Is It Easier for Children With Diabetes to Control Glucose Levels During Exercise if Insulin Is Stopped During Exercise?

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Prevention of hypoglycemia during exercise in children with type 1 diabetes by suspending basal insulin, by the Diabetes Research in Children (DirecNet) Study Group. Diabetes Care 29:2200-2204, 2006.

What is the problem and what is known about it so far?

Kids and teens with type 1 diabetes are encouraged to exercise, but it’s really difficult to control blood glucose levels during long periods of exercise. Sometimes people with type 1 diabetes suffer from hypoglycemia (or very low blood glucose levels) during or after long periods of exercise.

Why did the researchers do this particular study?

There haven’t been many studies on avoiding and preventing hypoglycemia in kids with type 1 diabetes during exercise. The research group wanted to see if stopping “basal insulin” during exercise could lower the risk of hypoglycemia.

What is basal insulin? Your body needs a basic amount of insulin all the time. If you have diabetes, basal insulin provides the body with a steady, low level of insulin throughout the day and night; it may be given by intermediate- or long-acting insulin injections or by continuous release of faster-acting insulin in a pump.

Who was studied?

Forty-nine children between 8 and 17 years old who were treating type 1 diabetes by using an insulin pump.

How was the study done?

The children took part in structured exercise sessions on two separate days. On the first day, basal insulin was stopped during exercise. On the second day, it was continued.

Each exercise session consisted of four 15-minute treadmill sessions, with five-minute breaks in between, and took place around 4:00 PM. The children had their blood glucose frequently measured before, during, and after the exercise sessions.

What did the researchers find?

Hypoglycemia during exercise occurred less frequently when the basal insulin was stopped during exercise.

Forty-five minutes after exercise, hyperglycemia (when blood glucose levels are too high) was more frequent when basal insulin was stopped during exercise.

What are the implications of the study?

Stopping basal insulin during exercise is an effective way for reducing the risk of hypoglycemia in children with type 1 diabetes. However, doing so increases the risk for hyperglycemia after exercise.

The results of the present study, as outlined in the final paragraph of the article, can be used to guide recommendations for youth who use an insulin pump during exercise.

FOR MORE INFORMATION

Insulin Pumps

Exercise and Blood Glucose

The ADA Guide to Raising a Child With Type 1 Diabetes