title: Insulin pump therapy is associated with less post-exercise hyperglycemia than multiple daily injections: an observational study of physically active type 1 diabetes patients.
abstract: BACKGROUND
  Aerobic exercise typically decreases blood glucose levels in individuals with type 1 diabetes. It is currently unknown if glucose responses to exercise and recovery differ between patients on multiple daily insulin injections (MDI) and continuous subcutaneous insulin infusion (CSII).
  
  
  METHODS
  Nineteen (16 male, three female) physically active individuals with type 1 diabetes took part in this observational study. Interstitial glucose levels (blinded) were compared during 45 min of standardized aerobic exercise (cycling or running at 60% peak aerobic capacity) and during 6 h of postexercise recovery between individuals using MDI (n=9) and CSII (n=10) therapy.
  
  
  RESULTS
  Both MDI and CSII groups had similar reductions in glucose levels during exercise, but responses in early and late recovery differed (group × time interaction, P<0.01). Participants using MDI had greater increases in glucose throughout recovery compared with individuals with CSII. Two-thirds of the MDI patients experienced late-onset post-exercise hyperglycemia (blood glucose >12 mmol/L) compared with only 1/10(th) of the CSII patients (P<0.01).
  
  
  CONCLUSIONS
  Among individuals performing regular moderate-to-heavy intensity aerobic exercise, use of CSII helped to limit post-exercise hyperglycemia compared with MDI therapy and is not associated with increased risk for post-exercise late-onset hypoglycemia.
authors.affiliation: Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Yardley
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Iscoe
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Sigal
authors.forename: Glen P
authors.initials: GP
authors.lastname: Kenny
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Perkins
authors.forename: Michael C
authors.initials: MC
authors.lastname: Riddell
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004334:Drug Administration Schedule; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D015918:Infusion Pumps, Implantable; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human