Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes.
OBJECTIVE
To determine the effects of reducing overnight basal insulin or a bedtime dose of terbutaline on nocturnal blood glucose (BG) nadir and hypoglycemia after exercise in children with type 1 diabetes mellitus.


METHODS
Sixteen youth (mean age 13.3 years) on insulin pumps were studied overnight on 3 occasions after a 60-minute exercise session with BG measurements every 30 minutes. Admissions were randomized to bedtime treatment with oral terbutaline 2.5 mg, 20% basal rate insulin reduction for 6 hours, or no treatment.


RESULTS
Mean overnight nadir BG was 188 mg/dL after terbutaline and 172 mg/dL with basal rate reduction compared with 127 mg/dL on the control night (P = .002 and .042, respectively). Terbutaline eliminated nocturnal hypoglycemia but resulted in significantly more hyperglycemia (≥250 mg/dL) when compared with the control visit (P < .0001). The basal rate reduction resulted in fewer BG readings <80 and <70 mg/dL but more readings ≥250 mg/dL when compared with the control visit.


CONCLUSIONS
A basal insulin rate reduction was safe and effective in raising post-exercise nocturnal BG nadir and in reducing hypoglycemia in children with type 1 diabetes mellitus. Although effective at preventing hypoglycemia, a 2.5-mg dose of terbutaline was associated with hyperglycemia.
Taplin
Craig E
CE
University of Colorado, Barbara Davis Center for Childhood Diabetes, Aurora, CO 80045, USA.
Cobry
Erin
E
Messer
Laurel
L
McFann
Kim
K
Chase
H Peter
HP
Fiallo-Scharer
Rosanna
R
D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D015444:Exercise; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000517:prevention & control*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D013726:Terbutaline / Q000627:therapeutic use*
D007328:Insulin; D013726:Terbutaline