OBJECTIVE: To determine the effects of reducing overnight basal insulin or a bedtime dose of terbutaline on nocturnal blood glucose (BG) nadir and hypoglycemia after exercise in children with type 1 diabetes mellitus. STUDY DESIGN:Sixteen youth (mean age 13.3 years) on insulin pumps were studied overnight on 3 occasions after a 60-minute exercise session with BG measurements every 30 minutes. Admissions were randomized to bedtime treatment with oral terbutaline 2.5 mg, 20% basal rate insulin reduction for 6 hours, or no treatment. RESULTS:Mean overnight nadir BG was 188 mg/dL after terbutaline and 172 mg/dL with basal rate reduction compared with 127 mg/dL on the control night (P = .002 and .042, respectively). Terbutaline eliminated nocturnal hypoglycemia but resulted in significantly more hyperglycemia (≥250 mg/dL) when compared with the control visit (P < .0001). The basal rate reduction resulted in fewer BG readings <80 and <70 mg/dL but more readings ≥250 mg/dL when compared with the control visit. CONCLUSIONS: A basal insulin rate reduction was safe and effective in raising post-exercise nocturnal BG nadir and in reducing hypoglycemia in children with type 1 diabetes mellitus. Although effective at preventing hypoglycemia, a 2.5-mg dose of terbutaline was associated with hyperglycemia.
RCT Entities:
OBJECTIVE: To determine the effects of reducing overnight basal insulin or a bedtime dose of terbutaline on nocturnal blood glucose (BG) nadir and hypoglycemia after exercise in children with type 1 diabetes mellitus. STUDY DESIGN: Sixteen youth (mean age 13.3 years) on insulin pumps were studied overnight on 3 occasions after a 60-minute exercise session with BG measurements every 30 minutes. Admissions were randomized to bedtime treatment with oral terbutaline 2.5 mg, 20% basal rate insulin reduction for 6 hours, or no treatment. RESULTS: Mean overnight nadir BG was 188 mg/dL after terbutaline and 172 mg/dL with basal rate reduction compared with 127 mg/dL on the control night (P = .002 and .042, respectively). Terbutaline eliminated nocturnal hypoglycemia but resulted in significantly more hyperglycemia (≥250 mg/dL) when compared with the control visit (P < .0001). The basal rate reduction resulted in fewer BG readings <80 and <70 mg/dL but more readings ≥250 mg/dL when compared with the control visit. CONCLUSIONS: A basal insulin rate reduction was safe and effective in raising post-exercise nocturnal BG nadir and in reducing hypoglycemia in children with type 1 diabetes mellitus. Although effective at preventing hypoglycemia, a 2.5-mg dose of terbutaline was associated with hyperglycemia.
Authors: Sarah K McMahon; Luis D Ferreira; Nirubasini Ratnam; Raymond J Davey; Leanne M Youngs; Elizabeth A Davis; Paul A Fournier; Timothy W Jones Journal: J Clin Endocrinol Metab Date: 2006-11-21 Impact factor: 5.958
Authors: Eva Tsalikian; Craig Kollman; William B Tamborlane; Roy W Beck; Rosanna Fiallo-Scharer; Larry Fox; Kathleen F Janz; Katrina J Ruedy; Darrell Wilson; Dongyuan Xing; Stuart A Weinzimer Journal: Diabetes Care Date: 2006-10 Impact factor: 19.112
Authors: Bharathi Raju; Ana Maria Arbelaez; Suzanne M Breckenridge; Philip E Cryer Journal: J Clin Endocrinol Metab Date: 2006-02-21 Impact factor: 5.958
Authors: Laura Scrimgeour; Erin Cobry; Kim McFann; Pat Burdick; Casey Weimer; Robert Slover; H Peter Chase Journal: Diabetes Technol Ther Date: 2007-10 Impact factor: 6.118
Authors: Ana Maria Gomez; Claudia Gomez; Pablo Aschner; Angelica Veloza; Oscar Muñoz; Claudia Rubio; Santiago Vallejo Journal: J Diabetes Sci Technol Date: 2015-01-01