Reducing IDeg dose before exercise may be beneficial for type 1 diabetes patients
medwireNews: Preliminary findings from a randomized crossover trial suggest that patients with type 1 diabetes who reduce their dose of insulin degludec (IDeg) before regular exercise may experience an improvement in the time spent in normoglycemia.
In the trial, which was presented at the 54th EASD Annual Meeting in Berlin, Germany, and published in Diabetes, Obesity and Metabolism, nine IDeg-treated patients who exercised frequently were assigned to receive either 75% or 100% of their usual IDeg dose 3 days before commencing five 55-minute sessions on an exercise bike, carried out on consecutive days, after which they switched to the alternate IDeg dose and performed the same exercise regimen. The two dosing periods were separated by a 4-week washout.
On average, patients receiving 75% of their usual dose (average 14 IU/day total basal insulin) spent 4008 minutes with glucose levels within the normal range (4.0–9.9 mmol/L) over the 5 day period, compared with 3566 minutes when they were given their full dose (average 19 IU/day), a significant difference.
However, presenting author Othmar Moser (Swansea University, UK) said that with the exception of this finding, “we found very few results that were [statistically] significant.”
Indeed, there was no significant difference in the average proportion of time spent in normoglycemia between the 75% and full-dose groups (62.0 vs 57.0%), nor in the time spent in hypo- or hyperglycemia, both in minutes (median 270 vs 240 minutes and 2187 vs 2440 minutes, respectively) and as a proportion of total time (median 4.0 vs 3.6% and mean 33.0 vs 38.0%, respectively).
The average number of hypoglycemic events was also statistically comparable in the 75% and full-dose groups (4.8 vs 4.7 per participant), as was the average dose of prandial and correction insulin used (72 vs 73 IU and 20 vs 17 IU, respectively) and the mean amount or prandial and correction carbohydrates consumed (739 vs 648 g and 219 vs 259 g, respectively).
Moser acknowledged the small number of patients in the study, which limits the interpretation of the findings.
And he concluded that “given the importance of exercise in patients with type 1 diabetes as a cornerstone of good diabetes management, more properly powered studies are needed to give good advice to people with type 1 diabetes on how we can use insulin degludec and other ultra-long acting insulins around regular exercise.”
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