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.
Melissa H Lee; Sara Vogrin; Barbora Paldus; Dilshani Jayawardene; Hannah M Jones; Sybil A McAuley; Varuni Obeyesekere; Judith Gooley; André La Gerche; Richard J MacIsaac; Vijaya Sundararajan; Alicia J Jenkins; Glenn M Ward; David N O'Neal
Abstract
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.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.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], = 0.37), and time with levels <54mg/dL post-exercise commencement was 0%. HIIE induced greater increases in cortisol ( = 0.002), noradrenaline ( = 0.005), and lactate ( = 0.002), with no differences in adrenaline, dopamine, growth hormone, or glucagon responses.PIAH adults using HCL undertaking HIIE and MIE exhibit heterogeneity in CRR. Novel findings were a preserved cortisol response and variable catecholamine responses to HIIE.
| Journal | DIABETES CARE |
| ISSN | 1935-5548 |
| Published | 01 Feb 2020 |
| Volume | 43 |
| Issue | 2 |
| Pages | 480-483 |
| DOI | 10.2337/dc19-1433 |
| Type | Journal Article |
| Sponsorship |