(DCP037) EFFECT OF TWO TIMINGS FOR POSTPRANDIAL EXERCISE ONSET ON HYPOGLYCEMIC RISK IN ADULTS LIVING WITH TYPE 1 DIABETES

Background: Reducing prandial insulin dose prior to an aerobic exercise session performed 90-min after a meal is efficient to limit the risk of hypoglycemia during exercise. People with type 1 diabetes also exercise further away or closer to their mealtime and the risk of hypoglycemia associated with those timings may be different. We aimed to evaluate the effect of two different timings for exercise onset (60-min vs. 120-min post-meal) associated with a 50% insulin bolus reduction on the risk of hypoglycemia during moderate intensity exercise in people with type 1 diabetes using multiple daily injections.

METHODS AND RESULTS: 40 participants (24 males; HbA1c: 7.4 ± 0.9%) received an ultra-rapid insulin dose (FiAsp) reduced by 50% and performed 60-min of continuous moderate intensity exercise (at 60% of VO2peak) either 60-min (EX60min) or 120-min (EX120min) after breakfast. Veinous blood glucose was measured every 10-min during exercise.

Results: Glucose levels at exercise onset was set as confounding factor and had a significant effect on our outcomes. Decrease in blood glucose between exercise onset and nadir (lowest point during exercise), time in range (3.9 – 10.0 mmol/L), time below range ( < 3.9mmol/L), and the number of hypoglycemic events during exercise and during recovery (90-min post-exercise) were similar between EX60min and EX120min. Decrease in blood glucose from start of exercise to post-recovery was more important with EX120 (-2.7 ± 3.4 mmol/L EX60 vs. -4.4 ± 3.1 mmol/L EX120, p< 0.001), without impacting time below range.

Conclusion:

Conclusion: The risk of hypoglycemia is limited when insulin meal bolus is reduced by 50%. Performing continuous moderate intensity exercise 60-min or 120-min post-meal does not impact the risk of hypoglycemia differently.