Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system

Montt, Denise; Sánchez, Raimundo; Dubois, Karen; Leppe, Jaime; Onetto, María

Publication:
Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system

dc.contributor.author	Montt, Denise
dc.contributor.author	Sánchez, Raimundo
dc.contributor.author	Dubois, Karen
dc.contributor.author	Leppe, Jaime
dc.contributor.author	Onetto, María
dc.date.accessioned	2023-04-26T13:59:22Z
dc.date.available	2023-04-26T13:59:22Z
dc.date.issued	2023
dc.description.abstract	Introduction: Maintaining glycemic control during and after physical activity (PA) is a major challenge in type 1 diabetes (T1D). This study compared the glycemic variability and exercise-related diabetic management strategies of adults with T1D achieving higher and lower PA loads in nighttime-daytime and active- sedentary behavior hours in free-living conditions. Research design and methods: Active adults (n=28) with T1D (ages: 35±10 years; diabetes duration: 21±11 years; body mass index: 24.8±3.4 kg/m2; glycated hemoglobin A1c: 6.9±0.6%) on continuous subcutaneous insulin delivery system with predictive low glucose suspend system and glucose monitoring, performed different types, duration and intensity of PA under free-living conditions, tracked by accelerometer over 14 days. Participants were equally divided into lower load (LL) and higher load (HL) by median of daily counts per minute (61122). Glycemic variability was studied monitoring predefined time in glycemic ranges (time in range (TIR), time above range (TAR) and time below range (TBR)), coefficient of variation (CV) and mean amplitude of glycemic excursions (MAGE). Parameters were studied in defined hours timeframes (nighttime-daytime and active-sedentary behavior). Self-reported diabetes management strategies were analysed during and post-PA. Results: Higher glycemic variability (CV) was observed in sedentary hours compared with active hours in the LL group (p≤0.05). HL group showed an increment in glycemic variability (MAGE) during nighttime versus daytime (p≤0.05). There were no differences in TIR and TAR across all timeframes between HL and LL groups. The HL group had significantly more TBR during night hours than the LL group (p≤0.05). Both groups showed TBR above recommended values. All participants used fewer post-PA management strategies than during PA (p≤0.05). Conclusion: Active people with T1D are able to maintain glycemic variability, TIR and TAR within recommended values regardless of PA loads. However, the high prevalence of TBR and the less use of post-PA management strategies highlights the potential need to increase awareness on actions to avoid glycemic excursions and hypoglycemia after exercise completion.
dc.description.version	Versión Publicada
dc.identifier.citation	Montt-Blanchard D, Sánchez R, Dubois-Camacho K, et al. Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system. BMJ Open Diab Res Care 2023;11:e003082. doi:10.1136/ bmjdrc-2022-003082
dc.identifier.doi	https://doi.org/10.1136/bmjdrc-2022-003082
dc.identifier.uri	https://repositorio.udd.cl/handle/11447/7392
dc.language.iso	en
dc.subject	Diabetes mellitus
dc.subject	Type 1
dc.subject	Exercise
dc.subject	Hyperglycemia
dc.subject	Hypoglycemia
dc.title	Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system
dc.type	Article
dcterms.accessRights	Acceso Abierto
dcterms.source	BMJ open diabetes research & care
dspace.entity.type	Publication