Department of Medicine, University of Melbourne, Melbourne, Australia.
Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia.
Diabetes Technol Ther. 2022 Dec;24(12):873-880. doi: 10.1089/dia.2022.0279.
To compare evening and overnight hypoglycemia risk after late afternoon exercise with a nonexercise control day in adults with type 1 diabetes using automated insulin delivery (AID). Thirty adults with type 1 diabetes using AID (Minimed 670G) performed in random order 40 min high intensity interval aerobic exercise (HIE), resistance (RE), and moderate intensity aerobic exercise (MIE) exercise each separated by >1 week. The closed-loop set-point was temporarily increased 2 h pre-exercise and a snack eaten if plasma glucose was ≤126 mg/dL pre-exercise. Exercise commenced at ∼16:00. A standardized meal was eaten at ∼20:40. Hypoglycemic events were defined as a continuous glucose monitor (CGM) reading <70 mg/dL for ≥15 min. Four-hour postevening meal and overnight (00:00-06:00) CGM metrics for exercise were compared with the prior nonexercise day. There was no severe hypoglycemia. Between 00:00 and 06:00, the proportion of nights with hypoglycemia did not differ postexercise versus control for HIE (18% vs. 11%; = 0.688), RE (4% vs. 14%; = 0.375), and MIE (7% vs. 14%; = 0.625). Time in range (TIR) (70-180 mg/dL), >75% for all nights, did not differ between exercise conditions and control. Hypoglycemia episodes postmeal after exercise versus control did not differ for HIE (22% vs. 7%; = 0.219) and MIE (10% vs. 14%; > 0.999), but were greater post-RE (39% vs. 10%; = 0.012). Overnight TIR was excellent with AID without increased hypoglycemia postexercise between 00:00 and 06:00 compared with nonexercise days. In contrast, hypoglycemia risk was increased after the first meal post-RE, suggesting the importance of greater vigilance and specific guidelines for meal-time dosing, particularly with vigorous RE. ACTRN12618000905268.
比较使用自动胰岛素输送（AID）的 1 型糖尿病成人在下午晚些时候进行运动与非运动对照日时夜间和夜间低血糖风险。30 名使用 AID（Minimed 670G）的 1 型糖尿病成人以随机顺序进行 40 分钟高强度间歇有氧运动（HIE）、阻力（RE）和中等强度有氧运动（MIE）运动，每次运动间隔>1 周。闭环设定点在运动前 2 小时暂时增加，如果运动前血浆葡萄糖≤126mg/dL，则进食零食。运动于 16:00 左右开始。20:40 左右吃一顿标准化的餐。低血糖事件定义为连续血糖监测仪（CGM）读数<70mg/dL 持续 15 分钟以上。将运动后的 4 小时晚餐后和夜间（00:00-06:00）CGM 指标与之前的非运动日进行比较。没有严重低血糖。在 00:00 到 06:00 之间，与对照相比，HIE（18% vs. 11%； = 0.688）、RE（4% vs. 14%； = 0.375）和 MIE（7% vs. 14%； = 0.625）后夜间发生低血糖的比例没有差异。所有夜间的时间在范围内（TIR）（70-180mg/dL）均为 70%，在运动条件和对照之间没有差异。与对照相比，HIE（22% vs. 7%； = 0.219）和 MIE（10% vs. 14%； > 0.999）后运动后餐后的低血糖发作并没有差异，但在 RE 后更大（39% vs. 10%； = 0.012）。与非运动日相比，使用 AID 后，00:00 到 06:00 之间夜间 TIR 极好，没有增加运动后的低血糖。相比之下，RE 后的第一餐后低血糖风险增加，这表明需要更加警惕，并为餐时给药制定具体指南，特别是在进行剧烈的 RE 时。ACTRN12618000905268。
