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  • 1
    In: JMIR mHealth and uHealth, JMIR Publications Inc., Vol. 6, No. 12 ( 2018-12-10), p. e10338-
    Type of Medium: Online Resource
    ISSN: 2291-5222
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2018
    detail.hit.zdb_id: 2719220-9
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  • 2
    In: Diabetes Care, American Diabetes Association, Vol. 44, No. 2 ( 2021-02-01), p. 610-613
    Abstract: Exercising while fasted with type 1 diabetes facilitates weight loss; however, the best strategy to maintain glucose stability remains unclear. RESEARCH DESIGN AND METHODS Fifteen adults on continuous subcutaneous insulin infusion completed three sessions of fasted walking (120 min at 45% VO2max) in a randomized crossover design: 50% basal rate reduction, set 90 min pre-exercise (−90min50%BRR); usual basal rate with carbohydrate intake of 0.3 g/kg/h (CHO-only); and combined 50% basal rate reduction set at exercise onset with carbohydrate intake of 0.3 g/kg/h (Combo). RESULTS Combo had a smaller change in glucose (5 ± 47 mg/dL) versus CHO-only (−49 ± 61 mg/dL, P = 0.03) or −90min50%BRR (−34 ± 45 mg/dL). The −90min50%BRR strategy produced higher β-hydroxybutyrate levels (0.4 ± 0.3 vs. 0.1 ± 0.1 mmol/L) and greater fat oxidation (0.51 ± 0.2 vs. 0.39 ± 0.1 g/min) than CHO-only (both P & lt; 0.05). CONCLUSIONS All strategies examined produced stable glycemia for fasted exercise, but a 50% basal rate reduction, set 90 min pre-exercise, eliminates carbohydrate needs and enhances fat oxidation better than carbohydrate feeding with or without a basal rate reduction set at exercise onset.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1490520-6
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  • 3
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: The amount of oral carbohydrate (CHO) needed to prevent hypoglycemia during prolonged fasted exercise in CSII is unclear. We assessed CHO intake needs during 3 different basal rate strategies during prolonged fasted exercise in active patients with T1D. Individuals with T1D on CSII (n=15) completed three 120-min treadmill exercise (∼45% of VO2peak) visits in a randomized crossover design. Strategies included: A) no basal rate reduction (BRR) and a dextrose intake of 0.3 g/kg/hr when BG was & lt;10mmol/L (CHO only); B) a 50% BRR set 90 min pre-exercise, with dextrose as needed to treat hypoglycemia (50% BRR); and C) a 50% BRR set at exercise start plus dextrose intake of 0.3 g/kg/hr when BG was & lt;10 mmol/L (Combo). Glycemia was higher in C compared to A or B by 105 min of exercise (P & lt; 0.05). The drop in blood glucose during exercise was greater in A (-2.7 ± 3.4 mmol/L) than in B (-1.9 ± 2.5 mmol/L) or C (0.3 ± 2.6 mmol/L). Total CHO intake was 38.0 ± 18.8 g, 0.8 ± 3.1 g, and 29.5 ± 16.2 g, for A, B and C, respectively. Compared to A, B had lower RER (0.83 ± 0.04 vs. 0.79 ± 0.04), higher ketones (0.1 ± 0.1 vs. 0.4 ± 0.3 mmol/L), greater net loss of calories (709.2 ± 217.4 vs. 859.7 ± 239.6 kcal) and greater fat oxidation rate (0.39 ± 0.1 vs. 0.51 ± 0.2 g/min) (all P & lt; 0.05). A BRR, set 90 min prior to exercise is associated with good glycemic control and an increased rate of lipid oxidation compared to CHO feeding alone or combined BRR and CHO feeding approach at exercise onset. Disclosure S.M. McGaugh: None. R. Pooni: None. D. Zaharieva: Speaker’s Bureau; Self; Ascensia Diabetes Care, Insulet Corporation, Medtronic. N.C. D’Souza: None. T. Vienneau: Employee; Self; Insulet Corporation. Stock/Shareholder; Self; Insulet Corporation. T.T. Ly: Employee; Self; Insulet Corporation. M. Riddell: Advisory Panel; Self; Zucara Therapeutics Inc. Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc., Insulet Corporation. Speaker’s Bureau; Self; Medtronic, Novo Nordisk A/S. Funding Insulet Corporation
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1501252-9
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  • 4
    Online Resource
    Online Resource
    American Diabetes Association ; 2019
    In:  Diabetes Vol. 68, No. Supplement_1 ( 2019-06-01)
    In: Diabetes, American Diabetes Association, Vol. 68, No. Supplement_1 ( 2019-06-01)
