D Turner1,2, S Luzio2,3, B J Gray1,2, S C Bain2,3, S Hanley1, A Richards3, D C Rhydderch3, R Martin4, M D Campbell5, L P Kilduff1, D J West5, R M Bracken1,2. 1. Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK. 2. Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK. 3. Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea, UK. 4. Cwm Taf University Health Board, Merthyr Tydfil, UK. 5. Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
Abstract
AIMS: To develop an algorithm that delivers an individualized dose of rapid-acting insulin after morning resistance exercise to counter post-exercise hyperglycaemia in individuals with Type 1 diabetes. METHODS:Eight people with Type 1 diabetes, aged 34 ± 7 years with HbA1c concentrations 72 ± 12 mmol/mol (8.7 ± 1.1%), attended our laboratory on two separate mornings after fasting, having taken their usual basal insulin the previous evening. These people performed a resistance exercise session comprising six exercises for two sets of 10 repetitions at 60% of the maximum amount of force that was generated in one maximal contraction (60% 1RM). In a randomized and counterbalanced order, the participants were administered an individualized dose of rapid-acting insulin (2 ± 1 units, range 0-4 units) immediately after resistance exercise (insulin session) by means of an algorithm or were not administered this (no-insulin session). Venous blood glucose concentrations were measured for 125 min after resistance exercise. Data (mean ± sem values) were analysed using anova (P ≤ 0.05). RESULTS: Participants had immediate post-resistance exercise hyperglycaemia (insulin session 13.0 ± 1.6 vs. no-insulin session 12.7 ± 1.5 mmol/l; P = 0.834). The decline in blood glucose concentration between peak and 125 min after exercise was greater in the insulin exercise session than in the no-insulin session (3.3 ± 1.0 vs. 1.3 ± 0.4 mmol/l: P = 0.015). There were no episodes of hypoglycaemia (blood glucose <3.9 mmol/l). CONCLUSIONS: Administration of rapid-acting insulin according to an individualized algorithm reduced the hyperglycaemia associated with morning resistance exercise without causing hypoglycaemia in the 2 h post-exercise period in people with Type 1 diabetes.
RCT Entities:
AIMS: To develop an algorithm that delivers an individualized dose of rapid-acting insulin after morning resistance exercise to counter post-exercise hyperglycaemia in individuals with Type 1 diabetes. METHODS: Eight people with Type 1 diabetes, aged 34 ± 7 years with HbA1c concentrations 72 ± 12 mmol/mol (8.7 ± 1.1%), attended our laboratory on two separate mornings after fasting, having taken their usual basal insulin the previous evening. These people performed a resistance exercise session comprising six exercises for two sets of 10 repetitions at 60% of the maximum amount of force that was generated in one maximal contraction (60% 1RM). In a randomized and counterbalanced order, the participants were administered an individualized dose of rapid-acting insulin (2 ± 1 units, range 0-4 units) immediately after resistance exercise (insulin session) by means of an algorithm or were not administered this (no-insulin session). Venous blood glucose concentrations were measured for 125 min after resistance exercise. Data (mean ± sem values) were analysed using anova (P ≤ 0.05). RESULTS:Participants had immediate post-resistance exercise hyperglycaemia (insulin session 13.0 ± 1.6 vs. no-insulin session 12.7 ± 1.5 mmol/l; P = 0.834). The decline in blood glucose concentration between peak and 125 min after exercise was greater in the insulin exercise session than in the no-insulin session (3.3 ± 1.0 vs. 1.3 ± 0.4 mmol/l: P = 0.015). There were no episodes of hypoglycaemia (blood glucose <3.9 mmol/l). CONCLUSIONS: Administration of rapid-acting insulin according to an individualized algorithm reduced the hyperglycaemia associated with morning resistance exercise without causing hypoglycaemia in the 2 h post-exercise period in people with Type 1 diabetes.
Authors: Olivia McCarthy; Othmar Moser; Max L Eckstein; Rachel Deere; Steve C Bain; Jason Pitt; Richard M Bracken Journal: Front Endocrinol (Lausanne) Date: 2019-08-02 Impact factor: 5.555
Authors: Othmar Moser; Michael C Riddell; Max L Eckstein; Peter Adolfsson; Rémi Rabasa-Lhoret; Louisa van den Boom; Pieter Gillard; Kirsten Nørgaard; Nick S Oliver; Dessi P Zaharieva; Tadej Battelino; Carine de Beaufort; Richard M Bergenstal; Bruce Buckingham; Eda Cengiz; Asma Deeb; Tim Heise; Simon Heller; Aaron J Kowalski; Lalantha Leelarathna; Chantal Mathieu; Christoph Stettler; Martin Tauschmann; Hood Thabit; Emma G Wilmot; Harald Sourij; Carmel E Smart; Peter G Jacobs; Richard M Bracken; Julia K Mader Journal: Pediatr Diabetes Date: 2020-10-13 Impact factor: 4.866