Seckold Rowen, Smart Carmel E, O'Neal David N, Riddell Michael C, Rafferty Jordan, Morrison Dale, Obeyesekere Varuni, Gooley Judy L, Paldus Barbora, Valkenborghs Sarah R, Vogrin Sara, Zaharieva Dessi P, King Bruce R
Department of Paediatric Diabetes and Endocrinology, John Hunter Children's Hospital, New Lambton Heights, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, New Lambton Heights, New South Wales, Australia.
Diabetes Technol Ther. 2025 Apr;27(4):308-322. doi: 10.1089/dia.2024.0254. Epub 2025 Jan 9.
To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. Twenty-eight adolescents (average age 16.3 ± 2.1 years, 50% females, average duration of T1D 9.4 ± 4 years) using HCL (Medtronic MiniMed 670G) undertook 40 min of MIE, HIE, and RE. A temporary glucose target (8.3 mmol/L, 150 mg/dL) was set for 2 h prior and during exercise. Heart rate, accelerometer, venous glucose, lactate, ketones, and counter-regulatory hormones were measured for 280 min postexercise commencement. The primary outcome was glucose percentage time in range (TIR): 3.9-10 mmol/L (70-180 mg/dL) for 14 h from exercise onset. Median (interquartile range) TIR for HIE was 88 (78, 96)%, MIE 79 (63, 88)%, and RE 86 (72, 95)% for 14 h from exercise onset. For MIE compared with HIE, TIR was lower ( = 0.012) and time above range (TAR) was greater (18 [2.4, 28] vs. 6.9 [0.0, 14]%, = 0.041). Hypoglycemia occurred in 13 (46%), 11 (39%), and 14 (50%) of participants for HIE, MIE, and RE, respectively, the majority following the meal after exercise. There were higher levels of lactate ( = 0.001), growth hormone ( = 0.001), noradrenaline ( = 0.001), and heart rate ( = 0.01) during HIE and RE compared with MIE. : HCL use in adolescents with T1D results in excellent TIR during different forms of exercise when a temporary target is set 2 h before. Extending the temporary target after exercise may also be needed to help minimize postexercise hypoglycemia.
在使用混合闭环（HCL）胰岛素泵的1型糖尿病（T1D）青少年中，比较中等强度运动（MIE）、高强度间歇运动（HIE）和抗阻运动（RE）期间及之后的血糖结果，同时测量与活动相关的其他生理信号。28名使用HCL（美敦力MiniMed 670G）的青少年（平均年龄16.3±2.1岁，50%为女性，T1D平均病程9.4±4年）进行了40分钟的MIE、HIE和RE。在运动前2小时及运动期间设定临时血糖目标（8.3 mmol/L，150 mg/dL）。在运动开始后280分钟测量心率、加速度计、静脉血糖、乳酸、酮体和反调节激素。主要结局是运动开始后14小时内血糖处于目标范围的时间百分比（TIR）：3.9 - 10 mmol/L（70 - 180 mg/dL）。运动开始后14小时，HIE的TIR中位数（四分位间距）为88（78，96）%，MIE为79（63，88）%，RE为86（72，95）%。与HIE相比，MIE的TIR较低（P = 0.012），高于目标范围的时间（TAR）较高（18 [2.4，28]% 对 6.9 [0.0，14]%，P = 0.041）。HIE、MIE和RE的参与者中分别有13名（46%）、11名（39%）和14名（50%）发生低血糖，大多数发生在运动后的餐后。与MIE相比，HIE和RE期间的乳酸水平（P = 0.001）、生长激素水平（P = 0.001）、去甲肾上腺素水平（P = 0.001）和心率（P = 0.01）更高。结论：在T1D青少年中使用HCL，当在运动前2小时设定临时目标时，在不同形式的运动中可产生优异的TIR。运动后可能还需要延长临时目标以帮助最小化运动后低血糖。
