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Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
Author(s) -
Moser Othmar,
Eckstein Max L.,
Mueller Alexander,
Birnbaumer Philipp,
Aberer Felix,
Koehler Gerd,
Sourij Caren,
Kojzar Harald,
Holler Peter,
Simi Helmut,
Pferschy Peter,
Dietz Pavel,
Bracken Richard M.,
Hofmann Peter,
Sourij Harald
Publication year - 2019
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13534
Subject(s) - medicine , glycated haemoglobin , dosing , crossover study , insulin degludec , randomized controlled trial , body mass index , randomization , diabetes mellitus , physical therapy , type 2 diabetes , endocrinology , placebo , insulin glargine , alternative medicine , pathology
Aims To compare the time spent in specified glycaemic ranges in people with type 1 diabetes (T1D) during 5 consecutive days of moderate‐intensity exercise while on either 100% or 75% of their usual insulin degludec (IDeg) dose. Materials and Methods Nine participants with T1D (four women, mean age 32.1 ± 9.0 years, body mass index 25.5 ± 3.8 kg/m 2 , glycated haemoglobin 55 ± 7 mmol/mol (7.2% ± 0.6%) on IDeg were enrolled in the trial. Three days before the first exercise period, participants were randomized to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 minutes at a moderate intensity for 5 consecutive days. After a 4‐week wash‐out period, participants performed the last exercise period for 5 consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve and numbers of hypoglycaemic events were compared for the 5 days on each treatment allocation using a paired Students' t test, Wilcoxon matched‐pairs signed‐rank test and two‐way ANOVA. Results Time spent in euglycaemia over 5 days was greater for the 75% IDeg dose versus the 100% IDeg dose (4008 ± 938 minutes vs. 3566 ± 856 minutes; P = 0.04). Numbers of hypoglycaemic events ( P = 0.91) and time spent in hypoglycaemia ( P = 0.07) or hyperglycaemia ( P = 0.38) was similar for both dosing schemes. Conclusions A 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia, with small effects on time spent in hypo‐ and hyperglycaemia.