Nocturnal Hypoglycemia Incidents Following Moderate and Vigorous Physical Activity in Athletes With Type 1 Diabetes

Abstract

PURPOSE: For adolescent athletes with type 1 diabetes mellitus (T1DM), proper glucose management during and after prolonged activity could prove difficult because of the body’s response throughout the process of gluconeogenesis. Understanding their body’s glucose response to physical activity could aid in effectively addressing nocturnal hypoglycemia. Therefore, the purpose of this investigation was to examine the acute temporal associations between blood glucose and measures of moderate and vigorous intensity physical activity via an accelerometer in a sample of athletes with T1DM. METHODS: 10 adolescent athletes with diagnosed T1DM between the ages of 13 - 17 and who were involved in competitive sports in the previous 12 months were recruited for this study. All participants wore an accelerometer and continuous glucose monitor (CGM) consecutively for a minimum of 2-weeks with a total of 168 patient-days of collected data. Nocturnal hypoglycemia was defined as a blood glucose reading <70 mg/dl during sleeping hours that lasted ≥ 10 minutes as indicated by the CGM. RESULTS: Incidents of nocturnal hypoglycemia occurred 29% of the nights measured with an average duration of 52.33 ± 41.04 minutes. A multiple linear regression showed vigorous intensity to be a significant predictor of nocturnal hypoglycemia after controlling for all variables (β=0.169, p=0.02) with an average time of 26 minutes of vigorous intensity. CONCLUSIONS: Engaging in vigorous intensity physical activity increased the risk of prolonged nocturnal hypoglycemia in adolescent athletes with T1DM. Incorporating accelerometers into patient care could prove beneficial when making further recommendations for athletes by improving glucose management. Funded by Children’s Hospital Foundation, Christensen Family, Norton Children’s Hospital, and University of Louisville.