Optimal predictive low glucose management settings during physical exercise in adolescents with type 1 diabetes

Valentino Cherubini, Rosaria Gesuita, Edlira Skrami, Ivana Rabbone, Riccardo Bonfanti, Claudia Arnaldi, Giuseppe D'Annunzio, Annapaola Frongia, Fortunato Lombardo, Elvira Piccinno, Riccardo Schiaffini, Sonia Toni, Stefano Tumini, Davide Tinti, Paola Cipriano, Nicola Minuto, Lorenzo Lenzi, Lucia Ferrito, Claudia Ventrici, Federica OrtolaniOhad Cohen, Andrea Scaramuzza

Research output: Contribution to journalArticle

Abstract

Objectives To assess the optimal setting of the predictive low glucose management (PLGM) algorithm for preventing exercise-induced hypoglycemia in adolescents with type 1 diabetes. Methods Thirty-four adolescents, 15 to 20 years, wearing PLGM system, were followed during 3?days exercise during a diabetes camp. PLGM threshold was set at 70?mg/dL between 8 am and 10 pm and 90?mg/dL during 10 pm and 8 am Adolescents were divided into group A and B, with PLGM threshold at 90 and 70?mg/dL, respectively, during exercise. Time spent in hypoglycemia and AUC for time slots 8 am to 1 pm, 1 to 4 pm, 4 to 11 pm, 11 pm to 3 am, 3 to 8 am, in 3?days were compared between groups by Wilcoxon rank sum test. Results We analyzed 31 patients (median age 15.0 years, 58.1% males, median diabetes duration 7.0 years, hemoglobin A1c [HbA1c] 7.1%). No significant difference has been observed in time spent in hypoglycemia between groups using threshold 70 or 90. Time spent in target was similar in both groups, as well as time spent in hypo or hyperglycemia. The trends of blood glucose over the 3 days in the 2 groups over-lapped without significant differences. Conclusions A PLGM threshold of 90?mg/dL during the night was associated with reduced time in hypoglycemia in adolescents doing frequent physical exercise, while maintaining 65.1% time in range during the day. However, a threshold of 70?mg/dL seems to be safe in the duration of the physical exercise. PLGM system in adolescents with type 1 diabetes was effective to prevent hypoglycemia during and after exercise, irrespective of the PLGM thresholds used.
Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalPediatric Diabetes
Volume20
Issue number1
DOIs
Publication statusPublished - 2019

Keywords

  • CGM
  • continuous glucose monitoring
  • continuous subcutaneous insulin infusion
  • insulin pump therapy
  • predictive low glucose suspend
  • SAP
  • thresholds

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    Cherubini, V., Gesuita, R., Skrami, E., Rabbone, I., Bonfanti, R., Arnaldi, C., D'Annunzio, G., Frongia, A., Lombardo, F., Piccinno, E., Schiaffini, R., Toni, S., Tumini, S., Tinti, D., Cipriano, P., Minuto, N., Lenzi, L., Ferrito, L., Ventrici, C., ... Scaramuzza, A. (2019). Optimal predictive low glucose management settings during physical exercise in adolescents with type 1 diabetes. Pediatric Diabetes, 20(1), 107-112. https://doi.org/10.1111/pedi.12792