Basal Insulin Reduction 90 Minutes Before Exercise Beneficial for Glucose Control, Hypoglycemia Risk in T1D
A 50% to eighty% basal charge discount finished 90 mins earlier than starting exercising will enhance open-loop glucose manage and decrease the hazard for hypoglycemia for the duration of workout in people with type 1 diabetes, in keeping with consequences of a examine published in Diabetes Care. Common techniques for reducing hypoglycemia risk in lively people with kind one diabetes include growing carbohydrate intake earlier than or at some point of exercising and performing a basal charge reduction before beginning the workout routine. Exercise tips for open-loop insulin transport also suggest performing a basal charge reduction at least 60 to ninety mins before exercise, even though there has been restricted the evidence to verify those guidelines. In the current examine, researchers sought to decide the diplomatic strategy for basal charge reductions to minimize hypoglycemia in a cohort of 17 people (imply age, 31 ± ten years) with kind one diabetes the use of continuous subcutaneous insulin infusion. In a randomized crossover design take a look at, contributors finished three 60-minute treadmill sporting activities (at ∼50% peak oxygen consumption). Insulin strategies in the examine protected pump suspension at the begin of exercising, 80% basal price reduction set ninety mins earlier than exercising, and 50% basal fee discount additionally set at ninety mins earlier than exercising. At the onset of workout, blood glucose ranges were better with 50% basal price reduction (191 ± 49 mg/dL) in comparison with 80% basal price reduction (164 ± forty one mg/dL; P <.001) and pump suspension (164 ± 45 mg/dL; P <.001). At the final touch of exercising, the smallest lower in glycemia become found with eighty% basal fee reduction (-31 ± fifty eight mg/dL) vs 50% basal rate reduction (-forty seven ± 50 mg/dL; P =.04) and pump suspension (-sixty seven ± forty one mg/dL; P <.001). There were seven hypoglycemic occasions with pump suspension in comparison with one occasion in each 80% and 50% basal rate reductions (P <.02). After a hot meal after the workout, glucose degrees increased with pump suspension and 50% basal price reduction (each P <.001), but not with 80% basal rate reduction (P =.16). The overnight mean percentage time spent in euglycemia was 83%, 83%, and 78%, and time in hypoglycemia was 2%, 1%, and 5% for 80% basal rate reduction, 50% basal rate reduction, and pump suspension, respectively, based on interstitial glucose (all P >.05).
“These findings guide recent pointers that preplanned [basal rate reduction] well in advance of extended exercise is an effective strategy to reduce hypoglycemia risk and decrease the want for carbohydrate feeding for the duration of the pastime,” the researchers concluded.
Zaharieva DP, McGaugh S, Pooni R, Vienneau T, Ly T, Riddell MC. Improved open-loop glucose manage with basal insulin discount ninety mins earlier than aerobic exercise in patients with kind one diabetes on non-stop subcutaneous insulin infusion [published online February 22, 2019]. Diabetes Care. Doi:10.2337/dc18-2204