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Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis

Max L. Eckstein, Olivia McCarthy, Norbert J. Tripolt, Alexander Müller, Philipp Birnbaumer, Peter N. Pferschy, Peter Hofmann, Richard Bracken Orcid Logo, Harald Sourij, Othmar Moser

Canadian Journal of Diabetes, Volume: 44, Issue: 8, Pages: 697 - 700

Swansea University Authors: Olivia McCarthy, Richard Bracken Orcid Logo

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DOI (Published version): 10.1016/j.jcjd.2020.03.003

Abstract

IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence aga...

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Published in: Canadian Journal of Diabetes
ISSN: 1499-2671
Published: Elsevier BV 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa53869
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2023-03-14T10:04:51.4427059</datestamp><bib-version>v2</bib-version><id>53869</id><entry>2020-03-27</entry><title>Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis</title><swanseaauthors><author><sid>4fea3e19b39712dea1d051d317614572</sid><firstname>Olivia</firstname><surname>McCarthy</surname><name>Olivia McCarthy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2020-03-27</date><deptcode>STSC</deptcode><abstract>IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence against hypoglycemia, it is unclear as to which one is more beneficial. Consequently, the aim of this study was to assess the efficacy of carbohydrate supplementation in comparison to bolus insulin dose reduction to prevent hypoglycemia during moderate-intensity exercise in individuals with type 1 diabetes.MethodsThis was a retrospective controlled analysis of two independent clinical trials. All participants performed a continuous moderate-intensity cycle ergometer exercise session for &#x223C;45 minutes. Two different therapy management groups and a control group were compared: Group (A) supplemented 15 &#x2013; 30 g carbohydrates at a glycemic threshold of 7.0 mmol/L during exercise, group (B) reduced their individual bolus insulin dose by 50% with their last meal prior to exercise and group (C) remained as a control.ResultsNo hypoglycemic events occurred in group A, which differed to each four events recorded in groups B (p = 0.02) and C (p = 0.02).ConclusionCarbohydrate supplementation was superior to bolus insulin reductions in the prevention of hypoglycemia during exercise in people with type 1 diabetes.</abstract><type>Journal Article</type><journal>Canadian Journal of Diabetes</journal><volume>44</volume><journalNumber>8</journalNumber><paginationStart>697</paginationStart><paginationEnd>700</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1499-2671</issnPrint><issnElectronic/><keywords>Physical Exercise, Type 1 Diabetes, Insulin Therapy, Carbohydrates</keywords><publishedDay>2</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2020</publishedYear><publishedDate>2020-12-02</publishedDate><doi>10.1016/j.jcjd.2020.03.003</doi><url>http://dx.doi.org/10.1016/j.jcjd.2020.03.003</url><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>The clinical trials described in this study were supported by Novo Nordisk A/S (DRKS00013509), Denmark, and through an unrestricted grant from Novo Nordisk, Austria (DRKS00013477).</funders><projectreference/><lastEdited>2023-03-14T10:04:51.4427059</lastEdited><Created>2020-03-27T08:32:55.7244975</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>Max L.</firstname><surname>Eckstein</surname><order>1</order></author><author><firstname>Olivia</firstname><surname>McCarthy</surname><order>2</order></author><author><firstname>Norbert J.</firstname><surname>Tripolt</surname><order>3</order></author><author><firstname>Alexander</firstname><surname>M&#xFC;ller</surname><order>4</order></author><author><firstname>Philipp</firstname><surname>Birnbaumer</surname><order>5</order></author><author><firstname>Peter N.</firstname><surname>Pferschy</surname><order>6</order></author><author><firstname>Peter</firstname><surname>Hofmann</surname><order>7</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>8</order></author><author><firstname>Harald</firstname><surname>Sourij</surname><order>9</order></author><author><firstname>Othmar</firstname><surname>Moser</surname><order>10</order></author></authors><documents><document><filename>53869__16936__9ebd37d01e344923abb5f8a394a01f22.pdf</filename><originalFilename>53869.pdf</originalFilename><uploaded>2020-03-27T08:34:39.8569653</uploaded><type>Output</type><contentLength>485696</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2021-03-22T00:00:00.0000000</embargoDate><documentNotes>&#xA9; 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by-nc-nd/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2023-03-14T10:04:51.4427059 v2 53869 2020-03-27 Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis 4fea3e19b39712dea1d051d317614572 Olivia McCarthy Olivia McCarthy true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2020-03-27 STSC IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence