Endocrinology Unit, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
Internal Medicine Department, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
Diabetes Technol Ther. 2024 Nov;26(11):823-828. doi: 10.1089/dia.2023.0589. Epub 2024 Sep 30.
To compare the safety in terms of hypoglycemic events and continuous glucose monitoring (CGM) metrics during aerobic exercise (AE) of using temporary target (TT) versus suspension of insulin infusion (SII) in adults with type 1 diabetes (T1D) using advanced hybrid closed-loop systems. This was a randomized crossover clinical trial. Two moderate-intensity AE sessions were performed, one with TT and one with SII. Hypoglycemic events and CGM metrics were analyzed during the immediate (baseline to 59 min), early (60 min to 6 h), and late (6 to 36 h) post-exercise phases. In total, 33 patients were analyzed (44.6 ± 13.8 years), basal time in range (%TIR 70-180 mg/dL) was 79.4 ± 12%, and time below range (%TBR) <70 mg/dL was 1.8 ± 1.7% and %TBR <54 mg/dL was 0.5 ± 0.9%. No difference was found in the number of hypoglycemic events, %TBR <70 mg/dL and %TBR <54 mg/dL between TT and SII. Differences were found in the early phase, with better values when using TT for %TIR 70-180 mg/dL (83.0 vs. 65.3, = 0.005), time in tight range (%TITR 70-140 mg/dL) (56.3 vs. 41.5, = 0.04), and time above range (%TAR >180 mg/dL) (15.3 vs. 31.8, = 0.01). In the diurnal period, again %TIR was better for TT use (82.1 vs. 73.1, = 0.02) and %TAR (15.0 vs. 22.96, = 0.04). No significant differences were found in the CGM metrics during the different phases of AE. Our data appear to show that the use of TT compared with SII is equally safe in all phases of AE. However, the use of TT allows for a better glycemic profile in the early phase of exercise.
比较使用先进的混合闭环系统的 1 型糖尿病（T1D）成人在有氧运动（AE）期间使用临时目标（TT）与暂停胰岛素输注（SII）的安全性，在低血糖事件和连续血糖监测（CGM）指标方面。这是一项随机交叉临床试验。进行了两次中等强度的 AE 疗程，一次使用 TT，一次使用 SII。分析运动后即刻（基线至 59 分钟）、早期（60 分钟至 6 小时）和晚期（6 至 36 小时）的低血糖事件和 CGM 指标。共有 33 名患者进行了分析（44.6±13.8 岁），范围内的基础时间（%TIR 70-180mg/dL）为 79.4±12%，低于范围的时间（%TBR）<70mg/dL 为 1.8±1.7%，低于范围的时间（%TBR）<54mg/dL 为 0.5±0.9%。TT 和 SII 之间在低血糖事件、%TBR<70mg/dL 和%TBR<54mg/dL 的数量上没有差异。在早期阶段发现了差异，TT 时的 %TIR 70-180mg/dL（83.0 对 65.3，=0.005）、紧密范围时间（%TITR 70-140mg/dL）（56.3 对 41.5，=0.04）和范围时间（%TAR>180mg/dL）（15.3 对 31.8，=0.01）的值更好。在日间期间，TT 时的%TIR 再次更好（82.1 对 73.1，=0.02）和%TAR（15.0 对 22.96，=0.04）。AE 不同阶段的 CGM 指标均无显着差异。我们的数据似乎表明，与 SII 相比，TT 的使用在 AE 的所有阶段同样安全。然而，TT 的使用可以在运动的早期阶段提供更好的血糖谱。
