Can laboratory based research regarding type 1 diabetes and exercise be applied into the real‐life environment?

Abstract

AbstractThe aim of this study was to determine whether results from laboratory based research examining glycaemic control during and after exercise can be applied to a real‐life (non‐laboratory) environment.A comparative study of individuals with type 1 diabetes (n = 9) using basal bolus analogue insulin regimens was undertaken. Glycaemic control before and after two 40‐minute runs at 70% VO2 max, in both laboratory and real‐life environments, was measured across 10 time‐points during and up to 12 hours after exercise. Insulin was adjusted in all participants following a self‐management algorithm.Pooled mean glucose concentrations at each time‐point were compared. There was no statistically significant difference (F[1, 8] = 1.489, p = 0.257) in overall mean glucose concentrations between environments. Similarly, the exercise environment or time‐point of measurement had no statistically significant effect on mean glucose concentration (F[9, 72] = 0.499, p = 0.871). However, during exercise, episodes of both hypoglycaemia (<4.0 mmol/L) and hyperglycaemia (>9.0 mmol/L) were more frequent in the laboratory environment than in the real‐life environment: 5 vs 1 and 25 vs 19 episodes, respectively; the frequency of acceptable concentrations (4.0–9.0 mmol/L) was greater in the real‐life environment (24 vs 34). In the 8–12 hours after exercise, hypoglycaemia occurred more frequently in the real‐life environment (3 vs 8) with hyperglycaemia occurring more frequently in the laboratory environment (22 vs 14); again, there were slightly increased acceptable concentrations in the real‐life environment (29 vs 33).The exercise environment does not appear to affect overall mean blood glucose concentrations. However, it may affect the timing and frequency of hypoglycaemia and hyperglycaemia. Copyright © 2015 John Wiley & Sons.