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.
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.