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Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial

Othmar Moser, Max Eckstein, Alexander Mueller, Philipp Birnbaumer, Felix Aberer, Gerd Koehler, Caren Sourij, Harald Kojzar, Peter Holler, Helmut Simi, Peter Pferschy, Pavel Dietz, Richard Bracken Orcid Logo, Peter Hofmann, Harald Sourij

Diabetes, Obesity and Metabolism, Volume: 21, Issue: 2, Pages: 349 - 356

Swansea University Authors: Othmar Moser, Max Eckstein, Richard Bracken Orcid Logo

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DOI (Published version): 10.1111/dom.13534

Abstract

AimsThough basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra‐long‐acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during...

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Published in: Diabetes, Obesity and Metabolism
ISSN: 1462-8902
Published: 2018
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa44852
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Abstract: AimsThough basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra‐long‐acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during five consecutive days of moderate‐intensity exercise, on either 100% or 75% of their usual insulin degludec (IDeg) dose.Material and MethodsNine participants with T1D (4 females, mean age 32.1±9.0 years, BMI 25.5±3.8 kg/m2, HbA1c 7.2±0.6% (55±7 mmol.mol‐1) on IDeg were enrolled in the trial. Three days before the first exercise period participants were randomised to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 min at a moderate intensity for five consecutive days. After a four‐week wash‐out period, participants performed the last exercise period for five consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve (AUC) and numbers of hypoglycaemic events were compared for the five days at each treatment allocation via paired students’ t‐test, Wilcoxon matched‐pairs signed‐rank test and two‐way ANOVA.ResultsTime spent in euglycaemia over five days was greater for 75%IDeg dose versus 100%IDeg dose (4008±938 min vs. 3566±856 min, p=0.04). Numbers of hypoglycaemic events (p=0.91) and time spent in hypo‐ (p=0.07) or hyperglycaemia (p=0.38) was similar for both dosing schemes.ConclusionsA 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia with small effects on time spent in hypo‐ and hyperglycaemia.
College: Faculty of Science and Engineering
Issue: 2
Start Page: 349
End Page: 356

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