against hypoglycemia, it is unclear as to which one is more beneficial. Consequently, the aim of this study was to assess the efficacy of carbohydrate supplementation in comparison to bolus insulin dose reduction to prevent hypoglycemia during moderate-intensity exercise in individuals with type 1 diabetes.MethodsThis was a retrospective controlled analysis of two independent clinical trials. All participants performed a continuous moderate-intensity cycle ergometer exercise session for ∼45 minutes. Two different therapy management groups and a control group were compared: Group (A) supplemented 15 – 30 g carbohydrates at a glycemic threshold of 7.0 mmol/L during exercise, group (B) reduced their individual bolus insulin dose by 50% with their last meal prior to exercise and group (C) remained as a control.ResultsNo hypoglycemic events occurred in group A, which differed to each four events recorded in groups B (p = 0.02) and C (p = 0.02).ConclusionCarbohydrate supplementation was superior to bolus insulin reductions in the prevention of hypoglycemia during exercise in people with type 1 diabetes. Journal Article Canadian Journal of Diabetes 44 8 697 700 Elsevier BV 1499-2671 Physical Exercise, Type 1 Diabetes, Insulin Therapy, Carbohydrates 2 12 2020 2020-12-02 10.1016/j.jcjd.2020.03.003 http://dx.doi.org/10.1016/j.jcjd.2020.03.003 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University The clinical trials described in this study were supported by Novo Nordisk A/S (DRKS00013509), Denmark, and through an unrestricted grant from Novo Nordisk, Austria (DRKS00013477). 2023-03-14T10:04:51.4427059 2020-03-27T08:32:55.7244975 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Max L. Eckstein 1 Olivia McCarthy 2 Norbert J. Tripolt 3 Alexander Müller 4 Philipp Birnbaumer 5 Peter N. Pferschy 6 Peter Hofmann 7 Richard Bracken 0000-0002-6986-6449 8 Harald Sourij 9 Othmar Moser 10 53869__16936__9ebd37d01e344923abb5f8a394a01f22.pdf 53869.pdf 2020-03-27T08:34:39.8569653 Output 485696 application/pdf Accepted Manuscript true 2021-03-22T00:00:00.0000000 © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
spellingShingle Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
Olivia McCarthy
Richard Bracken
title_short Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
title_full Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
title_fullStr Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
title_full_unstemmed Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
title_sort Efficacy of Carbohydrate Supplementation Compared With Bolus Insulin Dose Reduction Around Exercise in Adults With Type 1 Diabetes: A Retrospective, Controlled Analysis
author_id_str_mv 4fea3e19b39712dea1d051d317614572
f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv 4fea3e19b39712dea1d051d317614572_***_Olivia McCarthy
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Olivia McCarthy
Richard Bracken
author2 Max L. Eckstein
Olivia McCarthy
Norbert J. Tripolt
Alexander Müller
Philipp Birnbaumer
Peter N. Pferschy
Peter Hofmann
Richard Bracken
Harald Sourij
Othmar Moser
format Journal article
container_title Canadian Journal of Diabetes
container_volume 44
container_issue 8
container_start_page 697
publishDate 2020
institution Swansea University
issn 1499-2671
doi_str_mv 10.1016/j.jcjd.2020.03.003
publisher Elsevier BV
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 Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
url http://dx.doi.org/10.1016/j.jcjd.2020.03.003
document_store_str 1
active_str 0
description IntroductionIndividuals with type 1 diabetes try to manage the risk of exercise-induced hypoglycemia by means of pre-exercise/pre-meal bolus insulin dose reductions and/or consuming additional carbohydrates during exercise. Both strategies have proven to be effective in offsetting the occurrence against hypoglycemia, it is unclear as to which one is more beneficial. Consequently, the aim of this study was to assess the efficacy of carbohydrate supplementation in comparison to bolus insulin dose reduction to prevent hypoglycemia during moderate-intensity exercise in individuals with type 1 diabetes.MethodsThis was a retrospective controlled analysis of two independent clinical trials. All participants performed a continuous moderate-intensity cycle ergometer exercise session for ∼45 minutes. Two different therapy management groups and a control group were compared: Group (A) supplemented 15 – 30 g carbohydrates at a glycemic threshold of 7.0 mmol/L during exercise, group (B) reduced their individual bolus insulin dose by 50% with their last meal prior to exercise and group (C) remained as a control.ResultsNo hypoglycemic events occurred in group A, which differed to each four events recorded in groups B (p = 0.02) and C (p = 0.02).ConclusionCarbohydrate supplementation was superior to bolus insulin reductions in the prevention of hypoglycemia during exercise in people with type 1 diabetes.
published_date 2020-12-02T04:07:04Z
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