Avoiding hypoglycemia: the use of insulin pump combined with continuous glucose monitor in type 1 diabetes crossing a Rocky Gorge
| Autor: | E Kyrlaki, G Panagopoulos, K Anifantakis, A Vazeou, P Smyrnaki, T Arvanitaki, Petros Thomakos, N Kefalogiannis, D Mamoulakis, A. Pappas, Asimina Mitrakou, D Sakkas |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Blood Glucose Male Insulin pump Adolescent 030209 endocrinology & metabolism Hypoglycemia Drug Administration Schedule Young Adult 03 medical and health sciences Insulin Infusion Systems 0302 clinical medicine Diabetes management Diabetes mellitus Humans Hypoglycemic Agents Insulin Medicine Prospective Studies 030212 general & internal medicine Prospective cohort study Exercise Glycated Hemoglobin Type 1 diabetes Greece business.industry Continuous glucose monitoring Blood Glucose Self-Monitoring General Medicine medicine.disease Diabetes Mellitus Type 1 Clinical research Anesthesia Multivariate Analysis Linear Models Female business |
| Zdroj: | QJM: An International Journal of Medicine. 111:629-633 |
| ISSN: | 1460-2393 1460-2725 |
| DOI: | 10.1093/qjmed/hcy136 |
| Popis: | Background Continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring systems (CGMS) have been proven very effective in diabetes management. Aim This study evaluated the usefulness of these devices during prolonged, intense physical activity in an uncontrolled natural environment away from the clinical research center. Design Non-randomized, prospective and observational study. Methods During the summer, 38 participants with type 1 diabetes crossed the Samaria gorge, the second largest gorge in Europe (17 km). Twenty subjects on CSII combined with real-time CGMS and 18 on multiple daily injections (MDI) combined with professional (retrospective) CGMS participated in the program. All participants were unsupervised during the event. Results All 38 participants managed to reach the destination point safely. There were no episodes of severe hypoglycemia. The duration of the exercise (mean ±SD) was 6.4 ± 1.3 h. The CSII group exhibited significantly lower hypoglycemic episodes during exercise (0.1 ± 0.3 vs. 0.4 ± 0.6; P = 0.047) as well as lower AUC below 70 mg/dl compared with the MDI, during the 24 h (0.61 ± 0.78 vs. 1.84 ± 1.55; P = 0.007). Individuals on CSII were significantly less likely to develop a hypoglycemic episode during exercise (P = 0.038). Exercise induced nocturnal hypoglycemia was not prevented effectively in neither group. Conclusions CSII combined with CGMS is effective in controlling blood glucose levels in type 1 diabetics who perform prolonged strenuous exercise. The use of insulin pump technology in regions with hot Mediterranean climates is safe and can provide protection against exercise-induced hypoglycemia. Development of precise instructions for T1DM who occasionally get involved in exercise activities, requires further studies. |
| Databáze: | OpenAIRE |
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