Combined algorithm-based adaptations of insulin dose and carbohydrate intake during exercise in children with type 1 diabetes: results from the CAR2DIAB study

Details

Supervisors

Reychler, Gregory

Faculty

Faculté des sciences de la motricité

Degree label

Master [120] en sciences de la motricité, orientation générale, à finalité approfondie

Abstract

Objectives: To evaluate the evolution of subcutaneous glucose during two sessions of monitored exercise in youth with type 1 diabetes after adaptation of insulin doses and carbohydrate intake according to a combined algorithm. Methods: Twelve patients with type 1 diabetes (15.1±2 years) performed two series of exercise sessions after cardiac evaluation. First series (TE#1) consisted in a monitored exercise of moderate to vigorous intensity coupled with a bout of maximum effort. Second series of exercises (TE#2) were performed in real life and were monitored by connected watches. TE#2 sessions were performed after adaptation of insulin doses and carbohydrates according to decision algorithms. Results: No patient experienced episodes of severe hypoglycemia, symptomatic hyperglycemia or hyperglycemia associated with ketosis. Analysis of CGM data (15h) during TE#2 sessions revealed an overall improvement in glycemic average [± standard deviation] (P<0.001), and a decrease in proportion of hyperglycemia in periods ranging from 4h to 15h after performing the exercises. The proportion of hypoglycemia was not changed, except during the TE#2 +4-8h period, where a significant increase in hypoglycemia <60 mg/dL was observed (P=0.04), yet without concurrent complications. Conclusion: In our pediatric series, the application of algorithmic adaptations of insulin doses and carbohydrate intake has globally improved glycemic control during 15h after real-time exercises performed by children and adolescents with type 1 diabetes.