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

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

Citation

Charlton, J., Kilbride, L., MacLean, R., Darlison, M. G., & McKnight, J. (2015). The design and evaluation of a self-management algorithm for people with type 1 diabetes performing moderate intensity exercise. Practical Diabetes, 32(2), 64-69. https://doi.org/10.1002/pdi.1926

• 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