Safety and Feasibility Evaluation of Step Count Informed Meal Boluses in Type 1 Diabetes: A Pilot Study.
J Diabetes Sci Technol
; 16(3): 670-676, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-33794675
ABSTRACT
BACKGROUND:
Physical activity can cause glucose fluctuations both during and after it is performed, leading to hurdles in optimal insulin dosing in people with type 1 diabetes (T1D). We conducted a pilot clinical trial assessing the safety and feasibility of a physical activity-informed mealtime insulin bolus advisor that adjusts the meal bolus according to previous physical activity, based on step count data collected through an off-the-shelf physical activity tracker.METHODS:
Fifteen adults with T1D, each using a continuous glucose monitor (CGM) and an insulin pump with carbohydrate counting, completed two randomized crossover daily visits. Participants performed a 30 to 45-minute brisk walk before lunch and lunchtime insulin boluses were calculated based on either their standard therapy (ST) or the physical activity-informed bolus method. Post-lunch glycemic excursions were assessed using CGM readings.RESULTS:
There was no significant difference between visits in the time spent in hypoglycemia in the post-lunch period (median [IQR] standard 0 [0]% vs physical activity-informed 0 [0]%, P = NS). Standard therapy bolus yielded a higher time spent in 70 to 180 mg/dL target range (mean ± standard 77% ± 27% vs physical activity-informed 59% ± 31%, P = .03) yet, it was associated with a steeper negative slope in the early postprandial phase (P = .032).CONCLUSIONS:
Use of step count to adjust mealtime insulin following a walking bout has proved to be safe and feasible in a cohort of 15 T1D subjects. Physical activity-informed insulin dosing of meals eaten soon after a walking bout has a potential of mitigating physical activity related glucose reduction in the early postprandial phase.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus Tipo 1
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article