Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?

Lundemose, Sissel Banner; McCarthy, Olivia M.; Christensen, Merete Bechmann; Laugesen, Christian; Bracken, Richard; Holst, Jens Juul; Ranjan, Ajenthen Gayathri; Nørgaard, Kirsten

doi:10.1111/dom.16103

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Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?

Sissel Banner Lundemose

, Olivia M. McCarthy, Merete Bechmann Christensen, Christian Laugesen

, Richard Bracken

, Jens Juul Holst

, Ajenthen Gayathri Ranjan

, Kirsten Nørgaard

Diabetes, Obesity and Metabolism

Swansea University Author: Richard Bracken

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DOI (Published version): 10.1111/dom.16103

Abstract

Aim: To evaluate and compare the plasma glucose (PG) response during spontaneous fasted morning moderate‐intensity exercise with and without injection of subcutaneous glucagon in adults with type 1 diabetes (T1D) treated with an automated insulin delivery (AID) system. Methods: Ten adults (four fema...

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Published in:	Diabetes, Obesity and Metabolism
ISSN:	1462-8902 1463-1326
Published:	Wiley 2024
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa68504

first_indexed	2024-12-09T19:47:29Z
last_indexed	2025-01-09T20:33:44Z
id	cronfa68504
recordtype	SURis
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spelling	2024-12-13T10:08:41.6102872 v2 68504 2024-12-09 Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system? f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2024-12-09 EAAS Aim: To evaluate and compare the plasma glucose (PG) response during spontaneous fasted morning moderate‐intensity exercise with and without injection of subcutaneous glucagon in adults with type 1 diabetes (T1D) treated with an automated insulin delivery (AID) system. Methods: Ten adults (four female) with T1D (age 50 [42–67] years, diabetes duration: 22 [14–44] years, HbA1c: 55 [47–69] mmol/mol) treated with the MiniMed™ 780G AID system participated in a proof‐of‐concept two‐period, crossover trial. Fasting participants undertook a 45 min bout of continuous moderate‐intensity (~60% V̇O2peak) exercise on a cycle ergometer followed by 1 h of rest. Before exercise, 150‐μg glucagon was administered subcutaneously on visit 1 (GLUC) but not on visit 2 (NO‐GLUC). Temporary target on the AID was activated 15 min before until 15 min after exercise cessation. Blood samples were taken at 5‐ and 15‐min intervals for measuring PG and biomarkers. Data were analysed using paired t tests or repeated measures ANOVA. Results: Time in range (3.9–10.0 mmol/L) was 100% on both study visits. No hypoglycaemia (<3.9 mmol/L) occurred in either arm. The GLUC arm had significantly higher mean PG (p = 0.01), area under the PG curve (p = 0.01), coefficient of variation (p < 0.01), peak PG (p = 0.01) and PG at the end of exercise (p < 0.01). No differences in endogenous glucoregulatory hormones were observed between visits. Conclusion: Adults with T1D treated with the MiniMed™ 780G can perform spontaneous fasted moderate‐intensity exercise without hypoglycaemia. Therefore, glucagon was not needed for prevention of hypoglycaemia in such situations. Journal Article Diabetes, Obesity and Metabolism 0 Wiley 1462-8902 1463-1326 Artificial pancreas, hybrid closed loop, hypoglycaemia rescue and physical activity 27 11 2024 2024-11-27 10.1111/dom.16103 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Not Required This project received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. 2024-12-13T10:08:41.6102872 2024-12-09T13:29:43.9457370 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Sissel Banner Lundemose 0000-0002-4343-7777 1 Olivia M. McCarthy 2 Merete Bechmann Christensen 3 Christian Laugesen 0000-0001-9253-9457 4 Richard Bracken 0000-0002-6986-6449 5 Jens Juul Holst 0000-0001-6853-3805 6 Ajenthen Gayathri Ranjan 0000-0002-2253-6071 7 Kirsten Nørgaard 8
title	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
spellingShingle	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system? Richard Bracken
title_short	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
title_full	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
title_fullStr	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
title_full_unstemmed	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
title_sort	Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?
author_id_str_mv	f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv	f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author	Richard Bracken
author2	Sissel Banner Lundemose Olivia M. McCarthy Merete Bechmann Christensen Christian Laugesen Richard Bracken Jens Juul Holst Ajenthen Gayathri Ranjan Kirsten Nørgaard
format	Journal article
container_title	Diabetes, Obesity and Metabolism
container_volume	0
publishDate	2024
institution	Swansea University
issn	1462-8902 1463-1326
doi_str_mv	10.1111/dom.16103
publisher	Wiley
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
document_store_str	0
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description	Aim: To evaluate and compare the plasma glucose (PG) response during spontaneous fasted morning moderate‐intensity exercise with and without injection of subcutaneous glucagon in adults with type 1 diabetes (T1D) treated with an automated insulin delivery (AID) system. Methods: Ten adults (four female) with T1D (age 50 [42–67] years, diabetes duration: 22 [14–44] years, HbA1c: 55 [47–69] mmol/mol) treated with the MiniMed™ 780G AID system participated in a proof‐of‐concept two‐period, crossover trial. Fasting participants undertook a 45 min bout of continuous moderate‐intensity (~60% V̇O2peak) exercise on a cycle ergometer followed by 1 h of rest. Before exercise, 150‐μg glucagon was administered subcutaneously on visit 1 (GLUC) but not on visit 2 (NO‐GLUC). Temporary target on the AID was activated 15 min before until 15 min after exercise cessation. Blood samples were taken at 5‐ and 15‐min intervals for measuring PG and biomarkers. Data were analysed using paired t tests or repeated measures ANOVA. Results: Time in range (3.9–10.0 mmol/L) was 100% on both study visits. No hypoglycaemia (<3.9 mmol/L) occurred in either arm. The GLUC arm had significantly higher mean PG (p = 0.01), area under the PG curve (p = 0.01), coefficient of variation (p < 0.01), peak PG (p = 0.01) and PG at the end of exercise (p < 0.01). No differences in endogenous glucoregulatory hormones were observed between visits. Conclusion: Adults with T1D treated with the MiniMed™ 780G can perform spontaneous fasted moderate‐intensity exercise without hypoglycaemia. Therefore, glucagon was not needed for prevention of hypoglycaemia in such situations.
published_date	2024-11-27T05:41:33Z
_version_	1821382901921480704
score	11.04748

Is low‐dose glucagon needed and effective in preventing fasted exercise‐induced hypoglycaemia in type 1 diabetes treated with the MiniMed 780G, an automated insulin delivery system?

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