The phenomenon of post-exercise hyperglycemia following high-intensity training (HIT) in T1D patients has led to debate of corrective therapy options but has not been definitively investigated to date. The FIT study was a randomized, cross-over investigation of 4 post-HIT bolus insulin correction strategies in patients with T1D. Patients with T1D (n=18) using multi-daily injections (MDI) were enrolled and underwent an 8-week insulin optimization period using insulin glargine 300 U/mL as their basal insulin. On 4 separate days, each subject performed 25 minutes of HIT. If hyperglycemia (>8.0 mmol/L) resulted, subjects received a bolus insulin correction 15 minutes post-HIT, based on their own ICF, adjusted by one of 4 commonly used multipliers: 0%, 50%, 100%, or 150%. At 180 minutes following bolus correction, change in plasma glucose (PG) was greatest in both the 100% (-4.7 mmol/L) and 150% (-5.3 mmol/L) ICF arms, vs. 50% (-2.3 mmol/L, p<.05) and 0% (+1.0 mmol/L, p<.05) (Figure). Percent time in euglycemia (4.0-8.0 mmol/L) progressively increased with each increasing correction factor. Hypoglycemia was rare and only seen in the 150% arm. In correction of post-exercise hyperglycemia following HIT, correction based on a patient’s usual ICF is safe and effective. Optimal BG reduction, with no hypoglycemia, occurred in the 100% ICF correction arm.

Disclosure

R. Aronson: Other Relationship; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi, AstraZeneca. Research Support; Self; Eli Lilly and Company, Becton, Dickinson and Company, Merck & Co., Inc., Senseonics, Boehringer Ingelheim Pharmaceuticals, Inc.. R.E. Brown: None. M. Riddell: Speaker's Bureau; Self; Medtronic. Consultant; Self; Eli Lilly and Company, JAEB Center For Health Research, Xeris Pharmaceuticals, Inc.. Research Support; Self; Insulet Corporation. Speaker's Bureau; Self; Insulet Corporation. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Ascensia Diabetes Care. Stock/Shareholder; Self; Zucara Theraputics. Other Relationship; Self; JDRF.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.