Glycemic Management Around Postprandial Exercise in People With Type 1 Diabetes: Challenge Accepted
Authors' conclusion
Postprandial exercise of all modalities is effective, safe, and feasible if necessary precautions are taken (ie, prandial insulin reductions), as exercise lowered maximal PPG excursion and caused a consistent and clinically relevant BG decline during exercise while there was no hypoglycemia during or shortly after exercise. However, there seem to be 2 remaining challenges: subacute postexercise hyperglycemia and nocturnal hypoglycemia.
Study context
- Population
- Adults with T1D, aged 44 ± 13 years, BMI 24 ± 2.1
- Participants
- 8 adults
- Comparison
- 30 min postprandial walking, moderate-intensity or intermittent high-intensity exercise vs rest
- Primary endpoint
- BG change during exercise/control (acute)
- Follow-up
- During exercise/control
Methodological detailscrossover: 4 laboratory visits, 24-hour follow-up at home
- Crossover: 4 laboratory visits
- 24-hour follow-up at home
Primary result
As reported in the abstract
Walking (WALK)
−45
mean · ± 24 · mg/dL
MOD
−71
mean · ± 39 · mg/dL
IHE
−35
mean · ± 21 · mg/dL
WALK vs CONTROL: clinical superiority demonstrated · MOD vs CONTROL: clinical superiority demonstrated · IHE vs CONTROL: clinical superiority demonstrated · WALK vs MOD: noninferiority not demonstrated · WALK vs IHE: noninferiority demonstrated · IHE vs MOD: equivalence not demonstrated
- Consistent blood glucose (BG) decline in all patients for all modalities
- P < 0.001
Secondary outcomes
PPG excursion
- Exercise reduced PPG excursion vs CONTROL
BG change in the hour after exercise (subacute)
- BG increased, more than after CONTROL
- P < 0.001
- More than half of participants had hyperglycemia needing insulin correction
Safety
| Outcome | P value |
|---|---|
| Postexercise hyperglycemia · hour after exerciseExercise vs CONTROL · BG increase greater after exercise | P < 0.001 |
| Nocturnal hypoglycemic eventsExercise vs CONTROL · more events after exercise | P < 0.05 |
Hypoglycemia during exercise
- Hypoglycemia did not occur during exercise
Postexercise hyperglycemia · hour after exercise
- More than half of participants showed hyperglycemia after exercise necessitating insulin correction
Original publication
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