title: Impact of exercise on overnight glycemic control in children with type 1 diabetes mellitus.
abstract: OBJECTIVE
  To examine the effect of exercise on overnight hypoglycemia in children with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  At 5 clinical sites, 50 subjects with T1DM (age 11 to 17 years) were studied in a clinical research center on 2 separate days. One day included an afternoon exercise session on a treadmill. On both days, frequently sampled blood glucose levels were measured at the DirecNet central laboratory. Insulin doses were similar on both days.
  
  
  RESULTS
  During exercise, plasma glucose levels fell in almost all subjects; 11 (22%) developed hypoglycemia. Mean glucose level from 10 pm to 6 am was lower on the exercise day than on the sedentary day (131 vs 154 mg/dL; P=.003). Hypoglycemia developed overnight more often on the exercise nights than on the sedentary nights (P=.009), occurring on the exercise night only in 13 (26%), on the sedentary night only in 3 (6%), on both nights in 11 (22%), and on neither night in 23 (46%). Hypoglycemia was unusual on the sedentary night if the pre-bedtime snack glucose level was>130 mg/dL.
  
  
  CONCLUSIONS
  These findings indicate that overnight hypoglycemia after exercise is common in children with T1DM and support the importance of modifying diabetes management after afternoon exercise to reduce the risk of hypoglycemia.
authors.affiliation: DirectNet Coordinating Center, Jaeb Center for Health Research, Tampa, Florida 33647, USA. direcnet@jaeb.org
authors.forename: Eva
authors.initials: E
authors.lastname: Tsalikian
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: William V
authors.initials: WV
authors.lastname: Tamborlane
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Janz
authors.forename: H Peter
authors.initials: HP
authors.lastname: Chase
authors.forename: Tim
authors.initials: T
authors.lastname: Wysocki
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Weinzimer
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Buckingham
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Dongyuan
authors.initials: D
authors.lastname: Xing
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Ruedy
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology*; D015331:Cohort Studies; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D008297:Male
chemical_list: D001786:Blood Glucose