changes in Glucose with Exercise in Type 1 Diabetes: A Systematic Review and Meta-Analysis

et al. 2015

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Background The acute impact of different types of physical activity on glycemic control in type 1 diabetes has not been well quantified. Objectives Our objective was to estimate the rate of change (RoC) in glucose concentration induced acutely during the performance of structured exercise and at recovery in subjects with type 1 diabetes. .70 mmol/L h" 1 (p = 0.46, 95 % CI -1.14 to +2.54) for CONT vs. REST; RoC E -5.25 mmol/ L-h" 1 (p < 0.00001, 95 % CI -7.02 to -3.48) and RoC R +0.72 mmol/L h" 1 (p = 0.71, 95 % CI -3.10 to +4.54) for IHE vs. REST; RoC E -2.61 mmol/L h _1 (p = 0.30, 95 % CI -7.55 to +2.34) and RoC R -0.02 mmol/L h _1 (p = 1.00,95 % CI -7.58 to +7.53) for RESIST vs. REST. Conclusions Novel RoC magnitudes ROCE, ROC R reflected rapid decays of glycemia during CONT exercise and gradual recoveries immediately afterwards. RESIST showed more constrained decays, whereas discrepancies were found for IHE.Novel glycemia rate-of-change magnitude data expressed in measurable units may provide a means of translating the effects of exercise on glucose dynamics into information that benefits patient self-management.Rapid decays of glycemia were found during continuous moderate exercise, followed by mild increases immediately afterwards.Resistance exercise was associated with more constrained decreases, whereas discrepancies were found for intermittent high-intensity exercise.

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Section: Introduction 2 Methodsmentioning

confidence: 99%

Quantifying the Acute Changes in Glucose with Exercise in Type 1 Diabetes: A Systematic Review and Meta-Analysis

et al. 2015

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“…3.9-10.0 mmol · L −1 [73], thus minimizing the risk of immediate exercise-induced glycemic imbalances. Of note, as a reduction in the premeal insulin dose has been proposed to counter the risk of an excessive exercise-induced fall of blood glucose [74,75], the algorithm has been designed to also take into account occasional changes in the usual therapy, e.g., the reduced insulin doses in anticipation of exercise. This strategy, however, often does not exempt patients from a CHO supplement [18].…”

Section: Discussionmentioning

confidence: 99%

Whole-body glucose oxidation rate during prolonged exercise in type 1 diabetic patients under usual life conditions

et al. 2013

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“…One of the most discussed topics with patients around exercise management is the notion that there is unexplainable inter‐patient variability in the glucose responses to exercise . According to a limited number of small studies, a higher pre‐exercise blood glucose concentration tends to be associated with a greater absolute drop in glycemia during prolonged aerobic exercise .…”

Section: Introductionmentioning

confidence: 99%

Individual glucose responses to prolonged moderate intensity aerobic exercise in adolescents with type 1 diabetes: The higher they start, the harder they fall

et al. 2018

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Objective To evaluate the pattern of change in blood glucose concentrations and hypoglycemia risk in response to prolonged aerobic exercise in adolescents with type 1 diabetes (T1D) that had a wide range in pre‐exercise blood glucose concentrations. Methods Individual blood glucose responses to prolonged (~60 minutes) moderate‐intensity exercise were profiled in 120 youth with T1D. Results The mean pre‐exercise blood glucose concentration was 178 ± 66 mg/dL, ranging from 69 to 396 mg/dL, while the mean change in glucose during exercise was −76 ± 55 mg/dL (mean ± SD), ranging from +83 to −257 mg/dL. Only 4 of 120 youth (3%) had stable glucose levels during exercise (ie, ± ≤10 mg/dL), while 4 (3%) had a rise in glucose >10 mg/dL, and the remaining (93%) had a clinically significant drop (ie, >10 mg/dL). A total of 53 youth (44%) developed hypoglycemia (≤70 mg/dL) during exercise. The change in glucose was negatively correlated with the pre‐exercise glucose concentration (R2 = 0.44, P < 0.001), and tended to be greater in those on multiple daily insulin injections (MDI) vs continuous subcutaneous insulin infusion (CSII) (−98 ± 15 vs −65 ± 7 mg/dL, P = 0.05). No other collected variables appeared to predict the change in glucose including age, weight, height, body mass index, disease duration, daily insulin dose, HbA1c, or sex. Conclusion Youth with T1D have variable glycemic responses to prolonged aerobic exercise, but this variability is partially explained by their pre‐exercise blood glucose levels. When no implementation strategies are in place to limit the drop in glycemia, the incidence of exercise‐associated hypoglycemia is ~44% and having a high pre‐exercise blood glucose concentration is only marginally protective.

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Managing blood glucose during and after exercise in Type 1 diabetes: reproducibility of glucose response and a trial of a structured algorithm adjusting insulin and carbohydrate intake

Abstract: This information provides valuable baseline information for people with diabetes and health care professionals who wish to encourage physical activity and undertake further research in this area.

Cited by 16 publications

References 14 publications

Quantifying the Acute Changes in Glucose with Exercise in Type 1 Diabetes: A Systematic Review and Meta-Analysis

Quantifying the Acute Changes in Glucose with Exercise in Type 1 Diabetes: A Systematic Review and Meta-Analysis

Whole-body glucose oxidation rate during prolonged exercise in type 1 diabetic patients under usual life conditions

Individual glucose responses to prolonged moderate intensity aerobic exercise in adolescents with type 1 diabetes: The higher they start, the harder they fall

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