title: Similar risk of exercise-related hypoglycaemia for insulin degludec to that for insulin glargine in patients with type 1 diabetes: a randomized cross-over trial.
abstract: We compared changes in blood glucose (BG) and risk of hypoglycaemia during and after exercise in 40 patients with type 1 diabetes (T1D) treated with insulin degludec (IDeg) or insulin glargine (IGlar) in a randomized, open-label, two-period, crossover trial. After individual titration and a steady-state period, patients performed 30 min of moderate-intensity cycle ergometer exercise (65% peak rate of oxygen uptake). BG, counter-regulatory hormones and hypoglycaemic episodes were measured frequently during and for 24 h after exercise. BG changes during exercise were similar with IDeg and IGlar [estimated treatment difference (ETD) for maximum BG decrease: 0.14 mmol/l; 95% confidence interval (CI) -0.15, 0.42; p = 0.34], as was mean BG (ETD -0.16 mmol/l; 95% CI -0.36, 0.05; p = 0.13). No hypoglycaemic episodes occurred during exercise. Post-exercise mean BG, counter-regulatory hormone response and number of hypoglycaemic episodes in 24 h after starting exercise were similar with IDeg (18 events in 13 patients) and IGlar (23 events in 15 patients). This clinical trial showed that, in patients with T1D treated with a basal-bolus regimen, the risk of hypoglycaemia induced by moderate-intensity exercise was low with IDeg and similar to that with IGlar.
authors.affiliation: Profil, Neuss, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Heise
authors.affiliation: Diabetes and Endocrinology Department, Swansea University, Swansea, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Bain
authors.affiliation: Diabetes and Endocrinology Department, Swansea University, Swansea, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Bracken
authors.affiliation: Profil, Neuss, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Zijlstra
authors.affiliation: Profil, Neuss, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Nosek
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Stender-Petersen
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Rabøl
authors.affiliation: Novo Nordisk Inc., Plainsboro, NJ, USA.
authors.forename: E
authors.initials: E
authors.lastname: Rowe
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: H L
authors.initials: HL
authors.lastname: Haahr
mesh_terms: D000293:Adolescent; D000328:Adult; D002940:Circadian Rhythm; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005080:Exercise Test / Q000009:adverse effects; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D061267:Insulin Aspart / Q000009:adverse effects / Q000627:therapeutic use; D000069036:Insulin Glargine / Q000009:adverse effects* / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012306:Risk; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; C571886:insulin degludec; D061267:Insulin Aspart
keywords: exercise; glycaemic control; insulin therapy; type 1 diabetes