Post-exercise Glucose Management in Type 1 Diabetes: Comparing Carbohydrate Intake and Insulin Reduction Strategies.
Sémah Tagougui, Elsa Heyman, Nadine Taleb et al.
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In 30 seconds
This randomized comparative study evaluated two post-exercise glucose management strategies in 46 adults and adolescents with type 1 diabetes using continuous subcutaneous insulin infusion. After a 60-minute cycling session, participants received either reduced basal and dinner bolus insulin or a carbohydrate-snack strategy. Over 13 hours of recovery, the strategies did not differ significantly in time within the target glucose range or time below range. However, the first hypoglycemic event occurred later with basal insulin reduction: 140 vs 83 min (P= .04).
Key findings
- Time within 4.0-10.0 mmol/l was 54.4 ± 26.2 vs 57.7 ± 25.9% for the two strategies, with no significant difference.
- Time below 4.0 mmol/l was 1.8 ± 5.9 vs 5.5 ± 9.2%, a difference that did not reach statistical significance.
- Time to first interstitial glucose <4.0 mmol/L was longer with basal insulin reduction: 140 vs 83 min (P= .04).
Why it matters
Post-exercise hypoglycemia is a relevant concern in type 1 diabetes, and this comparison suggests that glucose stability over the recovery period may be similar with either approach while the timing of the first low glucose event differs. The findings help characterize a potential trade-off between insulin adjustment and carbohydrate-based strategies after exercise.
What to keep in mind
The study reports substantial interindividual variability, reflected in large standard deviations; the reported comparison covers only the 13-hour recovery period after a specific exercise session.