Assessing the influence of insulin type (ultra-rapid vs rapid insulin) and exercise timing on postprandial exercise-induced hypoglycaemia risk in individuals with type 1 diabetes: a randomised controlled trial
Authors' conclusion
EX60min blunted the pre-exercise glucose increase following breakfast and was associated with a smaller glucose reduction during exercise. Ultra-rapid aspart led to a smaller blood glucose reduction during exercise and might be associated with diminished post-exercise hypoglycaemia.
Study context
- Population
- Adults ≥18 years with T1D for ≥1 year on MDI, HbA1c ≤80 mmol/mol (9.5%); mean HbA1c 56 mmol/mol [7.4%]; Montreal Clinical Research Institutecrossover
- Participants
- 40 adults
- Comparison
- Exercise 60 vs 120 min post meal, and ultra-rapid aspart vs aspart
- Primary endpoint
- Change in blood glucose between exercise onset and nadir
Methodological detailsfour-way crossover, participant-masked, sequentially numbered, opaque sealed envelopes
- Four-way crossover
- Participant-masked
- Sequentially numbered, opaque sealed envelopes
Primary result
As reported in the abstract
EX60min
−3.8
± 2.7 · mmol/l
EX120min
−4.7
± 2.5 · mmol/l
Ultra-rapid aspart
−4.1
± 2.3 · mmol/l
Aspart
−4.4
± 2.8 · mmol/l
EX60min vs EX120min: P < 0.001 · Ultra-rapid aspart vs Aspart: P = 0.037
Further findings
| Outcome | EX60min | EX120min | P value |
|---|---|---|---|
| Time in hyperglycaemia (>10.0 mmol/l) before exercise onset · prior to exercise onsetEX60min vs EX120min · lower with EX60min | 56.6% (interval 1.2–100%) | 78.0% (interval 52.7–97.9%) | P < 0.001 |
Safety
| Outcome | Ultra-rapid aspart | Aspart | P value |
|---|---|---|---|
| Post-exercise hypoglycaemiaUltra-rapid aspart vs Aspart · less with ultra-rapid aspart | 0% | 38% | P = 0.003 |
Hypoglycaemia during exercise
- Similar number of hypoglycaemic events with both exercise timings
- Similar number of hypoglycaemic events during exercise with both insulin types
Original publication
Assessing the influence of insulin type (ultra-rapid vs rapid insulin) and exercise timing on postprandial exercise-induced hypoglycaemia risk in individuals with type 1 diabetes: a randomised controlled trial. Diabetologia. Published 29 July 2024. doi:10.
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