Algorithm that delivers an individualized rapid-acting insulin dose after morning resistance exercise counters post-exercise hyperglycaemia in people with Type 1 diabetes

• Published in: Diabetic medicine 2016-04, Vol.33 (4), p.506-510
• Main Authors: Turner, D., Luzio, S., Gray, B. J., Bain, S. C., Hanley, S., Richards, A., Rhydderch, D. C., Martin, R., Campbell, M. D., Kilduff, L. P., West, D. J., Bracken, R. M.
• Format: Article
• Language: English
• Subjects: Adult; Algorithms; Blood Glucose - analysis; Combined Modality Therapy; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - therapy; Drug Administration Schedule; Drug Dosage Calculations; Drug Monitoring; Drug Therapy, Combination - adverse effects; Glucose; Humans; Hyperglycemia; Hyperglycemia - epidemiology; Hyperglycemia - etiology; Hyperglycemia - prevention & control; Hypoglycemia; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin; Insulin Aspart - administration & dosage; Insulin Aspart - adverse effects; Insulin Aspart - therapeutic use; Insulin Detemir - administration & dosage; Insulin Detemir - adverse effects; Insulin Detemir - therapeutic use; Insulin Glargine - administration & dosage; Insulin Glargine - adverse effects; Insulin Glargine - therapeutic use; Pilot Projects; Precision Medicine; Resistance Training - adverse effects; Risk; United Kingdom - epidemiology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.12870

Aims To develop an algorithm that delivers an individualized dose of rapid‐acting insulin after morning resistance exercise to counter post‐exercise hyperglycaemia in individuals with Type 1 diabetes. Methods Eight people with Type 1 diabetes, aged 34 ± 7 years with HbA1c concentrations 72 ± 12 mmol/mol (8.7 ± 1.1%), attended our laboratory on two separate mornings after fasting, having taken their usual basal insulin the previous evening. These people performed a resistance exercise session comprising six exercises for two sets of 10 repetitions at 60% of the maximum amount of force that was generated in one maximal contraction (60% 1RM). In a randomized and counterbalanced order, the participants were administered an individualized dose of rapid‐acting insulin (2 ± 1 units, range 0–4 units) immediately after resistance exercise (insulin session) by means of an algorithm or were not administered this (no‐insulin session). Venous blood glucose concentrations were measured for 125 min after resistance exercise. Data (mean ± sem values) were analysed using anova (P ≤ 0.05). Results Participants had immediate post‐resistance exercise hyperglycaemia (insulin session 13.0 ± 1.6 vs. no‐insulin session 12.7 ± 1.5 mmol/l; P = 0.834). The decline in blood glucose concentration between peak and 125 min after exercise was greater in the insulin exercise session than in the no‐insulin session (3.3 ± 1.0 vs. 1.3 ± 0.4 mmol/l: P = 0.015). There were no episodes of hypoglycaemia (blood glucose