The design and evaluation of a self‐management algorithm for people with type 1 diabetes performing moderate intensity exercise

Abstract

AbstractLimited evidence is available to advise people with type 1 diabetes about self‐management strategies for maintaining acceptable glycaemic control when exercising.A systematic review was conducted to design a self‐management algorithm for moderate intensity exercise. The effectiveness was investigated regarding the attainment of acceptable glucose concentrations during and after 40 minutes of exercise at 70% VO2 max in the real‐life environment.Nine individuals with type 1 diabetes (five male, four female) completed the study over a two‐week period. All used a basal bolus analogue insulin regimen and exercised regularly. Participants undertook 40 minutes of moderate intensity exercise on days 1 and 8 in real‐life environments, and followed the self‐management algorithm. Data were collected for glucose concentrations at 10 time‐points, i.e. before, during and after exercise.Analysis showed that during the whole time‐period, 56% of participant episodes were in the acceptable glucose range of 4–9 mmol/L, and 39% were above 9 mmol/L. In relation to hypoglycaemic episodes, one episode occurred during exercise, and eight episodes occurred during 8–12 hours after exercise.Despite post‐exercise insulin reduction, nocturnal hypoglycaemia occurred and algorithm adjustments are required regarding carbohydrate consumption at bedtime for future prevention. An addition to the current self‐management algorithm would be to perform blood glucose monitoring 8–12 hours after post‐exercise insulin and meal. Copyright © 2015 John Wiley & Sons, Ltd.