TY - JOUR
T1 - Optimal predictive low glucose management settings during physical exercise in adolescents with type 1 diabetes
AU - Cherubini, Valentino
AU - Gesuita, Rosaria
AU - Skrami, Edlira
AU - Rabbone, Ivana
AU - Bonfanti, Riccardo
AU - Arnaldi, Claudia
AU - D'Annunzio, Giuseppe
AU - Frongia, Annapaola
AU - Lombardo, Fortunato
AU - Piccinno, Elvira
AU - Schiaffini, Riccardo
AU - Toni, Sonia
AU - Tumini, Stefano
AU - Tinti, Davide
AU - Cipriano, Paola
AU - Minuto, Nicola
AU - Lenzi, Lorenzo
AU - Ferrito, Lucia
AU - Ventrici, Claudia
AU - Ortolani, Federica
AU - Cohen, Ohad
AU - Scaramuzza, Andrea
N1 - Publisher Copyright:
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2019/2
Y1 - 2019/2
N2 - 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.
AB - 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.
KW - CGM
KW - SAP
KW - continuous glucose monitoring
KW - continuous subcutaneous insulin infusion
KW - insulin pump therapy
KW - predictive low glucose suspend
KW - thresholds
UR - http://www.scopus.com/inward/record.url?scp=85056876879&partnerID=8YFLogxK
U2 - 10.1111/pedi.12792
DO - 10.1111/pedi.12792
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C2 - 30378759
AN - SCOPUS:85056876879
SN - 1399-543X
VL - 20
SP - 107
EP - 112
JO - Pediatric Diabetes
JF - Pediatric Diabetes
IS - 1
ER -