Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes

McCarthy, Olivia; Deere, Rachel; Eckstein, Max L.; Pitt, Jason; Wellman, Benjamin; Bain, Steve; Moser, Othmar; Bracken, Richard

doi:10.3389/fpubh.2020.568832

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Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes

Olivia McCarthy, Rachel Deere, Max L. Eckstein, Jason Pitt, Benjamin Wellman, Steve Bain

, Othmar Moser, Richard Bracken

Frontiers in Public Health, Volume: 8

Swansea University Authors: Olivia McCarthy, Rachel Deere, Jason Pitt, Benjamin Wellman, Steve Bain , Richard Bracken

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DOI (Published version): 10.3389/fpubh.2020.568832

Abstract

Aim: To explore the influence of clinical exercise trial participation on glycaemia and insulin therapy use in adults with type 1 diabetes (T1D). Research Design and Methods: This study involved a secondary analysis of data collected from 16 individuals with T1D who completed a randomized clinical t...

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Published in:	Frontiers in Public Health
ISSN:	2296-2565
Published:	Frontiers Media SA 2021
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Results: Following study completion, there were significant decreases in both the mean nocturnal iG concentration (Δ-0.9 ± 4.5 mmol.L−1, p < 0.001) and the time spent in severe hyperglycaemia (Δ-7.2 ± 9.8%, p = 0.028) during the night-time period. The total daily (Δ-7.3 ± 8.4 IU, p = 0.003) and basal only (Δ-2.3 ± 3.8 IU, p = 0.033) insulin dose requirements were reduced over the course of study involvement. Conclusions: Participation in clinical research may foster improved nocturnal glycaemia and reduced insulin therapy use in people with T1D. Recognition of these outcomes may help encourage volunteers to partake in clinical research opportunities for improved diabetes-related health outcomes. 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spelling	2021-02-02T09:14:13.5451006 v2 55783 2020-11-30 Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes 4fea3e19b39712dea1d051d317614572 Olivia McCarthy Olivia McCarthy true false 3fd2ee8d0217f8487c472f52ba7c6b0a Rachel Deere Rachel Deere true false 0103027605e3ccd2909f4170d9d2c96f Jason Pitt Jason Pitt true false d7cdcf463ff032a37945843a10cad627 Benjamin Wellman Benjamin Wellman true false 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2020-11-30 STSC Aim: To explore the influence of clinical exercise trial participation on glycaemia and insulin therapy use in adults with type 1 diabetes (T1D). Research Design and Methods: This study involved a secondary analysis of data collected from 16 individuals with T1D who completed a randomized clinical trial consisting of 23-h in-patient phases with a 45-min evening bout of moderate intensity continuous exercise. Participants were switched from their usual basal-bolus therapy to ultra-long acting insulin degludec and rapid-acting insulin aspart as well as provided with unblinded interstitial flash-glucose monitoring systems. To assess the impact of clinical trial participation, weekly data obtained at the screening visit (pre-study involvement) were compared against those collated on the last experimental visit (post-study involvement). Interstitial glucose [iG] data were split into distinct glycaemic ranges and stratified into day (06:00–23:59) and night (00:00–05:59) time periods. A p-value of ≤ 0.05 was accepted for significance. Results: Following study completion, there were significant decreases in both the mean nocturnal iG concentration (Δ-0.9 ± 4.5 mmol.L−1, p < 0.001) and the time spent in severe hyperglycaemia (Δ-7.2 ± 9.8%, p = 0.028) during the night-time period. The total daily (Δ-7.3 ± 8.4 IU, p = 0.003) and basal only (Δ-2.3 ± 3.8 IU, p = 0.033) insulin dose requirements were reduced over the course of study involvement. Conclusions: Participation in clinical research may foster improved nocturnal glycaemia and reduced insulin therapy use in people with T1D. Recognition of these outcomes may help encourage volunteers to partake in clinical research opportunities for improved diabetes-related health outcomes. Clinical Trial Registration: DRKS.de; DRKS00013509. Journal Article Frontiers in Public Health 8 Frontiers Media SA 2296-2565 type 1 diabetes (T1D), exercise, insulin, glycaemia, research participant experience 7 1 2021 2021-01-07 10.3389/fpubh.2020.568832 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-02-02T09:14:13.5451006 2020-11-30T09:30:11.4841424 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Olivia McCarthy 1 Rachel Deere 2 Max L. Eckstein 3 Jason Pitt 4 Benjamin Wellman 5 Steve Bain 0000-0001-8519-4964 6 Othmar Moser 7 Richard Bracken 0000-0002-6986-6449 8 55783__19060__50163f8521de4604b37b0bb489e4ea35.pdf 55783.pdf 2021-01-14T13:16:10.9955805 Output 548621 application/pdf Version of Record true © 2021 McCarthy, Deere, Eckstein, Pitt, Wellman, Bain, Moser and Bracken. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) true eng http://creativecommons.org/licenses/by/4.0/
