Continuous Glucose Monitoring Reveals Delayed Nocturnal Hypoglycemia After Intermittent High-Intensity Exercise in Nontrained Patients with Type 1 Diabetes

2010 ◽  
Vol 12 (10) ◽  
pp. 763-768 ◽  
Author(s):  
Alberto Maran ◽  
Paola Pavan ◽  
Barbara Bonsembiante ◽  
Erica Brugin ◽  
Andrea Ermolao ◽  
...  
2018 ◽  
Vol 4 (1) ◽  
pp. e000432 ◽  
Author(s):  
Alif Abdulrahman ◽  
Janisha Manhas ◽  
Hannah Linane ◽  
Mark Gurney ◽  
Catriona Fitzgerald ◽  
...  

BackgroundThe benefits of exercise for patients with type 1 diabetes (T1D) are difficult to balance with associated glycaemic excursions. The aim of this cohort study was to show that continuous glucose monitoring (CGM) could reduce glycaemic excursions in patients with T1D already using insulin pumps, exercising at moderate to high intensity.MethodsQuestionnaires were used to identify patients with T1D using insulin pumps and naive to CGM use, who reported regular exercise. Six were enrolled and trained on Enlite sensor use with Medtronic Minimed Paradigm Veo system and given activity trackers and written advice on adjustment of insulin or carbohydrate intake for exercise. Resting heart rate (HR) and age were used to determine HR surrogates of moderate and high-intensity exercise. They were to exercise as usual for 3 weeks (run-in week, week 1 and week 2) using the activity trackers and heart rate monitors. Problem areas in Diabetes, Hypoglycaemia fear survey II, Diabetes Technology Questionnaire and Gold scores were completed prior to run-in and at the end. The downloaded sensor glucose data were used to compare the change in time in range (glucose 3.9–10.0 mmol/L) from week 1 to week 2.ResultsFor the duration of exercise, this time in glucose range increased from 72±20 to 88%±16 %, p=0.05. The time in hypoglycaemia range (glucose < 3.9 mmol/L) went from 3.9±7.9 to 2.4%±4.8 %, p=0.39. The time in hyperglycaemia range (> 10 mmol/L) reduced from 24±19 to 10%±17%, p=0.04.ConclusionThese results demonstrate the benefit of CGM use for patients with T1DM doing moderate-intensity to high-intensity exercise.


2011 ◽  
Vol 159 (2) ◽  
pp. 297-302.e1 ◽  
Author(s):  
Alexandra Ahmet ◽  
Simon Dagenais ◽  
Nick J. Barrowman ◽  
Catherine J. Collins ◽  
Margaret L. Lawson

2002 ◽  
Vol 141 (5) ◽  
pp. 625-630 ◽  
Author(s):  
Francine Ratner Kaufman ◽  
Juliana Austin ◽  
Aaron Neinstein ◽  
Lily Jeng ◽  
Mary Halvorson ◽  
...  

2019 ◽  
Vol 14 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Morten H. Jensen ◽  
Claus Dethlefsen ◽  
Peter Vestergaard ◽  
Ole Hejlesen

Background: Intensive insulin therapy has documented benefits but may also come at the expense of a higher risk of hypoglycemia. Hypoglycemia is associated with higher all-cause mortality and nocturnal hypoglycemia has been associated with the sudden dead-in-bed syndrome. This proof-of-concept study sought to investigate if nocturnal hypoglycemia can be predicted. Method: Continuous glucose monitoring, meal, insulin, and demographics data from 463 people with type 1 diabetes were obtained from a clinical trial. A total of 4721 nights without or with hypoglycemia (429) were available including data from three consecutive days before the night. Thirty-two features were calculated based on these data. Data were split into 20% participants for evaluation and 80% for training. The optimal feature subset was found from forward selection of the 80% participants with linear discriminant analysis as basis for the classifier. Results: The forward selection resulted in a feature subset of four features. The evaluation resulted in an area under the receiver operating characteristics curve (ROC-AUC) of 0.79 leading to a sensitivity and a specificity of, e.g., 75% and 70%. Conclusions: It was possible to predict nocturnal hypoglycemic episodes with a ROC-AUC of 0.79. A warning at bedtime about nocturnal hypoglycemia could be of great help for people with diabetes to enable preventive actions. Further development of the proposed algorithm is needed for implementation in everyday practice.


Sign in / Sign up

Export Citation Format

Share Document