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

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.

O uso de aromaterapia durante o trabalho de parto: uma revisão integrativa

“…Trata-se de uma revisão integrativa de literatura, que consiste em vários estudos científicos ampliados e completos na área de saúde. O tipo de estudo qualitativo e descritivo, realizado através de materiais científicos indexados nas pesquisas acadêmicas de saúde, nos diversos periódicos nacionais e internacionais (CHERUBINI et al, 2019).…”

“…intervenção em: Nível I -revisão sistemática ou metanálise; Nível II -estudos controlados e aleatórios; Nível III -estudos controlados sem randomização; Nível IV -estudos caso-controle ou de coorte; Nível V -revisão sistemática de estudos qualitativos ou descritivos; Nível VIestudos qualitativos ou descritivos e Nível VII -opiniões ou consensos(CHERUBINI et al, 2019). Os artigos selecionados para o estudo, apresenta as devidas recomendações do PRISMA, representado na Figura 1.…”

Hybrid Closed-Loop Systems for the Treatment of Type 1 Diabetes: A Collaborative, Expert Group Position Statement for Clinical Use in Central and Eastern Europe

“…Published evidence has indicated that SAPs are associated with reduced moderate and severe hypoglycemia compared with MDI and reduced severe hypoglycemia compared with CSII, as well as improved blood glucose levels and glycemic variability versus sensor-augmented MDI therapy, while SIPs have been associated with a significantly reduced time spent in hypoglycemia and substantially fewer non-severe and severe hypoglycemic events compared with CSII in individuals with T1D with a high risk of hypoglycemia [37][38][39]. SIPs have also been associated with effective prevention of exerciseinduced hypoglycemia [40,41].…”

Real-time continuous glucose monitoring systems in patients with type 1 diabetes. Expert group report

“…The Diabetes Poland clinical guidelines define the principles of determining the eligibility of people living with type 1 diabetes for practising sports, with consideration of professional and extreme sports. In line with the Diabetes Poland position, the use of CGM systems is recommended while practising high-risk sport disciplines [33][34][35][36][37][38][39][40][41][42][43][44].…”