575-P: Do Overnight Dips Exist following Afternoon Exercise? Factors Associated with Nocturnal Hypoglycemia in the Type 1 Diabetes Exercise Initiative Pediatric (T1DexiP) Study

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Some controlled studies have associated afternoon exercise with a biphasic pattern of hypoglycemia (hypo) risk: during exercise and 7-11hrs later. We explored factors relating to nocturnal hypo following afternoon exercise (12PM-6PM) among youth in the observational T1DexiP study. Youth with T1D (n=203; [mean±SD] age14±2 yrs; HbA1c=7.0± 1.2%; 42% female; T1D duration 5.4±3.9yrs; 12% on MDI and 58% on AID) wore a continuous glucose monitor, an activity monitor and logged activity using the Bant app for 10 days. Repeated measures logistic regression adjusted for bedtime glucose and % time below range (TBR < 70mg/dL) in the prior 24hrs. Of the 833 afternoon exercise sessions, 14% led to nocturnal hypo (≥15 consecutive minutes <70 mg/dL). Median TBR was higher in the 24hrs before exercise in youth who developed nocturnal hypo vs those who did not (3% vs 1%), while pre-exercise glucose level, heart rate, and insulin on board were similar. Nocturnal hypo risk was higher among teens who exercised more often during the study (Table). A trend for lower risk was noted with AID use. Our model revealed that participants who exercised >90 min/day had increased risk of nocturnal hypoglycemia, while AID use may reduce risk. This suggests algorithmically modulated insulin delivery may help to mitigate the impact of afternoon exercise on nocturnal glycemia. Disclosure J.Sherr: Advisory Panel; Bigfoot Biomedical, Inc., Insulet Corporation, Medtronic, Vertex Pharmaceuticals Incorporated, Cecelia Health, StartUp Health T1D Moonshot, Consultant; Bigfoot Biomedical, Inc., Insulet Corporation, Medtronic, Lilly, Research Support; Insulet Corporation, Medtronic, NIH - National Institutes of Health, Juvenile Diabetes Research Foundation (JDRF), Speaker's Bureau; Insulet Corporation, Zealand Pharma A/S, Lilly, Medtronic. S.Bergford: None. S.R.Patton: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes. P.Calhoun: None. R.L.Gal: None. M.Riddell: Advisory Panel; Zealand Pharma A/S, Zucara Therapeutics, Indigo Diabetes, Consultant; Lilly Diabetes, Eli Lilly and Company, Jaeb Center for Health Research, Speaker's Bureau; Dexcom, Inc., Novo Nordisk, Sanofi, Stock/Shareholder; Supersapiens, Zucara Therapeutics. T1dexip study group: n/a. Funding The Leona M. and Harry B. Helmsley Charitable Trust; Dexcom, Inc.