No insulin degludec dose adjustment required after aerobic exercise for people with type 1 diabetes: the ADREM study
Authors' conclusion
Post-exercise adjustment of degludec does not mitigate the risk of subsequent nocturnal hypoglycaemia in people with type 1 diabetes. Although reducing degludec reduced next-day time below range, this did not translate into fewer hypoglycaemic events, while postponing degludec should be avoided because of increased time above range. Altogether, these data do not support degludec dose adjustment after a single exercise bout.
Study context
- Population
- Adults with T1D at elevated risk of hypoglycaemia performing a 45 min afternoon aerobic exercise test; blinded CGM for 6 days6 women
- Participants
- 18 adults
- Comparison
- 40% degludec dose reduction (D40) or postponement and 20% dose reduction (D20-P) vs no dose adjustment (CON) after aerobic exercise
- Primary endpoint
- Incidence of (nocturnal) hypoglycaemia and subsequent glucose profiles
Methodological detailscrossover
- Crossover
Primary result
As reported in the abstract
- Time below range was generally low and occurrence did not differ between the treatment regimens
Further findings
Time above range (glucose >10 mmol/l) · subsequent whole day — D20-P vs CON · greater with D20-P
P = 0.001
Median, min
| Outcome | D40 | D20-P | CON | P value |
|---|---|---|---|---|
| Time below range (glucose <3.9 mmol/l) · subsequent whole dayD40 vs CON · lower with D40 | 0 (IQR 0–23) | — not stated in the abstract | 18 (IQR 0–55) | P = 0.043 |
| Time above range (glucose >10 mmol/l) · subsequent whole dayD20-P vs D40 · greater with D20-P | P = 0.003 |
— not stated in the abstract
Time below range (glucose <3.9 mmol/l) · subsequent whole day
- No differences in the number of hypoglycaemic events
Original publication
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