1. Glucose and Counterregulatory Responses to Exercise in Adults With Type 1 Diabetes and Impaired Awareness of Hypoglycemia Using Closed-Loop Insulin Delivery: A Randomized Crossover Study
- Author
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Dilshani Jayawardene, Judith L. Gooley, Hannah Jones, Richard J MacIsaac, David N O'Neal, Varuni R. Obeyesekere, Sybil A McAuley, Barbora Paldus, Melissa H Lee, Alicia J. Jenkins, Vijaya Sundararajan, Sara Vogrin, Glenn M. Ward, and Andre La Gerche
- Subjects
Adult ,Blood Glucose ,Male ,Research design ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Hypoglycemia ,03 medical and health sciences ,Insulin Infusion Systems ,0302 clinical medicine ,Insulin, Regular, Human ,Internal medicine ,Blood Glucose Self-Monitoring ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Insulin ,Glucose homeostasis ,Cognitive Dysfunction ,Lactic Acid ,030212 general & internal medicine ,Exercise ,Feedback, Physiological ,Advanced and Specialized Nursing ,Type 1 diabetes ,Cross-Over Studies ,business.industry ,Awareness ,Middle Aged ,medicine.disease ,Crossover study ,Diabetes Mellitus, Type 1 ,Glucose ,Cardiology ,Female ,business - Abstract
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 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.
- Published
- 2019