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Efficacy of carbohydrate supplementation compared to bolus insulin dose reduction around exercise in adults with type 1 diabetes: a retrospective controlled analysis / Max L. Eckstein; Olivia McCarthy; Norbert J. Tripolt; Alexander Müller; Philipp Birnbaumer; Peter N. Pferschy; Peter Hofmann; Richard Bracken; Harald Sourij; Othmar Moser

Canadian Journal of Diabetes

Swansea University Authors: Olivia, McCarthy, Richard, Bracken

  • Accepted Manuscript under embargo until: 22nd March 2021

Abstract

IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence aga...

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Published in: Canadian Journal of Diabetes
ISSN: 1499-2671
Published: Elsevier BV
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa53869
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Abstract: IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence against hypoglycemia, it is unclear as to which one is more beneficial. Consequently, the aim of this study was to assess the efficacy of carbohydrate supplementation in comparison to bolus insulin dose reduction to prevent hypoglycemia during moderate-intensity exercise in individuals with type 1 diabetes.MethodsThis was a retrospective controlled analysis of two independent clinical trials. All participants performed a continuous moderate-intensity cycle ergometer exercise session for ∼45 minutes. Two different therapy management groups and a control group were compared: Group (A) supplemented 15 – 30 g carbohydrates at a glycemic threshold of 7.0 mmol/L during exercise, group (B) reduced their individual bolus insulin dose by 50% with their last meal prior to exercise and group (C) remained as a control.ResultsNo hypoglycemic events occurred in group A, which differed to each four events recorded in groups B (p = 0.02) and C (p = 0.02).ConclusionCarbohydrate supplementation was superior to bolus insulin reductions in the prevention of hypoglycemia during exercise in people with type 1 diabetes.
Keywords: Physical Exercise, Type 1 Diabetes, Insulin Therapy, Carbohydrates