Introduction & Objective: We analyzed the unstructured real-world physical activity (PA) sessions from the T1DEXI study to evaluate hypoglycemia risk in terms of change in CGM (ΔCGM) readings and percentage of time below range (%TBR) of T1D participants.
Methods: For each session, we calculated the ∆CGM as the difference in glucose readings within 5 mins before and after PA and, %TBR as the percentage of readings <70 mg/dL during PA. ANOVA was used to measure variation in ΔCGM and %TBR associated with activity durations, starting glucose, insulin on board (IOB), and individual factors, i.e. age, sex, and A1c.
Results: We analyzed 9,322 sessions, with 46 activity types, for 404 participants (open and closed loop pump users, age 36.6 ± 14.0 yrs, 75.3% female, BMI 25.5 ± 3.9 kg/m2, A1c 6.6 ± 0.7%, T1D duration 18.5 ± 13.0 yrs, total daily dose 40.1 ± 16.2 U), with an average of 24 sessions in 4 weeks.
Table 1 shows larger ΔCGM and higher %TBR for increasing activity durations, and IOB (all p<0.01), lower %TBR for increasing starting glucose (p<0.01). %TBR differed significantly for age, A1c, and sex groups (all p<0.03), while ΔCGM only for age (p<0.01). Carbohydrate (CHO) intake correlated with a higher %TBR due to a lower starting glucose for sessions with CHO.
Conclusion: Hypoglycemia risk during PA is impacted by population and individual factors, which are important when tailoring glucose management strategies around PA.
M.P. Dhaliwal: Consultant; Tidepool. K. Tang: Consultant; Tidepool. E.M. Aiello: Other Relationship; Tidepool. D.P. Zaharieva: Research Support; Leona M. and Harry B. Helmsley Charitable Trust. Advisory Panel; Dexcom, Inc. Research Support; Insulet Corporation. Speaker's Bureau; Dexcom, Inc. Research Support; International Society for Pediatric and Adolescent Diabetes. Board Member; Juvenile Diabetes Research Foundation (JDRF). R. Lal: Consultant; Abbott, Adaptyx Biosciences, Biolinq, Capillary Biomedical, Inc., Deep Valley Labs, Gluroo, PhysioLogic Devices, Portal Insulin, Tidepool. Advisory Panel; Lilly Diabetes. C. Summers: Consultant; Tidepool. B. Arbiter: Stock/Shareholder; Eli Lilly and Company. Employee; Tidepool. Stock/Shareholder; Dexcom, Inc. K. Watson: Employee; Tidepool. Other Relationship; Luna Diabetes. Stock/Shareholder; Tandem Diabetes Care, Inc. L. Figg: None. I. Balistreri: None. R.S. Kingman: None. B. Suh: None. Y. Qin: None.
The Leona M. & Harry B. Helmsley Charitable Trust (Grant #2404-06905).
