Insulin Pump Therapy Is Associated with Less Post-Exercise Hyperglycemia than Multiple Daily Injections: An Observational Study of Physically Active Type 1 Diabetes Patients.
ABSTRACT Abstract Background: Aerobic exercise typically decreases blood glucose levels in individuals with type 1 diabetes. It is currently unknown if glucose responses to exercise and recovery differ between patients on multiple daily insulin injections (MDI) and continuous subcutaneous insulin infusion (CSII). Subjects and Methods: Nineteen (16 male, three female) physically active individuals with type 1 diabetes took part in this observational study. Interstitial glucose levels (blinded) were compared during 45 min of standardized aerobic exercise (cycling or running at 60% peak aerobic capacity) and during 6 h of postexercise recovery between individuals using MDI (n=9) and CSII (n=10) therapy. Results: Both MDI and CSII groups had similar reductions in glucose levels during exercise, but responses in early and late recovery differed (group×time interaction, P<0.01). Participants using MDI had greater increases in glucose throughout recovery compared with individuals with CSII. Two-thirds of the MDI patients experienced late-onset post-exercise hyperglycemia (blood glucose >12 mmol/L) compared with only 1/10(th) of the CSII patients (P<0.01). Conclusions: Among individuals performing regular moderate-to-heavy intensity aerobic exercise, use of CSII helped to limit post-exercise hyperglycemia compared with MDI therapy and is not associated with increased risk for post-exercise late-onset hypoglycemia.
Diabetes Technology & Therapeutics 05/2014; DOI:10.1089/dia.2014.0097 · 2.29 Impact Factor
Pediatric Diabetes 09/2014; 15(Suppl 20):203-23. DOI:10.1111/pedi.12176 · 2.13 Impact Factor
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ABSTRACT: To provide an understanding of both the preclinical and clinical aspects of closed-loop artificial pancreas systems, we provide a discussion of this topic as part of this two-part Bench to Clinic narrative. Here, the Bench narrative provides an in-depth understanding of insulin-glucose-glucagon physiology in conditions that mimic the free-living situation to the extent possible in type 1 diabetes that will help refine and improve future closed-loop system algorithms. In the Clinic narrative, Doyle and colleagues compare and evaluate technology used in current closed-loop studies to gain further momentum toward outpatient trials and eventual approval for widespread use.Diabetes care 05/2014; 37(5):1184-90. DOI:10.2337/dc13-2066 · 8.57 Impact Factor