and 1 other(s)
Introduction: Insulin pump therapy is currently the most physiological form of insulin delivery in patients with diabetes mellitus (DM). Nevertheless, exercise-induced hypoglycemia still remains a challenge in this population, as guidelines for minimizing hypoglycemia risk are general and recommendations given in the studies differ. Aim: To evaluate the effectiveness of current recommendations in non-trained diabetic patients on insulin pump therapy. Materials and Methods: Young patients with diabetes duration of more than a year with stable basal rate and blood glucose (BG) levels performed two sessions of a 30-minute moderate aerobic exercise. Before the first session patients installed a 50% temporary basal rate (TBR) 90 min before and during the exercise. If glucose levels remained stable, or hyperglycemia appeared during or in 2h after the exercise, the second session was performed without any BR reduction. If hypoglycemia appeared, 20% TBR was installed duting the second session. Results: Quite opposite reactions on physical activity were observed during the study. In some patients 50% TBR caused only the elevation of BG shortly after exercise and no changes in BG in sessions without any BR reductions. In the others hypoglycemia developed. Moreover, even 20% TBR couldn’t prevent hypoglycemia in some cases. Conclusion: The proper insulin correction remains the challenge even in patients on insulin pump therapy, as a number of factors should be taken into account. Despite the increasing number of studies, there is no consensus on the schemes of BR correction. Performed results are yet more proof that further studies are needed.
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