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Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial

Othmar Moser, Max Eckstein, Alexander Mueller, Philipp Birnbaumer, Felix Aberer, Gerd Koehler, Caren Sourij, Harald Kojzar, Peter Holler, Helmut Simi, Peter Pferschy, Pavel Dietz, Richard Bracken Orcid Logo, Peter Hofmann, Harald Sourij

Diabetes, Obesity and Metabolism, Volume: 21, Issue: 2, Pages: 349 - 356

Swansea University Authors: Othmar Moser, Max Eckstein, Richard Bracken Orcid Logo

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DOI (Published version): 10.1111/dom.13534

Abstract

AimsThough basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra‐long‐acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during...

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Published in: Diabetes, Obesity and Metabolism
ISSN: 1462-8902
Published: 2018
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URI: https://cronfa.swan.ac.uk/Record/cronfa44852
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We compared the time spent in specified glycaemic ranges in participants with T1D during five consecutive days of moderate&#x2010;intensity exercise, on either 100% or 75% of their usual insulin degludec (IDeg) dose.Material and MethodsNine participants with T1D (4 females, mean age 32.1&#xB1;9.0 years, BMI 25.5&#xB1;3.8 kg/m2, HbA1c 7.2&#xB1;0.6% (55&#xB1;7 mmol.mol&#x2010;1) on IDeg were enrolled in the trial. Three days before the first exercise period participants were randomised to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 min at a moderate intensity for five consecutive days. After a four&#x2010;week wash&#x2010;out period, participants performed the last exercise period for five consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve (AUC) and numbers of hypoglycaemic events were compared for the five days at each treatment allocation via paired students&#x2019; t&#x2010;test, Wilcoxon matched&#x2010;pairs signed&#x2010;rank test and two&#x2010;way ANOVA.ResultsTime spent in euglycaemia over five days was greater for 75%IDeg dose versus 100%IDeg dose (4008&#xB1;938 min vs. 3566&#xB1;856 min, p=0.04). Numbers of hypoglycaemic events (p=0.91) and time spent in hypo&#x2010; (p=0.07) or hyperglycaemia (p=0.38) was similar for both dosing schemes.ConclusionsA 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia with small effects on time spent in hypo&#x2010; and hyperglycaemia.</abstract><type>Journal Article</type><journal>Diabetes, Obesity and Metabolism</journal><volume>21</volume><journalNumber>2</journalNumber><paginationStart>349</paginationStart><paginationEnd>356</paginationEnd><publisher/><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1462-8902</issnPrint><issnElectronic/><keywords/><publishedDay>14</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2018</publishedYear><publishedDate>2018-10-14</publishedDate><doi>10.1111/dom.13534</doi><url/><notes/><college>COLLEGE NANME</college><department>Engineering and Applied Sciences School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>EAAS</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-01-14T13:52:55.9996165</lastEdited><Created>2018-10-11T09:29:07.7667101</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Othmar</firstname><surname>Moser</surname><order>1</order></author><author><firstname>Max</firstname><surname>Eckstein</surname><order>2</order></author><author><firstname>Alexander</firstname><surname>Mueller</surname><order>3</order></author><author><firstname>Philipp</firstname><surname>Birnbaumer</surname><order>4</order></author><author><firstname>Felix</firstname><surname>Aberer</surname><order>5</order></author><author><firstname>Gerd</firstname><surname>Koehler</surname><order>6</order></author><author><firstname>Caren</firstname><surname>Sourij</surname><order>7</order></author><author><firstname>Harald</firstname><surname>Kojzar</surname><order>8</order></author><author><firstname>Peter</firstname><surname>Holler</surname><order>9</order></author><author><firstname>Helmut</firstname><surname>Simi</surname><order>10</order></author><author><firstname>Peter</firstname><surname>Pferschy</surname><order>11</order></author><author><firstname>Pavel</firstname><surname>Dietz</surname><order>12</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>13</order></author><author><firstname>Peter</firstname><surname>Hofmann</surname><order>14</order></author><author><firstname>Harald</firstname><surname>Sourij</surname><order>15</order></author></authors><documents><document><filename>0044852-25102018132321.pdf</filename><originalFilename>moser2018(5).pdf</originalFilename><uploaded>2018-10-25T13:23:21.3770000</uploaded><type>Output</type><contentLength>665777</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>Released under the terms of a Creative Commons Attribution-NonCommercial License (CC-BY-NC).