Improved glycaemic variability and basal insulin dose reduction during a running competition in recreationally active adults with type 1 diabetes-A single-centre, prospective, controlled observational study

PLoS One. 2020 Sep 11;15(9):e0239091. doi: 10.1371/journal.pone.0239091. eCollection 2020.

Abstract

Introduction: To investigate the glycaemic response, macronutrient intake and insulin management in people with type 1 diabetes (T1D) compared to healthy individuals around a running competition.

Material and methods: This was a single-centre, prospective, controlled observational study performed in individuals with T1D and healthy people. 24 people (12 T1D) were included in this study (age: T1D 41±12 vs. healthy 38±6 years, females: 3 vs. 6, BMI: 25.53.0 vs. 22.9±2.8 kg/m2). Both groups received an intermittently scanned continuous glucose monitoring (isCGM; FreeStyle Libre 1, Abbott, USA) system to assess glycaemia 24 hours before, during and 24 hours after a running competition. During this period, participants recorded their food intake and insulin administration. Data were analysed via ANOVA and mixed model analyses with post-hoc testing (p≤0.05).

Results: For overall glycaemic ranges in comparison of groups, significant differences were found for time in range (T1D 63±21% vs. healthy 89±13%, p = 0.001), time above range (TAR) 1 (T1D 21±15% vs. healthy 0±0%, p<0.001) and TAR 2 (T1D 8 [0-16%] vs. healthy 0±0%, p<0.001). When glycaemic variability was assessed, people with T1D had a higher glycaemic variability compared to healthy individuals (p<0.0001). Basal insulin dose was significantly reduced when compared against the regular pre-study basal insulin dose (pre-study 22±6 vs. pre-competition day 11±9 (-50±41%), p = 0.02; competition day 15±5 (-32± 1%)).

Conclusion: People with T1D have impaired glucose responses around a running competition compared to healthy individuals. However, basal insulin dose reductions were sufficient to prevent further dysglycaemia.

Clinical trial id: drks.de; DRKS00019886.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / drug effects
  • Blood Glucose / physiology*
  • Blood Glucose Self-Monitoring / statistics & numerical data
  • Case-Control Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Dose-Response Relationship, Drug
  • Eating / physiology*
  • Female
  • Germany
  • Humans
  • Insulin / administration & dosage*
  • Male
  • Middle Aged
  • Prospective Studies
  • Running / physiology*
  • Young Adult

Substances

  • Blood Glucose
  • Insulin

Associated data

  • DRKS/DRKS00019886

Grants and funding

This work was supported by Eli Lilly Austria and Novo Nordisk Austria. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.