Impact of exercise on glucose in patients with type 1 diabetes who use a hybrid closed-loop system with the use of a temporary objective
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Keywords

Aerobic exercise
resistance exercise
Automated Insulin Delivery
Hybrid Closed loop system
time in range
hypoglycemia

How to Cite

Gómez Medina, A. M., Henao Carrillo, D. C. ., Robledo, S., Buendia, R., Jaramillo, P., & Muñoz , O. M. . (2022). Impact of exercise on glucose in patients with type 1 diabetes who use a hybrid closed-loop system with the use of a temporary objective. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 9(3). https://doi.org/10.53853/encr.9.3.721

Abstract

Introduction: The consensus on exercise management for patients with type 1 diabetes (T1D) does not include recommendations for patients using hybrid closed loop (HCL) systems. Objective: to describe the behavior of interstitial glucose during aerobic exercise (AE) and resistance exercise (RE) in patients with T1D users of HCL systems.

Methodology: Observational pilot study. Patients >18 years of age treated with HCL system were included. Baseline demographic data was recorded and moderate intensity AE and RE physical activity sessions were scheduled according to the consensus recommendations. In both sessions, it was indicated to use a temporary goal 60 minutes before and to measure capillary glucose during physical activity (baseline, 15, 30, 45 and 60 minutes). At the end of the exercise sessions, the data was downloaded from the device.

Results: 10 patients were included (80% women, mean age 41.1±11.8 years) with an TIR between 70-180 mg/dl >90%. During EA the mean basal glucose, 15,13,45 and 60 minutes were 147.1±24.1mg/dl, 131.4±15.5mg/dl, 131.4±15.5mg/dl, 107.9±17mg/dl and 101.3±19.5mg/dl, p <0.05, respectively. During the ER no significant changes were observed with respect to basal glucose. 36 hours after physical activity, there were 2.75 level 1 hypoglycemic events, without severe hypoglycemia.

Conclusions: EA lowers glucose levels early and significantly, while ER glucose levels remain stable. The data reported in this study suggest that the use of SCHA following the consensus guidelines and programming the time goal is safe.

https://doi.org/10.53853/encr.9.3.721
PDF (Español (España))

References

Referencias.

Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN, et al. Exercise management in type 1 diabetes: a consensus statement. lancet Diabetes Endocrinol. 2017 May;5(5):377–90.

Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016 Nov;39(11):2065–79.

Gomez AM, Gomez C, Aschner P, Veloza A, Muñoz O, Rubio C, et al. Effects of performing morning versus afternoon exercise on glycemic control and hypoglycemia frequency in type 1 diabetes patients on sensor-augmented insulin pump therapy. J Diabetes Sci Technol. 2015 May;9(3):619–24.

Camacho RC, Galassetti P, Davis SN, Wasserman DH. Glucoregulation during and after exercise in health and insulin-dependent diabetes. Exerc Sport Sci Rev. 2005 Jan;33(1):17–23.

Moser O, Riddell MC, Eckstein ML, Adolfsson P, Rabasa-Lhoret R, van den Boom L, et al. Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA). Pediatr Diabetes. 2020 Dec;21(8):1375–93.

Cohen O, Vigersky RA, Lee SW, Cordero TL, Kaufman FR. Automated Insulin Delivery System Nomenclature. Diabetes Technol Ther. 2017 Jun;19(6):379–80.

Aleppo G, Webb KM. INTEGRATED INSULIN PUMP AND CONTINUOUS GLUCOSE MONITORING TECHNOLOGY IN DIABETES CARE TODAY: A PERSPECTIVE OF REAL-LIFE EXPERIENCE WITH THE MINIMED(TM) 670G HYBRID CLOSED-LOOP SYSTEM. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol. 2018 Jul;24(7):684–92.

Gómez AM, Henao D, Parra D, Kerguelen A, Pinilla MV, Muñoz OM, et al. Virtual training on the hybrid close loop system in people with type 1 diabetes (T1D) during the COVID-19 pandemic. Diabetes Metab Syndr. 2021 Jan;15(1):243–7.

Garg SK, Weinzimer SA, Tamborlane W V, Buckingham BA, Bode BW, Bailey TS, et al. Glucose Outcomes with the In-Home Use of a Hybrid Closed-Loop Insulin Delivery System in Adolescents and Adults with Type 1 Diabetes. Diabetes Technol Ther. 2017 Mar;19(3):155–63.

Gomez AM, Gomez C, Aschner P, Veloza A, Muñoz O, Rubio C, et al. Effects of Performing Morning Versus Afternoon Exercise on Glycemic Control and Hypoglycemia Frequency in Type 1 Diabetes Patients on Sensor-Augmented Insulin Pump Therapy. J Diabetes Sci Technol [Internet]. 2015;9(3):619–24. Available from: http://journals.sagepub.com/doi/10.1177/1932296814566233

Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, et al. Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range. Diabetes Care. 2019 Aug;42(8):1593–603.

Lee MH, Vogrin S, Paldus B, Jayawardene D, Jones HM, McAuley SA, et al. Glucose and Counterregulatory Responses to Exercise in Adults With Type 1 Diabetes and Impaired Awareness of Hypoglycemia Using Closed-Loop Insulin Delivery: A Randomized Crossover Study. Diabetes Care. 2020 Feb;43(2):480–3.

Houlder SK, Yardley JE. Continuous Glucose Monitoring and Exercise in Type 1 Diabetes: Past, Present and Future. Biosensors. 2018 Aug;8(3).

Petruzelkova L, Soupal J, Plasova V, Jiranova P, Neuman V, Plachy L, et al. Excellent Glycemic Control Maintained by Open-Source Hybrid Closed-Loop AndroidAPS During and After Sustained Physical Activity. Diabetes Technol Ther. 2018 Nov;20(11):744–50.

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Copyright (c) 2022 Revista Colombiana de Endocrinología, Diabetes & Metabolismo

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