Insulin pump therapy is associated with less post-exercise hyperglycemia than multiple daily injections: an observational study of physically active type 1 diabetes patients

Diabetes Technol Ther. 2013 Jan;15(1):84-8. doi: 10.1089/dia.2012.0168. Epub 2012 Dec 6.

Abstract

Background: Aerobic exercise typically decreases blood glucose levels in individuals with type 1 diabetes. It is currently unknown if glucose responses to exercise and recovery differ between patients on multiple daily insulin injections (MDI) and continuous subcutaneous insulin infusion (CSII).

Subjects and methods: Nineteen (16 male, three female) physically active individuals with type 1 diabetes took part in this observational study. Interstitial glucose levels (blinded) were compared during 45 min of standardized aerobic exercise (cycling or running at 60% peak aerobic capacity) and during 6 h of postexercise recovery between individuals using MDI (n=9) and CSII (n=10) therapy.

Results: Both MDI and CSII groups had similar reductions in glucose levels during exercise, but responses in early and late recovery differed (group × time interaction, P<0.01). Participants using MDI had greater increases in glucose throughout recovery compared with individuals with CSII. Two-thirds of the MDI patients experienced late-onset post-exercise hyperglycemia (blood glucose >12 mmol/L) compared with only 1/10(th) of the CSII patients (P<0.01).

Conclusions: Among individuals performing regular moderate-to-heavy intensity aerobic exercise, use of CSII helped to limit post-exercise hyperglycemia compared with MDI therapy and is not associated with increased risk for post-exercise late-onset hypoglycemia.

Publication types

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

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Drug Administration Schedule
  • Exercise*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / administration & dosage*
  • Infusion Pumps, Implantable*
  • Injections, Subcutaneous*
  • Insulin / administration & dosage*
  • Insulin Infusion Systems
  • Male

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human