Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin.
Diabetes Care
; 29(10): 2200-4, 2006 Oct.
Article
em En
| MEDLINE
| ID: mdl-17003293
ABSTRACT
OBJECTIVE:
Strategies for preventing hypoglycemia during exercise in children with type 1 diabetes have not been well studied. The Diabetes Research in Children Network (DirecNet) Study Group conducted a study to determine whether stopping basal insulin could reduce the frequency of hypoglycemia occurring during exercise. RESEARCH DESIGN ANDMETHODS:
Using a randomized crossover design, 49 children 8-17 years of age with type 1 diabetes on insulin pump therapy were studied during structured exercise sessions on 2 days. On day 1, basal insulin was stopped during exercise, and on day 2 it was continued. Each exercise session, performed from approximately 400-500 p.m., consisted of four 15-min treadmill cycles at a target heart rate of 140 bpm (interspersed with three 5-min rest breaks over 75 min), followed by a 45-min observation period. Frequently sampled glucose concentrations (measured in the DirecNet Central Laboratory) were measured before, during, and after the exercise.RESULTS:
Hypoglycemia (< or = 70 mg/dl) during exercise occurred less frequently when the basal insulin was discontinued than when it was continued (16 vs. 43%; P = 0.003). Hyperglycemia (increase from baseline of > or = 20% to > or = 200 mg/dl) 45 min after the completion of exercise was more frequent without basal insulin (27 vs. 4%; P = 0.002). There were no cases of abnormal blood ketone levels.CONCLUSIONS:
Discontinuing basal insulin during exercise is an effective strategy for reducing hypoglycemia in children with type 1 diabetes, but the risk of hyperglycemia is increased.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sistemas de Infusão de Insulina
/
Exercício Físico
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Diabetes Mellitus Tipo 1
/
Hipoglicemia
Tipo de estudo:
Clinical_trials
Limite:
Adolescent
/
Child
/
Female
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Humans
/
Male
Idioma:
En
Revista:
Diabetes Care
Ano de publicação:
2006
Tipo de documento:
Article