Effect of Impaired Awareness of Hypoglycemia on Glucose Decline During and After Exercise in the T1DEXI Study.
J Clin Endocrinol Metab
; 109(9): 2233-2241, 2024 Aug 13.
Article
en En
| MEDLINE
| ID: mdl-38441232
ABSTRACT
CONTEXT Adults with type 1 diabetes (T1D) face the necessity of balancing the benefits of exercise with the potential hazards of hypoglycemia. OBJECTIVE:
This work aimed to assess whether impaired awareness of hypoglycemia (IAH) affects exercise-associated hypoglycemia in adults with T1D.METHODS:
We compared continuous glucose monitoring (CGM)-measured glucose during exercise and for 24 hours following exercise from 95 adults with T1D and IAH (Clarke score ≥4 or ≥1 severe hypoglycemic event within the past year) to 95 "aware" adults (Clarke score ≤2 and no severe hypoglycemic event within the past year) matched on sex, age, insulin delivery modality, and glycated hemoglobin A1c. A total of 4236 exercise sessions, and 1794 exercise days and 839 sedentary days, defined as 24 hours following exercise or a day without exercise, respectively, were available for analysis.RESULTS:
Participants with IAH exhibited a nonsignificant trend toward greater decline in glucose during exercise compared to "aware" (-21 ± 44 vs -19 ± 43â mg/dL [-1.17 ± 2.44 vs -1.05 ± 2.39 mmol/L], adjusted group difference of -4.2 [95% CI, -8.4 to 0.05] mg/dL [-0.23 95% CI, -.47 to 0.003â mmol/L]; P = .051). Individuals with IAH had a higher proportion of days with hypoglycemic events below 70â mg/dL [3.89â mmol/L] (≥15â minutes <70 mg/dL [<3.89 mmol/L]) both on exercise days (51% vs 43%; P = .006) and sedentary days (48% vs 30%; P = .001). The increased odds of experiencing a hypoglycemic event below 70 mg/dL (<3.89â mmol/L) for individuals with IAH compared to "aware" did not differ significantly between exercise and sedentary days (interaction P = .36).CONCLUSION:
Individuals with IAH have a higher underlying risk of hypoglycemia than "aware" individuals. Exercise does not appear to differentially increase risk for hypoglycemia during the activity, or in the subsequent 24 hours for IAH compared to aware individuals with T1D.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
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Automonitorización de la Glucosa Sanguínea
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Ejercicio Físico
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Diabetes Mellitus Tipo 1
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Hipoglucemia
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos