Specific Insulin-Based Exercise Strategies May Help Avoid Hypoglycemia with Pump Therapy

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Insulin-based exercise strategies may be the best way to avoid hypoglycemia while using insulin pumps.
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.

Reference

  1. Franc S, Daoudi A, Pochat A, et al. Insulin-based strategies to prevent hypoglycaemia during and after exercise in adult patients with type 1 diabetes on pump therapy: the DIABRASPORT randomized study. Diabetes Obes Metab. 2015;17(12):1150-1157.
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