Oral Presentation ANZOS-ASLM-ICCR 2019

Comparison of two carbohydrate intake strategies to improve glucose control during exercise in adolescents and adults with type 1 diabetes (#17)

Lucas Goulet Gélinas 1 2 , Marie-Béatrice Saade 1 3 , Corinne Suppère 1 , Sémah Tagougui 1 , Virginie Messier 1 , Andréanne Fortin 1 2 , Mélanie Henderson 3 , Rémi Rabasa-Lhoret 1 2 4
  1. Montreal Clinical Research Institute, Montreal
  2. Université de Montréal, Montreal
  3. Centre Hospitalier Universitaire Sainte-Justine, Montreal
  4. Montreal Diabetes Research Center, Montreal

During prolonged physical activity (PA), hypoglycemia is common in people living with type 1 diabetes (T1D)1. Few studies have compared the effectiveness of different carbohydrate intake strategies to prevent PA-induced hypoglycemia. The objective of this study is to compare the efficacy of 2 snacking strategies to maintain glucose levels in the target range (4.0 – 10.0 mmol/l) during PA in patients living with T1D.

One hour of PA at 60% of participant’s VO2peak was performed on a stationary bike. In a randomized order, participants consumed a single carbohydrate intake (SCI) of 0.5 g/kg of body weight prior to PA or a distributed carbohydrate intake (DCI) before and during PA.

Thirty-one of the 33 planned participants completed the study so far. At the start of PA, glucose levels were similar with both snacking strategies (SCI: 7.9 mmol/L and DCI 7.2 mmol/L) (p=0.155). Six hypoglycemic episodes occurred in 4 participants during PA with the SCI and 8 hypoglycemic episodes occurred in 8 participants during PA with the DCI. The percentage of time spent in the target range during PA was 74 +/- 35% with the SCI and 87 +/- 27% with the DCI (p=0.051). The percentage of time spent above 10 mmol/L during PA was 19 +/- 34% with the SCI and 7 +/- 24% with the DCI (p=0.056). The glycemic delta (peak glycemia–start glycemia) was +1.2 +/- 1.3 mmol/L with the SCI and +0.6 +/- 0.7 mmol/L with the DCI (p=0.010).

These preliminary results suggest that both snacking strategies seem appropriate to reduce hypoglycemic episodes during PA. From a clinical point of view, the DCI seems to result in more time spent in the target range and less time spent above 10 mmol/L than the SCI. The DCI also seems to result in less glycemic variation than the SCI.

  1. 1. Riddell, M.C., et al., Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol, 2017