    Abstract: Physical activity monitors have become increasingly popular in recent years and researchers have started integrating these devices into artificial pancreas (AP) systems to improve the management of T1D. The accuracy of these devices at measuring energy expenditure (EE) may be important for the function of AP systems. Most research to date has determined the accuracy of activity monitors during steady state aerobic exercise in healthy individuals. In this study, the accuracy of the Fitbit Ionic and Garmin vívosmart 3 at measuring EE was assessed against indirect calorimetry (Cosmed K5) during 5 forms of non-steady state activities in individuals with and without T1D. Fourteen adults (Age: 25.8 ± 8.1 year; BMI: 24.1 ± 3.4 kg/m2; 8 T1D) performed a VO2 peak test, resistance exercise, activities of daily living, and high-intensity interval training on treadmill and cycle ergometer, while wearing a Fitbit and Garmin watch. A significant difference in accuracy was displayed by Garmin between individuals with T1D and healthy controls (T1D: 22.6 ± 35.4%; Control: -15.6 ± 24.0%, P & lt;0.0001), but no such difference was exhibited by Fitbit (T1D: 13.5 ± 35.8%; Control: 19.5 ± 37.0%) (Figure). In summary, the Garmin vívosmart 3 overestimates EE during physical activity in individuals with T1D as compared to healthy controls. This difference may need to be addressed before integrating these devices into AP systems. Disclosure R. Pooni: None. S. McGaugh: None. R. Patel: None. M. Riddell: Advisory Panel; Self; Xeris Pharmaceuticals, Inc. Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc., Insulet Corporation, Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; Medtronic MiniMed, Inc., OmniPod. Stock/Shareholder; Self; Zucara Therapeutics Inc.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1501252-9
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  • 5
    In: Diabetes Technology & Therapeutics, Mary Ann Liebert Inc, Vol. 21, No. 6 ( 2019-06), p. 313-321
    Type of Medium: Online Resource
    ISSN: 1520-9156 , 1557-8593
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2019
    detail.hit.zdb_id: 2004914-6
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  • 6
    In: Diabetes, American Diabetes Association, Vol. 67, No. Supplement_1 ( 2018-07-01)
    Abstract: Hyperglycemia can occur when individuals with type 1 diabetes (T1D) perform high intensity interval training (HIIT). However, the reproducibility of the glycemic response to a HIIT session has not been definitively tested. Seventeen patients with T1D, all using insulin glargine 300 U/mL (Toujeo®) as basal insulin, were asked to perform four separate in clinic HIIT sessions in an overnight fasted state. HIIT consisted of two bouts of cycling at 90% peak power, separated by a series of ‘CrossFit’-type activities, spanned over a 25 min period (∼75-95% of maximal heart rate). Plasma glucose (YSI) was measured pre-exercise (-10 min) and at 5- and 15-min into the HIIT session, as well as at 5- and 15-min in recovery. A total of 64 HIIT sessions were compiled. Pre-exercise blood glucose levels were similar among the four HIIT visits (8.8 ± 1.0 mmol/L, mean SD), as were the rise in glucose levels in response to HIIT (+3.9 ± 1.6; +3.8 ± 1.8; +3.9 ± 2.3; +3.9 ± 1.5 mmol/L, in visits 1-4, respectively). In almost all occasions (63 of 64 sessions), HIIT produced a rise in glycemia, but the inter-individual responses did vary, ranging from -0.3 to +9.0 mmol/L. The change in glucose during HIIT was not influenced by the baseline glucose concentration and was predictable within an individual based on the measured response in visit 1 (composite correlation with post-exercise glucose rise among the four visits was 0.56 [0.33-0.79, 95% CI]). Following HIIT, there appears to be a consistent increase from the pre-exercise glucose concentration in patients living with T1D and the degree of response is moderately reproducible within a given patient. Individualized insulin correction strategies, which take into account the rise in glucose observed and the patient’s sensitivity to insulin, may be helpful in restoring glucose control after HIIT in patients living with T1D. Disclosure 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. R. Pooni: None. R.E. Brown: None. L. Yavelberg: None. Z. Li: None. C. Kollman: Research Support; Self; JDRF, Bigfoot Biomedical, Dexcom, Inc., Tandem Diabetes Care, Inc., Medtronic MiniMed, Inc., Helmsley Charitable Trust. 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..
