Rowen Seckold, Carmel E Smart, David N O'Neal, Michael C Riddell, Jordan Rafferty, Dale Morrison, Varuni Obeyesekere, Judy L Gooley, Barbora Paldus, Sarah R Valkenborghs, Sara Vogrin, Dessi P Zaharieva, Bruce R King
{"title":"使用混合闭环系统比较青少年1型糖尿病患者三种不同运动类型的葡萄糖和附加信号","authors":"Rowen Seckold, Carmel E Smart, David N O'Neal, Michael C Riddell, Jordan Rafferty, Dale Morrison, Varuni Obeyesekere, Judy L Gooley, Barbora Paldus, Sarah R Valkenborghs, Sara Vogrin, Dessi P Zaharieva, Bruce R King","doi":"10.1089/dia.2024.0254","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objective:</i></b> To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. <b><i>Methods:</i></b> Twenty-eight adolescents (average age 16.3 ± 2.1 years, 50% females, average duration of T1D 9.4 ± 4 years) using HCL (Medtronic MiniMed 670G) undertook 40 min of MIE, HIE, and RE. A temporary glucose target (8.3 mmol/L, 150 mg/dL) was set for 2 h prior and during exercise. Heart rate, accelerometer, venous glucose, lactate, ketones, and counter-regulatory hormones were measured for 280 min postexercise commencement. The primary outcome was glucose percentage time in range (TIR): 3.9-10 mmol/L (70-180 mg/dL) for 14 h from exercise onset. <b><i>Results:</i></b> Median (interquartile range) TIR for HIE was 88 (78, 96)%, MIE 79 (63, 88)%, and RE 86 (72, 95)% for 14 h from exercise onset. For MIE compared with HIE, TIR was lower (<i>P</i> = 0.012) and time above range (TAR) was greater (18 [2.4, 28] vs. 6.9 [0.0, 14]%, <i>P</i> = 0.041). Hypoglycemia occurred in 13 (46%), 11 (39%), and 14 (50%) of participants for HIE, MIE, and RE, respectively, the majority following the meal after exercise. There were higher levels of lactate (<i>P</i> = 0.001), growth hormone (<i>P</i> = 0.001), noradrenaline (<i>P</i> = 0.001), and heart rate (<i>P</i> = 0.01) during HIE and RE compared with MIE. <b><i>Conclusions</i></b>: HCL use in adolescents with T1D results in excellent TIR during different forms of exercise when a temporary target is set 2 h before. Extending the temporary target after exercise may also be needed to help minimize postexercise hypoglycemia.</p>","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":" ","pages":""},"PeriodicalIF":5.7000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Comparison of Glucose and Additional Signals for Three Different Exercise Types in Adolescents with Type 1 Diabetes Using a Hybrid Closed-Loop System.\",\"authors\":\"Rowen Seckold, Carmel E Smart, David N O'Neal, Michael C Riddell, Jordan Rafferty, Dale Morrison, Varuni Obeyesekere, Judy L Gooley, Barbora Paldus, Sarah R Valkenborghs, Sara Vogrin, Dessi P Zaharieva, Bruce R King\",\"doi\":\"10.1089/dia.2024.0254\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Objective:</i></b> To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. <b><i>Methods:</i></b> Twenty-eight adolescents (average age 16.3 ± 2.1 years, 50% females, average duration of T1D 9.4 ± 4 years) using HCL (Medtronic MiniMed 670G) undertook 40 min of MIE, HIE, and RE. A temporary glucose target (8.3 mmol/L, 150 mg/dL) was set for 2 h prior and during exercise. Heart rate, accelerometer, venous glucose, lactate, ketones, and counter-regulatory hormones were measured for 280 min postexercise commencement. The primary outcome was glucose percentage time in range (TIR): 3.9-10 mmol/L (70-180 mg/dL) for 14 h from exercise onset. <b><i>Results:</i></b> Median (interquartile range) TIR for HIE was 88 (78, 96)%, MIE 79 (63, 88)%, and RE 86 (72, 95)% for 14 h from exercise onset. For MIE compared with HIE, TIR was lower (<i>P</i> = 0.012) and time above range (TAR) was greater (18 [2.4, 28] vs. 6.9 [0.0, 14]%, <i>P</i> = 0.041). Hypoglycemia occurred in 13 (46%), 11 (39%), and 14 (50%) of participants for HIE, MIE, and RE, respectively, the majority following the meal after exercise. There were higher levels of lactate (<i>P</i> = 0.001), growth hormone (<i>P</i> = 0.001), noradrenaline (<i>P</i> = 0.001), and heart rate (<i>P</i> = 0.01) during HIE and RE compared with MIE. <b><i>Conclusions</i></b>: HCL use in adolescents with T1D results in excellent TIR during different forms of exercise when a temporary target is set 2 h before. Extending the temporary target after exercise may also be needed to help minimize postexercise hypoglycemia.</p>\",\"PeriodicalId\":11159,\"journal\":{\"name\":\"Diabetes technology & therapeutics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-01-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes technology & therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/dia.2024.0254\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes technology & therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/dia.2024.0254","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
A Comparison of Glucose and Additional Signals for Three Different Exercise Types in Adolescents with Type 1 Diabetes Using a Hybrid Closed-Loop System.
Objective: To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. Methods: Twenty-eight adolescents (average age 16.3 ± 2.1 years, 50% females, average duration of T1D 9.4 ± 4 years) using HCL (Medtronic MiniMed 670G) undertook 40 min of MIE, HIE, and RE. A temporary glucose target (8.3 mmol/L, 150 mg/dL) was set for 2 h prior and during exercise. Heart rate, accelerometer, venous glucose, lactate, ketones, and counter-regulatory hormones were measured for 280 min postexercise commencement. The primary outcome was glucose percentage time in range (TIR): 3.9-10 mmol/L (70-180 mg/dL) for 14 h from exercise onset. Results: Median (interquartile range) TIR for HIE was 88 (78, 96)%, MIE 79 (63, 88)%, and RE 86 (72, 95)% for 14 h from exercise onset. For MIE compared with HIE, TIR was lower (P = 0.012) and time above range (TAR) was greater (18 [2.4, 28] vs. 6.9 [0.0, 14]%, P = 0.041). Hypoglycemia occurred in 13 (46%), 11 (39%), and 14 (50%) of participants for HIE, MIE, and RE, respectively, the majority following the meal after exercise. There were higher levels of lactate (P = 0.001), growth hormone (P = 0.001), noradrenaline (P = 0.001), and heart rate (P = 0.01) during HIE and RE compared with MIE. Conclusions: HCL use in adolescents with T1D results in excellent TIR during different forms of exercise when a temporary target is set 2 h before. Extending the temporary target after exercise may also be needed to help minimize postexercise hypoglycemia.
期刊介绍:
Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.