Michael Müller-korbsch, Austria
MedVienna ÄrztezentrumPresenter of 1 Presentation
NEW INSULIN ALGORITHM REDUCES CARBOHYDRATES (CHO) REQUIREMENTS DURING PROLONGED OUTDOOR
Abstract
Background and Aims
Individuals with T1D are generally advised to reduce basal rates and increase CHO intake during aerobic exercise. We assessed the effects of a different insulin regimen guided by rtCGM data on CHO intake and glucose levels in 17 T1D adults treated with insulin pumps (11 male, 42±8.8 years, 24±10 years DM duration, 6.6±0.8% A1C) vs. traditional insulin adjustment guidance during 2 consecutive days of extended biking activities with 49 km, 30 miles.
Methods
On day1 (D1) subjects reduced their basal rate by 50% and consumed CHO as guided by their rtCGM (Dexcom G6) data to maintain target range 70-180 mg/dL. Basal insulin infusion was stopped 1hr at the start of the day2 activity (D2) then resumed at a minimal rate 0.23±0,1U/hr during biking. All CHO from 1hour before, during and 10min after the activity was recorded. Times within/below target range, glycemic variability and mean glucose were calculated from rtCGM data.
Results
CHO intake was notably lower during day2 vs. day1 (36±32 vs. 40±27 g, p=NS), with slightly more time in range and <70 mg/dL but no difference in time <54 mg/dL both p=NS. Significant reductions in GV (34±7 vs. 47±13 mg/dL, p<0.01) and slight reductions in mean glucose 124±24 vs. 110±14 mg/dL were seen, p=NS. No severe hypoglycemic events occurred.
Conclusions
T1D individuals using rtCGM in conjunction with insulin pump therapy can safely reduce their CHO requirements during prolonged exercise using the new algorithm.