Cited by 61Diabetes Management and ResearchPhysical Activity and HealthDiabetes Management and Education

The Effects of Basal Insulin Suspension at the Start of Exercise on Blood Glucose Levels During Continuous Versus Circuit-Based Exercise in Individuals with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion

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Zaharieva, Dessi, Yavelberg, Loren, Jamnik, Veronica, Cinar, Ali, Turksoy, Kamuran, Riddell, Michael C.·2017·Diabetes Technology & Therapeutics

Abstract

BACKGROUND: Exercise causes glycemic disturbances in individuals with type 1 diabetes (T1D). Continuous moderate-intensity aerobic exercise (CON) generally lowers blood glucose (BG) levels and often leads to hypoglycemia. In comparison, circuit-based exercise (CIRC) may attenuate the drop in BG. The goal of this study is to contrast the effects of basal insulin suspension at the onset of two different forms of exercise (CON vs. CIRC). METHODS: Twelve individuals (six men and six women) with T1D on insulin pump therapy were recruited for the study. All participants completed a maximal aerobic fitness test and two 40-min exercise sessions, consisting of either continuous treadmill walking or a circuit workout. Basal insulin infusion was stopped at the onset of exercise and resumed in recovery. After providing an initial reference value, volunteers were blinded to their [BG] and were asked to estimate their levels during exercise. RESULTS: , P = 0.03) and heart rate (122 ± 20 vs. 144 ± 20 bpm, P = 0.003) were lower in CON vs. CIRC. Despite the lower workload, BG levels dropped more with CON vs. CIRC (delta BG = -3.8 ± 1.5 vs. -0.5 ± 3.0 mmol/L for CON vs. CIRC, respectively, P = 0.001). Participants were able to estimate their BG more accurately during CON (r = 0.83) vs. CIRC (r = 0.33) based on a regression analysis. CONCLUSION: Despite a lower intensity of exercise, with full basal insulin suspension at the start of exercise, CON results in a larger drop in BG vs. CIRC. These findings have implications for single hormone-based artificial pancreas development for exercise. While this study does not negate the importance of frequent capillary BG monitoring during exercise, it does suggest that if persons are knowledgeable about their pre-exercise BG levels, they can accurately perceive the changes in BG during CON, but not during CIRC.

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  • Monitoring of patient physical activity levels may be helpful in implementing insulin and/or nutritional strategies to optimize glucose control in type 1 diabetes.

    “Monitoring of patient physical activity levels may be helpful in implementing insulin and/or nutritional strategies to optimize glucose control in type 1 diabetes [4].”

    From Accuracy of Wrist-Worn Activity Monitors During Common Daily Physical Activities and Types of Structured Exercise: Evaluation Study (2018) · cites this paper as [4]

    The Introduction (page unavailable) says exercise type affects blood glucose in type 1 diabetes and that insulin adjustments or carbohydrate intake can affect the response. The Discussion (page unavailable) also reports different glucose responses to continuous and circuit-based exercise. The paper does not establish that monitoring patients’ physical activity levels helps implement insulin or nutritional strategies; its monitoring recommendation concerns blood glucose. (LLM, conf=0.78)

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Research works printed but not linked: 2

  1. [11]Jamnik VK, Warburton DE, Makarski J, et al. : Enhancing the effectiveness of clearance for physical activity participation: background and overall process. Appl Physiol Nutr Metab 2011;36:S3–S13 [DOI] [PubMed] [Google Scholar]
  2. [29]Riddell MC, Bar-Or O: Children and adolescents. In: Ruderman N, Devlin JT, Schneider SH, eds. Handbook of Exercise and Diabetes. Alexandria, VA: American Diabetes Association, 2002, pp. 547–566 [Google Scholar]

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Authors
Zaharieva, D., Yavelberg, L., Jamnik, V., Cinar, A., Turksoy, K., & Riddell, M. C.
Affiliations
  • York University (CA)
  • Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois.
  • Illinois Institute of Technology (US)
Corresponding author
Riddell, Michael C.
Venue
Diabetes Technology & Therapeutics
Published
2017-06
Volume
19
Issue
6
Pages
370-378
ISSN
  • 1520-9156 (ISSN-L)
  • 1557-8593
OpenAlex
W2728434455
Cited by
61
References
38
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 6 · 2022: 6 · 2021: 8 · 2020: 10 · 2019: 18 · 2018: 8 · 2017: 1
FWCI
8.00
Type
journal article
Language
en
Open access
Locations
  • Diabetes Technology & Therapeutics (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (DP3DK101075, DP3DK101077)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
type 1 diabetes, insulin pump therapy, continuous aerobic exercise, hypoglycemia, self-monitoring of blood glucose, heart rate, artificial pancreas
MeSH terms
Adult, Algorithms, Blood Glucose, Combined Modality Therapy, Diabetes Mellitus, Type 1, Physical Exertion, Female, Heart Rate, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Ontario, Oxygen Consumption, Suspensions, Exercise, Single-Blind Method, Cross-Over Studies, Young Adult

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