Specific Insulin-Based Exercise Strategies May Help Avoid Hypoglycemia with Pump Therapy
Insulin-based exercise strategies may be the best way to avoid hypoglycemia while using insulin pumps.
(HealthDay News) — Insulin-based strategies of basal rate reduction or pump cessation may be the best approach in avoiding hypoglycemia associated with exercise after lunch, according to a study published in Diabetes, Obesity & Metabolism.
Sylvia Franc, MD, from the Centre for Study and Research for Improvement of the Treatment of Diabetes in Evry, France, and colleagues validated strategies to prevent exercise-induced hypoglycemia via insulin dose adjustment.
Twenty adults with type 1 diabetes on pump therapy were randomly assigned to perform 4 30-minute late post-lunch exercise sessions (2 moderate sessions with 50% or 80% basal rate [BR] reduction during exercise, and 2 intense sessions, with 80% BR reduction or with their pump stopped; all performed 3 hours after lunch) and a rest session. Hypoglycemia incidence was compared for BR reduction vs bolus reduction in 2 early post-lunch sessions (90 minutes after lunch).
The researchers found that, compared with the rest session, in the afternoon, no more hypoglycemia events occurred with 80% BR reduction/moderate exercise or with pump discontinuation/intense exercise, while more hypoglycemic events occurred with 50% BR reduction/moderate exercise and 80% BR reduction/intense exercise.
There was a trend toward fewer hypoglycemic episodes with bolus reduction vs BR reduction (P=.07).
"To limit the hypoglycemic risk associated with 30 minutes of exercise three hours after lunch, without carbohydrate supplements, the best options seem to be to reduce BR by 80% or to stop the pump for moderate or intense exercise," the researchers wrote.
The study was partially funded by Lifescan. Medtronic provided the Ipro2 devices and sensors.