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A Comparison of Three Basal Insulins Following Exercise in Type 1’s

Three basal insulins were compared for the effects of exercise on plasma glucose excursions and hypoglycemia in people with Type 1 diabetes.

 

This was a multinational, open-label, randomized, three-period, crossover clinical trial. People with Type 1 diabetes [n = 51, age 39 +/- 10 (+/- sd) years, 67% men] managed with mealtime plus basal insulin regimens, were exercised for 30 minutes, 5 h after the last mealtime and basal insulin injection when using insulin detemir, insulin glargine or neutral protamine Hagedorn (NPH) insulin.  

The results showed that the there were no significant differences in the plasma glucose excursions during or for 150 minutes after exercise.  

During 30 minutes exercise, five (11%) participants on insulin detemir developed minor hypoglycemia, six (12%) for NPH and 18 (38%) for glargine.  

From the end of exercise to 150 minutes, five (11%) on insulin detemir developed minor hypoglycemia, seven (14%) for NPH and nine (19%) for glargine.

In total, from start of exercise to 150 minutes after exercise, 10 (21%) participants on insulin detemir experienced minor hypoglycaemia as compared with 13 (27%) for NPH and 27 (57%) for glargine (P < 0.001 glargine vs. detemir and NPH).

Maximum plasma cortisol levels were lower on detemir and NPH than glargine.  

From the results it was concluded that insulin detemir was associated with less hypoglycemia than insulin  glargine but not NPH insulin in relatively well-controlled people with Type 1 diabetes during and after exercise.

Diabet Med. 2009 Oct;26(10):1027-32.