There is no specific recommendations on the adjustments of the insulin treatment in the event of physical activity (PA) in T1D patients treated on insulin pump therapy. Patients often prefer additional carbohydrates intake rather than the reduction of their insulin doses because of the lack of specific algorithms. The DIABRASPORT 2 study aims to demonstrate that using algorithms DIABRASPORT, during a week of physical activity (PA), the incidence of hypoglycaemia is not different from that obtained during a week of rest without physical activity. It is a multi-center European, controlled, randomized, cross-over, study, in 100 T1D patients practicing an occasional AP. 25 centers involved in this study. After agreeing to participate in the study, patients will read the information leaflet, ask questions to the investigator physician and they will date and sign the consent form. The investigator physician will do the same. They will be then drawn randomly via the electronic CRF (eCRF) to determine the order in which they will realize the rest vs DIABRASPORT sessions. The study will take place in 5 weeks: During the weeks Baseline and Diabrasport, patients will have to make 3 physical activity of 30 to 60 minutes separated by at least 24 hours: * moderate activity 3 hours after lunch * intense activity 3 hours after lunch * activity moderate 90 min after lunch They will use their usual algorithms (Cho intake or adjustment of the dose of insulin) during the week Baseline and they will use the Diabrasport algorithm during the week Diabrasport. Patients will be equipped with a holter Glycemic iPro2, Medtronic, whose data are hidden. During the week of rest, patients should do no physical activity during the week. They will be equipped with the Glycemic holter. Patients will have to fill a food survey the days they practice PA. Between each period, the patient must respect a period of wash-out for one week at least, during which he will be asked to not practice physical activity. Validation of algorithms simple, easy to implement, adaptable by patients, could help to improve balance metabolic and practice of sport among the T1D.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
50
The patient will be fitted with a CGMS (continuous glucose monitoring system) (data not shown) and it will be given the booklet to collect events + food survey The patient goes home and he must perform 3 physical activities during the week (30-60 minutes) using its usual algorithms (glucose administration or adaptation of the BR), in the afternoon, and spacing them at least 24 hours : * Moderate activity 3 hours after lunch * Intense activity 3 hours after lunch * Moderate activity 90 min after lunch These activities should not exceed 1 hour in wherever possible
The patient will be fitted with a CGMS (data not shown) and it will be given the booklet to collect events + food survey The patient goes home and he must perform 3 physical activities during the week (identical to those carried out during the week "test algorithms usual" and during comparable periods) using DIABRASPORT algorithms, the afternoon and in the spacing at least 24 hours: * Moderate activity 3 hours after lunch * Intense activity 3 hours after lunch * Moderate activity 90min after lunch These activities shall not exceed one hour
The patient will be fitted with a CGMS (data not shown) and it will be given the booklet to collect events + food survey. The patient goes home and he will not perform any physical activity during the week
Hôpital Universitaire
Angers, France
Hôpital Henri Duffaut
Avignon, France
Hôpital Jean Minjoz
Besançon, France
Hôpital Universitaire
Brest, France
Centre Hospitalier Sud-Francilien
Corbeil-Essonnes, France
Centre Hospitalier Louis Pasteur
Dole, France
Centre Hospitalier
Douai, France
Hôpital Universitaire
Grenoble, France
Fondation Hôtel Dieu du Creusot
Le Creusot, France
Centre Hospitalier Régional Universitaire
Lille, France
...and 7 more locations
the number of hypoglycemic events, defined by any threshold crossing 60 mg / dL (3.33mmol / L), measured in the interstitial glucose sensor continuously over a period of 24h
Time frame: 24h
percentage of time spent over 24 hours in the euglycemic range [70; 180] mg / dL ([3.89, 10] mmol / L)
Time frame: 24h
percentage of time spent over 24 hours in hyperglycemia (> 180 mg / dL) (> 10 mmol / L)
Time frame: 24h
Number of hypoglycemic events, defined by any threshold crossing 70 mg / dL (3.9 mml / L), and <54 mg / dL (3 mmol / l) measured by interstitial continuous glucose sensors
Time frame: 1 week
Number of hyperglycemic events, defined by any crossing of the threshold of 180 mg / dL (10 mml / L), measured by continuous interstitial glucose sensors.
Time frame: 1 week
Metabolic goals analysis:
* percentage of time spent in the intervals \[70; 180\] and \[80; 140\] mg / dL, \[3.89; 10\] and \[4.44; 7.78\] mmol / L * percentage of time passes hypoglycemia (\<60mg / dL) (\<3.33 mmol / L) * percentage of time spent in hypoglycemia (\<54mg / dL) (\<3 mmol / L) * percentage of time spent in hypoglycemia (\<70mg / dL) (\<3.89 mmol / L) * percentage of time spent \<80 mg / dL; (\<4.44 mmol / L) * percentage of time spent in hyperglycemia (\> 180 mg / dL) (\> 10 mmol / L) * percentage of time spent\> 140 mg / dL (\> 7.78 mmol / L)
Time frame: 1 week
Nadirs analysis of blood glucose during the night (value reached)
Time frame: 1 week
Nadirs analysis of blood glucose during the night (time to onset)
Time frame: 1 week
Analysis of quantities of glucose administration consumed during and at the waning of physical activity
Time frame: 1 week
Comparison of average values of continuous glucose measurements according to the period (DIABRASPORT, rest and Baseline) and at different times of the day and night.
Time frame: 1 week
Analysis by subgroups, depending on the type of physical activity and its duration, a link between a typology of physical activity or patients, and the number of hypoglycemia events during or waning of physical activity
Time frame: 1 week
Analysis of evaluation questionnaires intensity PA (Borg) and quality of life (EVA)
Time frame: 1 week
Comparison between number of hypoglycemic events predicted by the prediction function "DIABRASPORT" and number of hypoglycemic events actually occurred.
Time frame: 1 week
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