Document Detail


Management of exercise-induced glycemic imbalances in type 1 diabetes.
MedLine Citation:
PMID:  21682691     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Regular moderate-intensity exercise is strongly recommended for its beneficial effects in all people. In patients with type 1 diabetes, however, the exercise-associated glycemic imbalances remain an unresolved clinical challenge. Current guidelines require an in-depth understanding of the glycemic responses to exercise and each patient has to discover, by trial-and-error, his/her own strategy, several attempts being usually required to gain sufficient experience. Consequently, fear of hypoglycemia remains the strongest barrier to physical activity. This paper explores the potential strategies that may be employed to minimize the risk of exercise related glycemic imbalances. Moreover, a newly developed algorithm (ECRES, Exercise Carbohydrate Requirement Estimating Software) is described, which estimates on a patient- and situation-specific basis the glucose supplement required by the patient to maintain safe blood glucose levels. The algorithm was tested on 27 patients who performed three 1-hr constant intensity walks (each starting at a different time interval following insulin injection). Results showed that in 70.4% of the trials, independent of the time of day, the algorithm provided a satisfactory estimate of the carbohydrates needed by patients to complete the exercise with a glucose level within safe thresholds (i.e. 3.9 - 10 mmol·L-1). Despite the algorithm requires further experimental testing to be applied by the majority of patients, these results indicate its potential usefulness as a tool for preventing immediate exercise-induced glycemic imbalances (i.e. during exercise) in type 1 diabetic patients, in particular for spontaneous activities not planned in advance, thus allowing all insulin-dependent patients to safely enjoy the benefits of exercise.
Authors:
Maria P Francescato; Sergio Carrato
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current diabetes reviews     Volume:  7     ISSN:  1875-6417     ISO Abbreviation:  Curr Diabetes Rev     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-12     Completed Date:  2011-11-21     Revised Date:  2012-04-23    
Medline Journal Info:
Nlm Unique ID:  101253260     Medline TA:  Curr Diabetes Rev     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  253-63     Citation Subset:  IM    
Affiliation:
Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy. maria.francescato@uniud.it
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MeSH Terms
Descriptor/Qualifier:
Diabetes Mellitus, Type 1 / blood,  complications*,  metabolism,  therapy*
Exercise / physiology*
Humans
Hypoglycemia / blood,  etiology*,  prevention & control,  therapy*
Insulin / blood
Models, Biological
Motor Activity / physiology
Chemical
Reg. No./Substance:
0/Insulin

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