A Comparison of Glucose and Additional Signals for Three Different Exercise Types in Adolescents with Type 1 Diabetes...

Area of Science:

• Endocrinology
• Pediatrics
• Sports Medicine

Background:

• Adolescents with type 1 diabetes (T1D) face challenges managing blood glucose during physical activity.
• Hybrid closed-loop (HCL) insulin pump systems offer advanced glycemic control but require optimization for exercise.

Purpose of the Study:

• To compare glycemic outcomes and physiological responses across moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with T1D using an HCL system.
• To evaluate the effectiveness of a temporary glucose target set before and during exercise.

Main Methods:

• Twenty-eight adolescents with T1D using HCL pumps participated in 40-minute sessions of MIE, HIE, and RE.
• A temporary glucose target of 8.3 mmol/L was implemented 2 hours prior to and during exercise.
• Continuous glucose monitoring, heart rate, lactate, ketones, and counter-regulatory hormones were measured for 280 minutes post-exercise onset.

Main Results:

• High-intensity interval exercise (HIE) and resistance exercise (RE) showed higher time in range (TIR) compared to moderate-intensity exercise (MIE).
• Hypoglycemia occurred in a significant portion of participants, primarily after meals post-exercise.
• Elevated lactate, growth hormone, noradrenaline, and heart rate were observed during HIE and RE compared to MIE.

Conclusions:

• HCL systems, with pre-set temporary glucose targets, facilitate excellent glycemic control during various exercise types in adolescents with T1D.
• Post-exercise adjustments to the temporary glucose target may be necessary to mitigate hypoglycemia risk.