Valentino Cherubini1, Rosaria Gesuita2, Edlira Skrami2, Ivana Rabbone3, Riccardo Bonfanti4, Claudia Arnaldi5, Giuseppe D'Annunzio6, Annapaola Frongia7, Fortunato Lombardo8, Elvira Piccinno9, Riccardo Schiaffini10, Sonia Toni11, Stefano Tumini12, Davide Tinti3, Paola Cipriano12, Nicola Minuto13, Lorenzo Lenzi11, Lucia Ferrito1, Claudia Ventrici8, Federica Ortolani9, Ohad Cohen13,14, Andrea Scaramuzza15. 1. Division of Pediatric and Adolescent Diabetes, Department of Women's and Children's Health, AOU Salesi Hospital, Ancona, Italy. 2. Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy. 3. Department of Pediatrics, University of Turin, Turin, Italy. 4. Pediatric Diabetes and Diabetes Research Institute, San Raffaele Hospital, Milan, Italy. 5. UOS Diabetologia Pediatrica ASL Viterbo, Viterbo, Italy. 6. Department of Pediatrics, Istituto "G. Gaslini" Children's Hospital, Genoa, Italy. 7. Unit of Pediatric Diabetes, Brotzu Hospital, Cagliari, Italy. 8. Department of Pediatrics, University of Messina, Messina, Italy. 9. Metabolic Diseases and Diabetology, Pediatric Hospital Giovanni XXIII, Bari, Italy. 10. Endocrinology and Diabetes Unit, Bambino Gesù Hospital, Rome, Italy. 11. Juvenile Diabetes Center, Anna Meyer Children's Hospital, Florence, Italy. 12. Center of Pediatric Diabetology, University of Chieti, Chieti, Italy. 13. Institute of Endocrinology, Sheba Medical Center, Ramat Gan, Israel. 14. Medtronic, Tolochenaz, Switzerland. 15. Division of Pediatrics, ASST Cremona, "Ospedale Maggiore di Cremona", Cremona, Italy.
Abstract
OBJECTIVES: To assess the optimal setting of the predictive low glucose management (PLGM) algorithm for preventing exercise-induced hypoglycemia in adolescents with type 1 diabetes. METHODS: Thirty-four adolescents, 15 to 20 years, wearing PLGM system, were followed during 3 days exercise during a diabetes camp. PLGM threshold was set at 70 mg/dL between 8 am and 10 pm and 90 mg/dL during 10 pm and 8 am Adolescents were divided into group A and B, with PLGM threshold at 90 and 70 mg/dL, respectively, during exercise. Time spent in hypoglycemia and AUC for time slots 8 am to 1 pm, 1 to 4 pm, 4 to 11 pm, 11 pm to 3 am, 3 to 8 am, in 3 days were compared between groups by Wilcoxon rank sum test. RESULTS: We analyzed 31 patients (median age 15.0 years, 58.1% males, median diabetes duration 7.0 years, hemoglobin A1c [HbA1c] 7.1%). No significant difference has been observed in time spent in hypoglycemia between groups using threshold 70 or 90. Time spent in target was similar in both groups, as well as time spent in hypo or hyperglycemia. The trends of blood glucose over the 3 days in the 2 groups over-lapped without significant differences. CONCLUSIONS: A PLGM threshold of 90 mg/dL during the night was associated with reduced time in hypoglycemia in adolescents doing frequent physical exercise, while maintaining 65.1% time in range during the day. However, a threshold of 70 mg/dL seems to be safe in the duration of the physical exercise. PLGM system in adolescents with type 1 diabetes was effective to prevent hypoglycemia during and after exercise, irrespective of the PLGM thresholds used.
OBJECTIVES: To assess the optimal setting of the predictive low glucose management (PLGM) algorithm for preventing exercise-induced hypoglycemia in adolescents with type 1 diabetes. METHODS: Thirty-four adolescents, 15 to 20 years, wearing PLGM system, were followed during 3 days exercise during a diabetescamp. PLGM threshold was set at 70 mg/dL between 8 am and 10 pm and 90 mg/dL during 10 pm and 8 am Adolescents were divided into group A and B, with PLGM threshold at 90 and 70 mg/dL, respectively, during exercise. Time spent in hypoglycemia and AUC for time slots 8 am to 1 pm, 1 to 4 pm, 4 to 11 pm, 11 pm to 3 am, 3 to 8 am, in 3 days were compared between groups by Wilcoxon rank sum test. RESULTS: We analyzed 31 patients (median age 15.0 years, 58.1% males, median diabetes duration 7.0 years, hemoglobin A1c [HbA1c] 7.1%). No significant difference has been observed in time spent in hypoglycemia between groups using threshold 70 or 90. Time spent in target was similar in both groups, as well as time spent in hypo or hyperglycemia. The trends of blood glucose over the 3 days in the 2 groups over-lapped without significant differences. CONCLUSIONS: A PLGM threshold of 90 mg/dL during the night was associated with reduced time in hypoglycemia in adolescents doing frequent physical exercise, while maintaining 65.1% time in range during the day. However, a threshold of 70 mg/dL seems to be safe in the duration of the physical exercise. PLGM system in adolescents with type 1 diabetes was effective to prevent hypoglycemia during and after exercise, irrespective of the PLGM thresholds used.
Authors: Artur Myśliwiec; Maria Skalska; Arkadiusz Michalak; Jędrzej Chrzanowski; Małgorzata Szmigiero-Kawko; Agnieszka Lejk; Joanna Jastrzębska; Łukasz Radzimiński; Guillermo F López-Sánchez; Andrzej Gawrecki; Zbigniew Jastrzębski Journal: Int J Environ Res Public Health Date: 2021-01-15 Impact factor: 3.390