Gardner Daphne, Tan Hong Chang, Lim Gek Hsiang, Zin Oo May, Xin Xiaohui, Kingsworth Andrew, Choudhary Pratik, Rama Chandran Suresh
Department of Endocrinology, Academia, Singapore General Hospital, Singapore.
Health Sciences Research Unit, Singapore General Hospital, Singapore.
J Diabetes Sci Technol. 2025 Mar;19(2):377-384. doi: 10.1177/19322968231186401. Epub 2023 Jul 12.
Nocturnal hypoglycemia (NH) remains a major burden for people with type 1 diabetes (T1D). Daytime physical activity (PA) increases the risk of NH. This pilot study tested whether cumulative daytime PA measured using a smartphone-based step tracker was associated with NH.
Adults with T1D for ≥ 5 years (y) on multiple daily insulin or continuous insulin infusion, not using continuous glucose monitoring and HbA1c 6 to 10% wore blinded Freestyle Libre Pro sensors and recorded total daily carbohydrate (TDC) and total daily dose (TDD) of insulin. During this time, daily step count (DSC) was tracked using the smartphone-based Fitbit MobileTrack application. Mixed effects logistic regression was used to estimate the effect of DSC on NH (sensor glucose <70, <54 mg/dl for ≥15 minutes), while adjusting for TDC and TDD of insulin, and treating participants as a random effect.
Twenty-six adults, with 65.4% females, median age 27 years (interquartile range: 26-32) mean body mass index 23.9 kg/m, median HbA1c 7.6% (7.1-8.1) and mean Gold Score 2.1 (standard deviation 1.0) formed the study population. The median DSC for the whole group was 2867 (1820-4807). There was a significant effect of DSC on NH episodes <70 mg/dl. (odds ratio 1.11 [95% CI: 1.01-1.23, = .04]. There was no significant effect on NH <54 mg/dl.
Daily PA measured by a smartphone-based step tracker was associated with the risk of NH in people with type 1 diabetes.
夜间低血糖（NH）仍然是1型糖尿病（T1D）患者的主要负担。白天的身体活动（PA）会增加夜间低血糖的风险。这项初步研究测试了使用基于智能手机的步数追踪器测量的累积白天身体活动是否与夜间低血糖有关。
使用多次每日胰岛素注射或持续胰岛素输注治疗≥5年的1型糖尿病成年患者，未使用持续葡萄糖监测且糖化血红蛋白（HbA1c）为6%至10%，佩戴盲法Freestyle Libre Pro传感器，并记录每日总碳水化合物（TDC）和胰岛素每日总剂量（TDD）。在此期间，使用基于智能手机的Fitbit MobileTrack应用程序追踪每日步数（DSC）。采用混合效应逻辑回归估计DSC对NH（传感器葡萄糖<70，<54 mg/dl持续≥15分钟）的影响，同时调整胰岛素的TDC和TDD，并将参与者视为随机效应。
26名成年人组成了研究人群，其中65.4%为女性，中位年龄27岁（四分位间距：26 - 32），平均体重指数23.9 kg/m，中位HbA1c 7.6%（7.1 - 8.1），平均金氏评分2.1（标准差1.0）。整个组的中位DSC为2867（1820 - 4807）。DSC对<70 mg/dl的NH发作有显著影响（优势比1.11 [95%置信区间：1.01 - 1.23，P = 0.04]）。对<54 mg/dl的NH无显著影响。
基于智能手机的步数追踪器测量的每日身体活动与1型糖尿病患者的夜间低血糖风险相关。
