Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: A randomized controlled trial

BMJ Open Diabetes Research and Care

Volumn 3, Issue 1, 2015, Pages

  Campbell, Matthew D ^a   Walker, Mark ^b   Bracken, Richard M ^c   Turner, Daniel ^c   Stevenson, Emma J ^a   Gonzalez, Javier T ^a   Shaw, James A ^b   West, Daniel J ^a  

^a NORTHUMBRIA UNIVERSITY   (United Kingdom)

^b NEWCASTLE UNIVERSITY   (United Kingdom)

^c SWANSEA UNIVERSITY   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

GLUCOSE; GLYCOSYLATED HEMOGLOBIN; INSULIN; INSULIN DETEMIR; INSULIN GLARGINE; INTERLEUKIN 6; TUMOR NECROSIS FACTOR ALPHA;

ADULT; ARTICLE; CLINICAL ARTICLE; CONTROLLED STUDY; DIET THERAPY; EXERCISE; GLUCOSE BLOOD LEVEL; HUMAN; INSULIN DEPENDENT DIABETES MELLITUS; MALE; NOCTURNAL HYPOGLYCEMIA; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL;

EID: 84982879467     PISSN: None     EISSN: 20524897     Source Type: Journal    
DOI: 10.1136/bmjdrc-2015-000085     Document Type: Article

References (28)

1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2011;27:S5-S10.
2. Chu L, Hamilton J, Riddell MC. Clinical management of the physically active patient with type 1 diabetes. Phys Sports Med 2011;39:64-77.
3. Metcalf KM, Singhvi A, Tsalikian E, et al. Effects of moderate-tovigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes. Diabetes Care 2014;37:1272-8.
4. Brazeau AS, Rabasa-Lhoret R, Strychar I, et al. Barriers to physical activity among patients with type 1 diabetes. Diabetes Care 2008;31:2108-9.
5. Tsalikian E, Mauras N, Beck RW, et al. Impact of exercise on overnight glycemic control in children with type 1 diabetes mellitus. J Pediatr 2005;147:528-34.
6. Briscoe VJ, Tate DB, Davis SN. Type 1 diabetes: exercise and hypoglycemia. Appl Physiol Nutr Metab 2007;32:576-82.
7. Campbell MD, Walker M, Trenell MI, et al. A low-glycemic index meal and bedtime snack prevents postprandial hyperglycemia and associated rises in inflammatory markers, providing protection from early but not late nocturnal hypoglycemia following evening exercise in type 1 diabetes. Diabetes Care 2014;37:1845-53.
8. Campbell MD, Walker M, Trenell MI, et al. Large pre-and postexercise rapid-acting insulin reductions preserves glycemia and prevents early-but not late-onset hypoglycemia in patients with type 1 diabetes. Diabetes Care 2013;36:2217-24.
9. West DJ, Morton RD, Bain SC, et al. Blood glucose responses to reductions in pre-exercise rapid-acting insulin for 24 h after running in individuals with type 1 diabetes. J Sports Sci 2010;28:781-8.
10. McMahon SK, Ferreira LD, Ratnam N, et al. Glucose requirements to maintain euglycemia after moderate-intensity afternoon exercise in adolescents with type 1 diabetes are increased in a biphasic manner. J Clin Endocrinol Metab 2007;92:963-8.
11. Campbell M, West D, Bain S, et al. Simulated games activity vs continuous running exercise: a novel comparison of the glycemic and metabolic responses in T1DM patients. Scand J Med Sci Sports 2015;25:216-22.
12. Gallen I. Type 1 diabetes. Springer, 2012.
13. Edelmann E, Staudner V, Bachmann W, et al. Exercise-induced hypoglycaemia and subcutaneous insulin infusion. Diabet Med 1986;3:526-31.
14. Sonnenberg G, Kemmer F, Berger M. Exercise in type 1 (insulin-dependent) diabetic patients treated with continuous subcutaneous insulin infusion. Diabetologia 1990;33:696-703.
15. Admon G, Weinstein Y, Falk B, et al. Exercise with and without an insulin pump among children and adolescents with type 1 diabetes mellitus. Pediatrics 2005;116:348-55.
16. Tsalikian E, Kollman C, Tamborlane W, et al. Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin. Diabetes Care 2006;29:2200-4.
17. Clarke WL, Cox DJ, Gonder-Frederick LA, et al. Reduced awareness of hypoglycemia in adults with IDDM: a prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care 1995;18:517-22.
18. Keenan DB, Mastrototaro JJ, Zisser H, et al. Accuracy of the Enlite 6-day glucose sensor with guardian and Veo calibration algorithms. Diabetes Technol Ther 2012;14:225-31.
19. Robertson K, Adolfsson P, Scheiner G, et al. Exercise in children and adolescents with diabetes. Pediatr Diabetes 2009;10(s12): 154-68.
20. Campbell MD, Walker M, Trenell MI, et al. Metabolic implications when employing heavy pre-and post-exercise rapid-acting insulin reductions to prevent hypoglycaemia in type 1 diabetes patients: a randomised clinical trial. PLoS ONE 2014;9:e97143. http://journals.plos.org/plosone/article?id=10.1371/journal.pone. 0097143 (accessed 18 Jan 2015).
21. West DJ, Stephens JW, Bain SC, et al. A combined insulin reduction and carbohydrate feeding strategy 30 min before running best preserves blood glucose concentration after exercise through improved fuel oxidation in type 1 diabetes mellitus. J Sports Sci 2011;29:279-89.
22. Medicine ACoS. ACSM 's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, 2013.
23. Dill D, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 1974;37:247-8.
24. Wolever TM, Jenkins D. The use of the glycemic index in predicting the blood glucose response to mixed meals. Am J Clin Nutr 1986;43:167-72.
25. West D, Morton R, Stephens J, et al. Isomaltulose improves post-exercise glycemia by reducing CHO oxidation in T1DM. J Med Sci Sports Exerc 2011;43:204-10.
26. Rosa JS, Oliver SR, Flores RL, et al. Altered inflammatory, oxidative, and metabolic responses to exercise in pediatric obesity and type 1 diabetes. Pediatr Diabetes 2011;12:464-72.
27. Desjardins K, Brazeau AS, Strychar I. Are bedtime nutritional strategies effective in preventing nocturnal hypoglycaemia in patients with type 1 diabetes? Diabetes Obes Metab 2014;16:577-87.
28. Plotnikoff RC, Taylor LM, Wilson PM, et al. Factors associated with physical activity in Canadian adults with diabetes. Med Sci Sports Exerc 2006;38:1526-34.