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2018
    detail.hit.zdb_id: 1501252-9
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  • 7
    In: Diabetes Care, American Diabetes Association, Vol. 42, No. 5 ( 2019-05-01), p. 824-831
    Abstract: To reduce exercise-associated hypoglycemia, individuals with type 1 diabetes on continuous subcutaneous insulin infusion typically perform basal rate reductions (BRRs) and/or carbohydrate feeding, although the timing and amount of BRRs necessary to prevent hypoglycemia are unclear. The goal of this study was to determine if BRRs set 90 min pre-exercise better attenuate hypoglycemia versus pump suspension (PS) at exercise onset. RESEARCH DESIGN AND METHODS Seventeen individuals completed three 60-min treadmill exercise (∼50% of VO2peak) visits in a randomized crossover design. The insulin strategies included 1) PS at exercise onset, 2) 80% BRR set 90 min pre-exercise, and 3) 50% BRR set 90 min pre-exercise. RESULTS Blood glucose level at exercise onset was higher with 50% BRR (191 ± 49 mg/dL) vs. 80% BRR (164 ± 41 mg/dL; P & lt; 0.001) and PS (164 ± 45 mg/dL; P & lt; 0.001). By exercise end, 80% BRR showed the smallest drop (−31 ± 58 mg/dL) vs. 50% BRR (−47 ± 50 mg/dL; P = 0.04) and PS (−67 ± 41 mg/dL; P & lt; 0.001). With PS, 7 out of 17 participants developed hypoglycemia versus 1 out of 17 in both BRR conditions (P & lt; 0.05). Following a standardized meal postexercise, glucose rose with PS and 50% BRR (both P & lt; 0.05), but failed to rise with 80% BRR (P = 0.16). Based on interstitial glucose, overnight mean percent time in range was 83%, 83%, and 78%, and time in hypoglycemia was 2%, 1%, and 5% with 80% BRR, 50% BRR, and PS, respectively (all P & gt; 0.05). CONCLUSIONS Overall, a 50–80% BRR set 90 min pre-exercise improves glucose control and decreases hypoglycemia risk during exercise better than PS at exercise onset, while not compromising the postexercise meal glucose control.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2019
    detail.hit.zdb_id: 1490520-6
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  • 8
    Online Resource
    Online Resource
    Canadian Science Publishing ; 2022
    In:  Applied Physiology, Nutrition, and Metabolism Vol. 47, No. 10 ( 2022-10-01), p. 1023-1030
    In: Applied Physiology, Nutrition, and Metabolism, Canadian Science Publishing, Vol. 47, No. 10 ( 2022-10-01), p. 1023-1030
    Abstract: The purpose of this study was to examine whether using both objectively (accelerometer) and subjectively (questionnaire) measured moderate- to vigorous-intensity physical activity (MVPA) and sedentary time (SED) improves the prediction of prediabetes and type 2 diabetes (pre/T2D) using data from the Framingham Heart Study ( n = 4200). Logistic regression was used to examine the odds ratio of pre/T2D in groups cross-classified by subjective and objective MVPA and SED. Less than half of participants fell into concordant categories of MVPA and SED using subjective and objective measures, with 7.0%–9.4% of participants in the extreme discordant categories of high-low or low-high subjective–objective MVPA or SED. Low objective MVPA, regardless of subjective MVPA status, was associated with a higher prevalence of pre/T2D ( P  〈  0.05). When cross-classifying by MVPA and SED, the majority of participants fell into concordant categories of MVPA-SED, with  〈 4% of participants in the extreme discordant categories of MVPA-SED. Low objective MVPA, regardless of objective SED, was associated with a higher prevalence of pre/T2D ( P  〈  0.05). These findings suggest that low objectively measured MVPA appears more closely associated with pre/T2D risk compared with subjective measures, and there does not appear to be an additive effect of SED on pre/T2D risk after accounting for MVPA.
    Type of Medium: Online Resource
    ISSN: 1715-5312 , 1715-5320
    Language: English
    Publisher: Canadian Science Publishing
    Publication Date: 2022
    SSG: 31
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  • 9
    In: Diabetes Research and Clinical Practice, Elsevier BV, Vol. 148 ( 2019-02), p. 137-143
    Type of Medium: Online Resource
    ISSN: 0168-8227
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2004910-9
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  • 10
    Online Resource
    Online Resource
    Canadian Science Publishing ; 2021
    In:  Applied Physiology, Nutrition, and Metabolism Vol. 46, No. 8 ( 2021-08), p. 945-951
    In: Applied Physiology, Nutrition, and Metabolism, Canadian Science Publishing, Vol. 46, No. 8 ( 2021-08), p. 945-951
    Abstract: We examined the separate and combined associations for cardiorespiratory fitness (CRF) and muscular strength (MS) with total and regional fat, and insulin sensitivity (IS) in 204 adolescents (BMI ≥85th percentile, 12–18 years) at UPMC Children’s Hospital of Pittsburgh. CRF was measured by maximum oxygen consumption during a graded treadmill test. MS was quantified by combining 1-repetition maximum test for the leg and bench press. Participants were stratified as having either high or low CRF and MS based on sex-specific median split. Both high CRF and high MS groups had lower (P 〈 0.05) total fat after adjustment for sex, Tanner stage and ethnicity than the low CRF and MS groups (Difference: 6.6, 2.6–9.6% and 5.4, 2.4–8.3%, respectively). High CRF, but not high MS, had lower visceral (67.5 versus 77.9 cm 2 , P 〈 0.01) and intermuscular fat (3.6 versus 4.0 kg, P = 0.01) than the low CRF groups. Differences by CRF remained significant after adjustment for MS. High CRF, but not high MS, was associated (P 〈 0.05) with lower fasting glucose and higher IS after accounting for sex, Tanner stage and ethnicity than the low CRF group, and high CRF remained associated with these markers after adjustment for MS. High CRF is associated with lower total and regional fat, and higher IS after adjustment for MS. Novelty: CRF is associated with lower total fat, visceral and intermuscular fat, and higher insulin sensitivity adjusting for muscular strength. Muscular strength is not associated with regional body fat and insulin sensitivity after accounting for CRF.
    Type of Medium: Online Resource
    ISSN: 1715-5312 , 1715-5320
    Language: English
    Publisher: Canadian Science Publishing
    Publication Date: 2021
    SSG: 31
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