High intensity interval training as a novel treatment for impaired awareness of hypoglycaemia in people with type 1 diabetes (HIT4HYPOS): a randomised parallel-group study
Authors' conclusion
In this pilot clinical trial in people with type 1 diabetes and IAH, we found continuing benefits of HIIT for overall hormonal and symptomatic CRR to subsequent hypoglycaemia. Our findings also suggest that HIIT may improve the glucagon response to insulin-induced hypoglycaemia.
Study context
- Population
- Adults aged 18–55 years with T1D ≥5 years, HbA1c <75 mmol/mol (<9%) and impaired awareness of hypoglycaemia; single centre, Dundee, UKall analysed
- Participants
- 18 adults
- Comparison
- Real-time continuous glucose monitoring (RT-CGM)+high intensity interval training (HIIT) vs RT-CGM for 4 weeks
- RT-CGM+HIITn = 9
- RT-CGMn = 9reference
- Primary endpoint
- Change from baseline in hypoglycaemia-induced adrenaline responses (hyperinsulinaemic-hypoglycaemic 2.5 mmol/l clamp)
- Follow-up
- 4 weeks
Methodological detailspilot, single-centre, parallel-group, open-label, Participants and investigators were not masked to group assignment
- Pilot
- Single-centre
- Parallel-group
- Open-label
- Participants and investigators were not masked to group assignment
Primary result
As reported in the abstract
Change from baseline in adrenergic (adrenaline) response to hypoglycaemia
RT-CGM
−298
mean · SE 687 · pmol/l
RT-CGM+HIIT
1130
mean · SE 747 · pmol/l
P = 0.11
Further findings
| Outcome | RT-CGM+HIIT | RT-CGM | P value |
|---|---|---|---|
| Change from baseline in noradrenergic response to hypoglycaemia · 4 weeksGreater with RT-CGM+HIIT · mean, pmol/l | 514 (SE 732) | −988 (SE 447) | P = 0.02 |
| Change from baseline in glucagon CRR to hypoglycaemia · 4 weeksBenefit of RT-CGM+HIIT · mean, ng/l | 16 (SE 6) | 1 (SE 4) | P = 0.01 |
| Symptomatic response to hypoglycaemia (adjusted for baseline) · 4 weeksGreater with RT-CGM+HIIT · mean | 0 (SE 2) | −4 (SE 2) | P < 0.05 |
CGM-derived mean glucose, SD of glucose and GMI · 4 weeks
- Did not differ between groups
Safety
Level 1 hypoglycaemia episodes during intervention · 4 weeks · no significant difference
P = 0.45
Level 2 hypoglycaemia episodes during intervention · 4 weeks · no significant difference
P = 0.29
Original publication
High intensity interval training as a novel treatment for impaired awareness of hypoglycaemia in people with type 1 diabetes (HIT4HYPOS): a randomised parallel-group study. Diabetologia. Published 27 November 2023. doi:10.
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