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

Charlton, Jacqui; Kilbride, Lynn; MacLean, Rory; Darlison, Mark G; McKnight, John

Authors

Jacqui Charlton

Lynn Kilbride

Mark G Darlison

John McKnight



Abstract

Limited 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

Journal Article Type Article
Acceptance Date Jan 12, 2015
Online Publication Date Mar 11, 2015
Publication Date 2015-03
Deposit Date Mar 16, 2015
Print ISSN 2047-2900
Electronic ISSN 2047-2900
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 64-69
DOI https://doi.org/10.1002/pdi.1926
Keywords type 1 diabetes; moderate intensity exercise; self-management algorithm; self-management strategies
Public URL http://researchrepository.napier.ac.uk/id/eprint/7676
Publisher URL http://dx.doi.org/10.1002/pdi.1926