title: Algorithm that delivers an individualized rapid-acting insulin dose after morning resistance exercise counters post-exercise hyperglycaemia in people with Type 1 diabetes.
abstract: OBJECTIVE
  To develop an algorithm that delivers an individualized dose of rapid-acting insulin after morning resistance exercise to counter post-exercise hyperglycaemia in individuals with Type 1 diabetes.
  
  
  METHODS
  Eight people with Type 1 diabetes, aged 34 ± 7 years with HbA1c concentrations 72 ± 12 mmol/mol (8.7 ± 1.1%), attended our laboratory on two separate mornings after fasting, having taken their usual basal insulin the previous evening. These people performed a resistance exercise session comprising six exercises for two sets of 10 repetitions at 60% of the maximum amount of force that was generated in one maximal contraction (60% 1RM). In a randomized and counterbalanced order, the participants were administered an individualized dose of rapid-acting insulin (2 ± 1 units, range 0-4 units) immediately after resistance exercise (insulin session) by means of an algorithm or were not administered this (no-insulin session). Venous blood glucose concentrations were measured for 125 min after resistance exercise. Data (mean ± sem values) were analysed using anova (P ≤ 0.05).
  
  
  RESULTS
  Participants had immediate post-resistance exercise hyperglycaemia (insulin session 13.0 ± 1.6 vs. no-insulin session 12.7 ± 1.5 mmol/l; P = 0.834). The decline in blood glucose concentration between peak and 125 min after exercise was greater in the insulin exercise session than in the no-insulin session (3.3 ± 1.0 vs. 1.3 ± 0.4 mmol/l: P = 0.015). There were no episodes of hypoglycaemia (blood glucose <3.9 mmol/l).
  
  
  CONCLUSIONS
  Administration of rapid-acting insulin according to an individualized algorithm reduced the hyperglycaemia associated with morning resistance exercise without causing hypoglycaemia in the 2 h post-exercise period in people with Type 1 diabetes.
authors.affiliation: Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK.|Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK.
authors.forename: D
authors.initials: D
authors.lastname: Turner
authors.affiliation: Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK.|Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea, UK.
authors.forename: S
authors.initials: S
authors.lastname: Luzio
authors.affiliation: Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK.|Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Gray
authors.affiliation: Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK.|Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Bain
authors.affiliation: Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK.
authors.forename: S
authors.initials: S
authors.lastname: Hanley
authors.affiliation: Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea, UK.
authors.forename: A
authors.initials: A
authors.lastname: Richards
authors.affiliation: Abertawe Bro Morgannwg University Health Board, Singleton Hospital, Swansea, UK.
authors.forename: D C
authors.initials: DC
authors.lastname: Rhydderch
authors.affiliation: Cwm Taf University Health Board, Merthyr Tydfil, UK.
authors.forename: R
authors.initials: R
authors.lastname: Martin
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Campbell
authors.affiliation: Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK.
authors.forename: L P
authors.initials: LP
authors.lastname: Kilduff
authors.affiliation: Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: West
authors.affiliation: Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, UK.|Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Bracken
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000628:therapy; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D016903:Drug Monitoring; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D061267:Insulin Aspart / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000069057:Insulin Detemir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000069036:Insulin Glargine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010865:Pilot Projects; D057285:Precision Medicine; D055070:Resistance Training / Q000009:adverse effects*; D012306:Risk; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D000069057:Insulin Detemir; D061267:Insulin Aspart