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

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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
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引用次数: 0

摘要

目的:利用混合型闭环胰岛素泵测量与活动相关的额外生理信号,比较青少年1型糖尿病(T1D)患者中强度运动(MIE)、高强度间歇运动(HIE)和阻力运动(RE)期间和之后的血糖结局。方法:28名青少年(平均年龄16.3±2.1岁,50%为女性,平均T1D持续时间9.4±4年)使用HCL(美敦力MiniMed 670G)进行40分钟的MIE、HIE和RE,并在运动前和运动中设定临时血糖目标(8.3 mmol/L, 150 mg/dL)。在运动开始后280分钟测量心率、加速度计、静脉葡萄糖、乳酸、酮和反调节激素。主要终点是葡萄糖百分比时间范围(TIR):从运动开始14小时内3.9-10 mmol/L (70-180 mg/dL)。结果:运动开始后14小时,HIE的TIR中位数(四分位数间距)为88 (78,96)%,MIE为79 (63,88)%,RE为86(72,95)%。MIE与HIE相比,TIR更低(P = 0.012),时间高于范围(TAR)更高(18%[2.4,28]比6.9 [0.0,14]%,P = 0.041)。HIE、MIE和RE参与者中分别有13人(46%)、11人(39%)和14人(50%)发生低血糖,其中大多数发生在运动后进餐后。HIE和RE患者的乳酸水平(P = 0.001)、生长激素(P = 0.001)、去甲肾上腺素(P = 0.001)和心率(P = 0.01)均高于MIE。结论:在T1D青少年患者中使用HCL,在不同形式的运动中,如果提前2小时设定临时目标,可以获得优异的TIR。延长运动后的临时目标也可能有助于减少运动后低血糖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
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.
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