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2021-01-14T13:52:55.9996165 v2 44852 2018-10-11 Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial 3b249efea402d5413effa1e67f31bdfa Othmar Moser Othmar Moser true false 88e3800018f862425765f3e36da8de30 Max Eckstein Max Eckstein true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2018-10-11 EAAS AimsThough basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra‐long‐acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during five consecutive days of moderate‐intensity exercise, on either 100% or 75% of their usual insulin degludec (IDeg) dose.Material and MethodsNine participants with T1D (4 females, mean age 32.1±9.0 years, BMI 25.5±3.8 kg/m2, HbA1c 7.2±0.6% (55±7 mmol.mol‐1) on IDeg were enrolled in the trial. Three days before the first exercise period participants were randomised to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 min at a moderate intensity for five consecutive days. After a four‐week wash‐out period, participants performed the last exercise period for five consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve (AUC) and numbers of hypoglycaemic events were compared for the five days at each treatment allocation via paired students’ t‐test, Wilcoxon matched‐pairs signed‐rank test and two‐way ANOVA.ResultsTime spent in euglycaemia over five days was greater for 75%IDeg dose versus 100%IDeg dose (4008±938 min vs. 3566±856 min, p=0.04). Numbers of hypoglycaemic events (p=0.91) and time spent in hypo‐ (p=0.07) or hyperglycaemia (p=0.38) was similar for both dosing schemes.ConclusionsA 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia with small effects on time spent in hypo‐ and hyperglycaemia. Journal Article Diabetes, Obesity and Metabolism 21 2 349 356 1462-8902 14 10 2018 2018-10-14 10.1111/dom.13534 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University 2021-01-14T13:52:55.9996165 2018-10-11T09:29:07.7667101 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Othmar Moser 1 Max Eckstein 2 Alexander Mueller 3 Philipp Birnbaumer 4 Felix Aberer 5 Gerd Koehler 6 Caren Sourij 7 Harald Kojzar 8 Peter Holler 9 Helmut Simi 10 Peter Pferschy 11 Pavel Dietz 12 Richard Bracken 0000-0002-6986-6449 13 Peter Hofmann 14 Harald Sourij 15 0044852-25102018132321.pdf moser2018(5).pdf 2018-10-25T13:23:21.3770000 Output 665777 application/pdf Version of Record true Released under the terms of a Creative Commons Attribution-NonCommercial License (CC-BY-NC). true eng http://creativecommons.org/licenses/by-nc/4.0/
title Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
spellingShingle Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
Othmar Moser
Max Eckstein
Richard Bracken
title_short Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
title_full Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
title_fullStr Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
title_full_unstemmed Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
title_sort Reduction in insulin degludec dosing for multiple exercise sessions improves time spent in euglycaemia in people with type 1 diabetes: A randomized crossover trial
author_id_str_mv 3b249efea402d5413effa1e67f31bdfa
88e3800018f862425765f3e36da8de30
f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv 3b249efea402d5413effa1e67f31bdfa_***_Othmar Moser
88e3800018f862425765f3e36da8de30_***_Max Eckstein
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Othmar Moser
Max Eckstein
Richard Bracken
author2 Othmar Moser
Max Eckstein
Alexander Mueller
Philipp Birnbaumer
Felix Aberer
Gerd Koehler
Caren Sourij
Harald Kojzar
Peter Holler
Helmut Simi
Peter Pferschy
Pavel Dietz
Richard Bracken
Peter Hofmann
Harald Sourij
format Journal article
container_title Diabetes, Obesity and Metabolism
container_volume 21
container_issue 2
container_start_page 349
publishDate 2018
institution Swansea University
issn 1462-8902
doi_str_mv 10.1111/dom.13534
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
active_str 0
description AimsThough basal insulin dose reductions are recommended when people with type 1 diabetes (T1D) are exercising regularly, no research has explored ultra‐long‐acting basal insulin dose reductions around exercise. We compared the time spent in specified glycaemic ranges in participants with T1D during five consecutive days of moderate‐intensity exercise, on either 100% or 75% of their usual insulin degludec (IDeg) dose.Material and MethodsNine participants with T1D (4 females, mean age 32.1±9.0 years, BMI 25.5±3.8 kg/m2, HbA1c 7.2±0.6% (55±7 mmol.mol‐1) on IDeg were enrolled in the trial. Three days before the first exercise period participants were randomised to either 100% or 75% of their usual IDeg dose. Participants exercised on a cycle ergometer for 55 min at a moderate intensity for five consecutive days. After a four‐week wash‐out period, participants performed the last exercise period for five consecutive days with the alternate IDeg dose. Time spent in specified glycaemic ranges, area under the curve (AUC) and numbers of hypoglycaemic events were compared for the five days at each treatment allocation via paired students’ t‐test, Wilcoxon matched‐pairs signed‐rank test and two‐way ANOVA.ResultsTime spent in euglycaemia over five days was greater for 75%IDeg dose versus 100%IDeg dose (4008±938 min vs. 3566±856 min, p=0.04). Numbers of hypoglycaemic events (p=0.91) and time spent in hypo‐ (p=0.07) or hyperglycaemia (p=0.38) was similar for both dosing schemes.ConclusionsA 25% reduction in usual IDeg dose around regular exercise led to more time spent in euglycaemia with small effects on time spent in hypo‐ and hyperglycaemia.
published_date 2018-10-14T19:34:17Z
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