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  1. Article ; Online: Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly

    Signe Schmidt / Isabelle Isa Kristin Steineck / Ajenthen G Ranjan

    BMJ Open Diabetes Research & Care, Vol 9, Iss

    a randomized crossover study in people with type 1 diabetes

    2021  Volume 1

    Abstract: Introduction People with type 1 diabetes are recommended to exercise regularly. However, limited evidence exists on how frequency and duration of exercise affect the risk of hypoglycemia. The study aimed to compare the percentage of time spent in ... ...

    Abstract Introduction People with type 1 diabetes are recommended to exercise regularly. However, limited evidence exists on how frequency and duration of exercise affect the risk of hypoglycemia. The study aimed to compare the percentage of time spent in hypoglycemia between two 5-day periods with different frequency and duration of physical activity.Research design and methods In this outpatient randomized crossover study, 26 participants aged 18–65 years with type 1 diabetes for ≥2 years and insulin pump use for ≥1 year were included. After a 7-day observation period, participants completed two 5-day intervention periods separated by a washout period of at least 14 days. One period included five exercise sessions on 5 consecutive days (5S), each consisting of 4 min of resistance training and 30 min of aerobic exercise. Another period included two exercise sessions on 2 days with at least 2 days in between (2S), each consisting of 10 min of resistance training and 75 min of aerobic exercise. During each period, participants performed in total 150 min of aerobic exercise and 20 min of resistance training and wore continuous glucose monitors (Dexcom G6) and accelerometers (ActiGraph wGT3X-BT).Results Twenty insulin pump-treated adults (10 women) with type 1 diabetes completed the study. The baseline median (range) age was 48 (24–64) years, glycated hemoglobin 55 (44–66) mmol/mol, diabetes duration 24 (8–57) years, and body mass index 28.4 (22.3–35.8) kg/m2. No differences were observed between 5S and 2S in the percentage (mean±SD) of time spent below 3.9 mmol/L (3.5%±2.8% vs 4.5%±4.2%, p=0.28), time spent in 3.9–10.0 mmol/L (65.3%±15.0% vs 68.5%±13.6%, p=0.31), time spent above 10.0 mmol/L (31.2%±16.4% vs 27.3%±14.5%, p=0.15), mean glucose (8.7±1.3 mmol/L vs 8.5±1.2 mmol/L, p=0.33) and glycemic variability (35.8%±5.3% vs 35.8%±6.6%, p=0.97).Conclusions Time spent in hypoglycemia was comparable between the two 5-day periods with different duration and frequency of physical activity.Trial registration number NCT04089462.
    Keywords Diseases of the endocrine glands. Clinical endocrinology ; RC648-665
    Subject code 796
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Effect of adjunctive glucose-lowering drugs on body weight in people with type 1 diabetes

    Christian Laugesen / Ajenthen G. Ranjan / Lauge Neimann Rasmussen / Ole Nørgaard

    BMJ Open, Vol 10, Iss

    a systematic review and network meta-analysis protocol

    2020  Volume 11

    Abstract: Introduction Obesity increases the risk of comorbidities and diabetes-related complications and, consequently, efforts to prevent and reduce excess weight in people with type 1 diabetes are essential. The aim of this systematic review and network meta- ... ...

    Abstract Introduction Obesity increases the risk of comorbidities and diabetes-related complications and, consequently, efforts to prevent and reduce excess weight in people with type 1 diabetes are essential. The aim of this systematic review and network meta-analysis is to assess the effect of adjunctive glucose-lowering drugs on body weight and other important health outcomes in people with type 1 diabetes.Methods and analysis This systematic review and network meta-analysis will include randomised controlled trials (RCTs) evaluating the use of adjunctive glucose-lowering drugs for treatment of people with type 1 diabetes. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched from inception to present. Key eligibility criteria include: RCT study design; adult participants with type 1 diabetes; treatment with a glucose-lowering drug for ≥24 weeks; and comparison of the intervention to placebo, usual care or another glucose-lowering drug. The primary outcome is change in body weight. Other major outcomes include change in HbA1c and total daily insulin dose and risk of hypoglycaemia and other adverse events. Dual study selection, data extraction and risk of bias assessment will be performed. Results from the meta-analysis will be presented as weighted mean differences for continuous outcomes and risk ratios for dichotomous outcomes. Sources of heterogeneity will be explored by subgroup and sensitivity analysis. A network meta-analysis for the primary outcome will be performed using an arm-based random-effects model based on the Bayesian framework while assessing for transitivity across studies and consistency between direct and indirect estimates. The overall quality of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach for each outcome.Ethics and dissemination No ethical assessment is required. The results of this review will be disseminated through peer-reviewed publication and conference presentation.PROSPERO registration number CRD42020158676
    Keywords Medicine ; R
    Subject code 310
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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