Melissa H Lee1,2, Sara Vogrin1, Barbora Paldus1, Dilshani Jayawardene1, Hannah M Jones1,2, Sybil A McAuley1,2, Varuni Obeyesekere2, Judith Gooley1, André La Gerche3,4, Richard J MacIsaac1,2, Vijaya Sundararajan1,5, Alicia J Jenkins1,2,6, Glenn M Ward2,7, David N O'Neal8,2. 1. University of Melbourne, Department of Medicine, Melbourne, Australia. 2. Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Melbourne, Australia. 3. Department of Cardiology, St Vincent's Hospital Melbourne, Melbourne, Australia. 4. Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Australia. 5. Department of Public Health, La Trobe University, Melbourne, Australia. 6. NHMRC Clinical Trials Centre at the University of Sydney, Sydney, Australia. 7. Department of Pathology, University of Melbourne, Melbourne, Australia. 8. University of Melbourne, Department of Medicine, Melbourne, Australia dno@unimelb.edu.au.
Abstract
OBJECTIVE: To evaluate exercise-related glucose and counterregulatory responses (CRR) in adults with type 1 diabetes with impaired awareness of hypoglycemia (IAH) usinghybrid closed-loop (HCL) insulin delivery to maintain glucose homeostasis. RESEARCH DESIGN AND METHODS: Twelve participants undertook 45-min high-intensity intermittent exercise (HIIE) and moderate-intensity exercise (MIE) in random order. The primary outcome was continuous glucose monitoring (CGM) time in range (70-180 mg/dL) for 24-h post-exercise commencement. RESULTS:CGM time in range was similar for HIIE and MIE (median 79.5% [interquartile range 73.2, 87.6] vs. 76.1% [70.3, 83.9], P = 0.37), and time with levels <54mg/dL post-exercise commencement was 0%. HIIE induced greater increases in cortisol (P = 0.002), noradrenaline (P = 0.005), and lactate (P = 0.002), with no differences in adrenaline, dopamine, growth hormone, or glucagon responses. CONCLUSIONS:IAH adults using HCL undertaking HIIE and MIE exhibit heterogeneity in CRR. Novel findings were a preserved cortisol response and variable catecholamine responses to HIIE.
RCT Entities:
OBJECTIVE: To evaluate exercise-related glucose and counterregulatory responses (CRR) in adults with type 1 diabetes with impaired awareness of hypoglycemia (IAH) using hybrid closed-loop (HCL) insulin delivery to maintain glucose homeostasis. RESEARCH DESIGN AND METHODS: Twelve participants undertook 45-min high-intensity intermittent exercise (HIIE) and moderate-intensity exercise (MIE) in random order. The primary outcome was continuous glucose monitoring (CGM) time in range (70-180 mg/dL) for 24-h post-exercise commencement. RESULTS:CGM time in range was similar for HIIE and MIE (median 79.5% [interquartile range 73.2, 87.6] vs. 76.1% [70.3, 83.9], P = 0.37), and time with levels <54mg/dL post-exercise commencement was 0%. HIIE induced greater increases in cortisol (P = 0.002), noradrenaline (P = 0.005), and lactate (P = 0.002), with no differences in adrenaline, dopamine, growth hormone, or glucagon responses. CONCLUSIONS:IAH adults using HCL undertaking HIIE and MIE exhibit heterogeneity in CRR. Novel findings were a preserved cortisol response and variable catecholamine responses to HIIE.
Authors: Barbora Paldus; Melissa H Lee; Dale Morrison; Dessi P Zaharieva; Hannah Jones; Varuni Obeyesekere; Jean Lu; Sara Vogrin; André LaGerche; Sybil A McAuley; Richard J MacIsaac; Alicia J Jenkins; Glenn M Ward; Peter Colman; David N O'Neal Journal: J Diabetes Sci Technol Date: 2021-07-27