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Mitigating Reductions in Glucose During Exercise on Closed-Loop Insulin Delivery: The Ex-Snacks Study.
Neha S Patel1, Michelle A Van Name1, Eda Cengiz1
1Yale School of Medicine , Yale Pediatric Endocrinology & Diabetes, New Haven, Connecticut.
Diabetes Technology & Therapeutics
|December 21, 2016
Summary
Snacking during exercise helps people with type 1 diabetes maintain stable blood glucose levels when using closed-loop insulin delivery. This strategy prevents dangerous drops and elevations in plasma glucose, reducing the need for hypoglycemia treatment.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Exercise Physiology
Background:
- Type 1 diabetes (T1D) management requires careful monitoring of plasma glucose (PG).
- Exercise can cause significant PG fluctuations in individuals with T1D.
- Closed-loop (CL) insulin delivery systems aim to automate glucose control.
Purpose of the Study:
- To determine if snacking can prevent exercise-induced hypoglycemia during CL insulin delivery.
- To assess if snacking mitigates post-exercise hyperglycemia when using CL systems.
Main Methods:
- Twelve individuals with T1D participated in two 105-minute exercise sessions under CL control.
- Sessions involved moderate-intensity treadmill walking with and without carbohydrate snacks.
- Plasma glucose and insulin delivery were monitored throughout the exercise protocols.
Main Results:
- Snacking significantly attenuated exercise-induced plasma glucose drops compared to CL alone (10 vs. 53 mg/dL change).
- No hypoglycemia events requiring rescue treatment occurred during snacking sessions, versus three in the non-snacking sessions.
- Insulin delivery was higher during the CL+snack sessions (1.8 U) compared to CL alone (0.7 U).
Conclusions:
- A simple snacking strategy is effective in preventing exercise-induced hypoglycemia with CL insulin delivery.
- This approach helps maintain stable plasma glucose levels during and after exercise in T1D.
- Snacking complements CL systems for improved glucose management during physical activity.
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