title	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
spellingShingle	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes Olivia McCarthy Rachel Deere Jason Pitt Benjamin Wellman Steve Bain Richard Bracken
title_short	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
title_full	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
title_fullStr	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
title_full_unstemmed	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
title_sort	Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes
author_id_str_mv	4fea3e19b39712dea1d051d317614572 3fd2ee8d0217f8487c472f52ba7c6b0a 0103027605e3ccd2909f4170d9d2c96f d7cdcf463ff032a37945843a10cad627 5399f4c6e6a70f3608a084ddb938511a f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv	4fea3e19b39712dea1d051d317614572_*_Olivia McCarthy 3fd2ee8d0217f8487c472f52ba7c6b0a__Rachel Deere 0103027605e3ccd2909f4170d9d2c96f__Jason Pitt d7cdcf463ff032a37945843a10cad627__Benjamin Wellman 5399f4c6e6a70f3608a084ddb938511a__Steve Bain f5da81cd18adfdedb2ccb845bddc12f7_*_Richard Bracken
author	Olivia McCarthy Rachel Deere Jason Pitt Benjamin Wellman Steve Bain Richard Bracken
author2	Olivia McCarthy Rachel Deere Max L. Eckstein Jason Pitt Benjamin Wellman Steve Bain Othmar Moser Richard Bracken
format	Journal article
container_title	Frontiers in Public Health
container_volume	8
publishDate	2021
institution	Swansea University
issn	2296-2565
doi_str_mv	10.3389/fpubh.2020.568832
publisher	Frontiers Media SA
college_str	Faculty of Science and Engineering
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hierarchy_top_id	facultyofscienceandengineering
hierarchy_top_title	Faculty of Science and Engineering
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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
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description	Aim: To explore the influence of clinical exercise trial participation on glycaemia and insulin therapy use in adults with type 1 diabetes (T1D). Research Design and Methods: This study involved a secondary analysis of data collected from 16 individuals with T1D who completed a randomized clinical trial consisting of 23-h in-patient phases with a 45-min evening bout of moderate intensity continuous exercise. Participants were switched from their usual basal-bolus therapy to ultra-long acting insulin degludec and rapid-acting insulin aspart as well as provided with unblinded interstitial flash-glucose monitoring systems. To assess the impact of clinical trial participation, weekly data obtained at the screening visit (pre-study involvement) were compared against those collated on the last experimental visit (post-study involvement). Interstitial glucose [iG] data were split into distinct glycaemic ranges and stratified into day (06:00–23:59) and night (00:00–05:59) time periods. A p-value of ≤ 0.05 was accepted for significance. Results: Following study completion, there were significant decreases in both the mean nocturnal iG concentration (Δ-0.9 ± 4.5 mmol.L−1, p < 0.001) and the time spent in severe hyperglycaemia (Δ-7.2 ± 9.8%, p = 0.028) during the night-time period. The total daily (Δ-7.3 ± 8.4 IU, p = 0.003) and basal only (Δ-2.3 ± 3.8 IU, p = 0.033) insulin dose requirements were reduced over the course of study involvement. Conclusions: Participation in clinical research may foster improved nocturnal glycaemia and reduced insulin therapy use in people with T1D. Recognition of these outcomes may help encourage volunteers to partake in clinical research opportunities for improved diabetes-related health outcomes. Clinical Trial Registration: DRKS.de; DRKS00013509.
published_date	2021-01-07T04:10:15Z
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Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes

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