Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes. J Pediatr 2010 Nov;157(5):784-8.e1
Date
07/24/2010Pubmed ID
20650471Pubmed Central ID
PMC2957531DOI
10.1016/j.jpeds.2010.06.004Scopus ID
2-s2.0-77958067191 (requires institutional sign-in at Scopus site) 88 CitationsAbstract
OBJECTIVE: To determine the effects of reducing overnight basal insulin or a bedtime dose of terbutaline on nocturnal blood glucose (BG) nadir and hypoglycemia after exercise in children with type 1 diabetes mellitus.
STUDY DESIGN: Sixteen youth (mean age 13.3 years) on insulin pumps were studied overnight on 3 occasions after a 60-minute exercise session with BG measurements every 30 minutes. Admissions were randomized to bedtime treatment with oral terbutaline 2.5 mg, 20% basal rate insulin reduction for 6 hours, or no treatment.
RESULTS: Mean overnight nadir BG was 188 mg/dL after terbutaline and 172 mg/dL with basal rate reduction compared with 127 mg/dL on the control night (P = .002 and .042, respectively). Terbutaline eliminated nocturnal hypoglycemia but resulted in significantly more hyperglycemia (≥250 mg/dL) when compared with the control visit (P < .0001). The basal rate reduction resulted in fewer BG readings <80 and <70 mg/dL but more readings ≥250 mg/dL when compared with the control visit.
CONCLUSIONS: A basal insulin rate reduction was safe and effective in raising post-exercise nocturnal BG nadir and in reducing hypoglycemia in children with type 1 diabetes mellitus. Although effective at preventing hypoglycemia, a 2.5-mg dose of terbutaline was associated with hyperglycemia.
Author List
Taplin CE, Cobry E, Messer L, McFann K, Chase HP, Fiallo-Scharer RAuthor
Rosanna V. Fiallo-Scharer MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentDiabetes Mellitus, Type 1
Exercise
Female
Humans
Hypoglycemia
Insulin
Male
Terbutaline
