Comparing Long-acting Insulins During Exercise in Type 1 Diabetes
Status:
Unknown status
Trial end date:
2012-06-01
Target enrollment:
Participant gender:
Summary
Exercise is an important part of a healthy lifestyle, and many people with Type 1 Diabetes
like to take part in regular sport and exercise. The majority of people with Type 1 Diabetes
are treated with a "basal bolus" insulin regimen, with background insulin provided by
long-acting "basal" insulin doses, and "bolus" doses of short-acting insulin used to
accompany food intake. Evidence shows that the main factor preventing people with diabetes
from pursuing a more active lifestyle is fear of low blood glucose (hypoglycaemia). A
previous study has shown that the type of background insulin affects the likelihood of an
individual suffering hypoglycaemia during exercise and for 2 and a half hours afterwards. The
aim of this study is to examine this further.
The two most commonly used long-acting insulins, insulin glargine and insulin detemir, will
be compared. Previous data suggests that there is a greater likelihood of hypoglycaemia with
insulin glargine than insulin detemir. Exercise intensity can have an influence on the
likelihood of hypoglycaemia, and in this previous study exercise intensity was measured using
heart rate. This study will use a more formal definition of exercise intensity. The
investigators will study blood glucose during exercise, but also metabolism as measured by
hormones affecting blood glucose levels as well as markers of fat metabolism. The
investigators will also use a continuous glucose monitoring system (CGMS) to consider
hypoglycaemia on thei night following exercise as this is a recognised consequence of
exercise in type 1 diabetes.
The null hypothesis to be tested in this study is that there is no difference between the two
insulins in their effect on blood glucose levels and metabolism during exercise and rates of
nocturnal hypoglycaemia after exercise.