Cardiovascular Diabetology Research Group, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
Applied Sport, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom.
Can J Diabetes. 2020 Dec;44(8):697-700. doi: 10.1016/j.jcjd.2020.03.003. Epub 2020 Mar 22.
Individuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by either pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting hypoglycemia, but it remains unclear which one is more beneficial. The aim of this study was to assess the efficacy of carbohydrate supplementation vs bolus insulin dose reduction in prevention of hypoglycemia during moderate-intensity exercise in those with type 1 diabetes.
This investigation was a retrospective, controlled analysis of 2 independent clinical trials. All participants performed continuous, moderate-intensity cycle ergometer exercise for ∼45 minutes. Two therapy management groups and a control group were compared. Group A was supplemented with 15 to 30 g carbohydrates at a glycemic threshold of 7.0 mmol/L during exercise, group B reduced their individual bolus insulin dose by 50% with their last meal before exercise and group C served as a control.
No hypoglycemic events occurred in group A, whereas 4 events were recorded in groups B (p=0.02) and C (p=0.02).
Carbohydrate supplementation was superior to bolus insulin reduction for prevention of hypoglycemia during exercise in people with type 1 diabetes.
1 型糖尿病患者通过运动前/餐前胰岛素剂量减少和/或运动期间额外摄入碳水化合物来管理运动引起的低血糖风险。这两种策略都已被证明可以有效抵消低血糖，但哪种更有效仍不清楚。本研究旨在评估在 1 型糖尿病患者进行中等强度运动期间，碳水化合物补充与减少胰岛素推注剂量预防低血糖的效果。
这是对 2 项独立临床试验的回顾性对照分析。所有参与者都进行了大约 45 分钟的连续中等强度的脚踏车测力计运动。将两个治疗管理组和一个对照组进行比较。组 A 在运动时，当血糖阈值达到 7.0mmol/L 时，补充 15 至 30 克碳水化合物；组 B 在运动前的最后一餐时将其个体胰岛素推注剂量减少 50%；组 C 作为对照组。
组 A 没有发生低血糖事件，而组 B（p=0.02）和组 C（p=0.02）各发生了 4 起。
在 1 型糖尿病患者运动期间，碳水化合物补充预防低血糖的效果优于胰岛素推注剂量减少。
