Exercise Snacking And Detraining Effects On Postprandial Glucose Responses - A Randomized Crossover Trial In Trained Older Adults

IntroductionMeal composition is known to affect glycemic variability and glucose control in type 1 diabetes. The objective of this work was to evaluate the effect of high carbohydrate meals of different nutritional composition and alcohol on the postprandial glucose response in patients with type 1 diabetes.Research design and methodsTwelve participants were recruited to this randomized crossover trial. Following a 4-week run-in period, participants received a mixed meal on three occasions with the same carbohydrate content but different macronutrient composition: high protein-high fat with alcohol (0.7g/kg body weight, beer), high protein-high fat without alcohol, and low protein-low fat without alcohol at 2-week intervals. Plasma and interstitial glucose, insulin, glucagon, growth hormone, cortisol, alcohol, free fatty acids, lactate, and pH concentrations were measured during 6 hours. A statistical analysis was then carried out to determine significant differences between studies.ResultsSignificantly higher late postprandial glucose was observed in studies with higher content of fats and proteins (p=0.0088). This was associated with lower time in hypoglycemia as compared with the low protein and fat study (p=0.0179), at least partially due to greater glucagon concentration in the same period (p=0.04). Alcohol significantly increased lactate, decreased pH and growth hormone, and maintained free fatty acids suppressed during the late postprandial phase (p<0.001), without significant changes in plasma glucose.ConclusionsOur data suggest that the addition of proteins and fats to carbohydrates increases late postprandial blood glucose. Moreover, alcohol consumption together with a mixed meal has relevant metabolic effects without any increase in the risk of hypoglycemia, at least 6 hours postprandially.Trial registration numberNCT03320993.

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Closed-Loop Insulin Delivery Versus Sensor-Augmented Pump Therapy in Older Adults With Type 1 Diabetes (ORACL): A Randomized, Crossover Trial

Diabetes Care ◽

10.2337/dc21-1667 ◽

2021 ◽

pp. dc211667

Author(s):

Sybil A. McAuley ◽

Steven Trawley ◽

Sara Vogrin ◽

Glenn M. Ward ◽

Spiros Fourlanos ◽

...

Keyword(s):

Older Adults ◽

Type 1 Diabetes ◽

Closed Loop ◽

Crossover Trial ◽

Insulin Delivery ◽

Pump Therapy ◽

Randomized Crossover Trial

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212-OR: Closed-Loop Increases Time-in-Range in Older Adults with Type 1 Diabetes Compared with Sensor-Augmented Pump Therapy: A Randomized Crossover Trial

Diabetes ◽

10.2337/db21-212-or ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 212-OR

Author(s):

SYBIL A. MCAULEY ◽

SARA VOGRIN ◽

STEVEN TRAWLEY ◽

PETER G. COLMAN ◽

SPIROS FOURLANOS ◽

...

Keyword(s):

Older Adults ◽

Type 1 Diabetes ◽

Closed Loop ◽

Crossover Trial ◽

Pump Therapy ◽

Randomized Crossover Trial ◽

Time In Range

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Implementation and Effects of Information Technology-Based and Print-Based Interventions to Promote Physical Activity Among Community-Dwelling Older Adults: Protocol for a Randomized Crossover Trial

JMIR Research Protocols ◽

10.2196/15168 ◽

2020 ◽

Vol 9 (4) ◽

pp. e15168

Author(s):

Claudia R Pischke ◽

Claudia Voelcker-Rehage ◽

Manuela Peters ◽

Tiara Ratz ◽

Hermann Pohlabeln ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Information Technology ◽

Crossover Trial ◽

Community Dwelling ◽

Randomized Crossover Trial ◽

T1 And T2 ◽

Group Sessions ◽

Community Dwelling Older Adults

Background Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. Objective We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. Methods Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. Results The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. Conclusions Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. Trial Registration German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m International Registered Report Identifier (IRRID) DERR1-10.2196/15168

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Implementation and Effects of Information Technology-Based and Print-Based Interventions to Promote Physical Activity Among Community-Dwelling Older Adults: Protocol for a Randomized Crossover Trial (Preprint)

10.2196/preprints.15168 ◽

2019 ◽

Author(s):

Claudia R Pischke ◽

Claudia Voelcker-Rehage ◽

Manuela Peters ◽

Tiara Ratz ◽

Hermann Pohlabeln ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Information Technology ◽

Crossover Trial ◽

Community Dwelling ◽

Randomized Crossover Trial ◽

T1 And T2 ◽

Group Sessions ◽

Community Dwelling Older Adults

BACKGROUND Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. OBJECTIVE We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. METHODS Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. RESULTS The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. CONCLUSIONS Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. CLINICALTRIAL German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15168

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