Τίτλος:
Avoiding hypoglycemia: The use of insulin pump combined with continuous glucose monitor in type 1 diabetes crossing a Rocky Gorge
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring systems (CGMS) have been proven very effective in diabetes management. Aim: This study evaluated the usefulness of these devices during prolonged, intense physical activity in an uncontrolled natural environment away from the clinical research center. Design: Non-randomized, prospective and observational study. Methods: During the summer, 38 participants with type 1 diabetes crossed the Samaria gorge, the second largest gorge in Europe (17 km). Twenty subjects on CSII combined with real-time CGMS and 18 on multiple daily injections (MDI) combined with professional (retrospective) CGMS participated in the program. All participants were unsupervised during the event. Results: All 38 participants managed to reach the destination point safely. There were no episodes of severe hypoglycemia. The duration of the exercise (mean 6SD) was 6.4 6 1.3 h. The CSII group exhibited significantly lower hypoglycemic episodes during exercise (0.1 6 0.3 vs. 0.4 6 0.6; P ¼ 0.047) as well as lower AUC below 70 mg/dl compared with the MDI, during the 24 h (0.61 6 0.78 vs. 1.84 6 1.55; P ¼ 0.007). Individuals on CSII were significantly less likely to develop a hypoglycemic episode during exercise (P ¼ 0.038). Exercise induced nocturnal hypoglycemia was not prevented effectively in neither group. Conclusions: CSII combined with CGMS is effective in controlling blood glucose levels in type 1 diabetics who perform prolonged strenuous exercise. The use of insulin pump technology in regions with hot Mediterranean climates is safe and can provide protection against exercise-induced hypoglycemia. Development of precise instructions for T1DM who occasionally get involved in exercise activities, requires further studies. © The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.
Συγγραφείς:
Thomakos, P.
Vazeou, A.
Sakkas, D.
Panagopoulos, G.
Anifantakis, K.
Smyrnaki, P.
Arvanitaki, T.
Kyrlaki, E.
Kefalogiannis, N.
Mamoulakis, D.
Pappas, A.
Mitrakou, A.
Περιοδικό:
QJM-MONTHLY JOURNAL OF THE ASSOCIATION OF PHYSICIANS
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
glucose; insulin; antidiabetic agent; glycosylated hemoglobin; insulin, adult; area under the curve; Article; body mass; clinical article; controlled study; disease duration; female; glucose blood level; human; hyperglycemia; hypoglycemia; insulin dependent diabetes mellitus; insulin infusion; male; nocturnal hypoglycemia; observational study; physical activity; priority journal; prospective study; adolescent; analysis; blood glucose monitoring; devices; drug administration; exercise; Greece; hypoglycemia; insulin dependent diabetes mellitus; insulin infusion; multivariate analysis; statistical model; young adult, Adolescent; Adult; Blood Glucose; Blood Glucose Self-Monitoring; Diabetes Mellitus, Type 1; Drug Administration Schedule; Exercise; Female; Glycated Hemoglobin A; Greece; Humans; Hypoglycemia; Hypoglycemic Agents; Insulin; Insulin Infusion Systems; Linear Models; Male; Multivariate Analysis; Prospective Studies; Young Adult
DOI:
10.1093/qjmed/hcy136
