Effectiveness of SmartGuard Technology in the Prevention of Nocturnal Hypoglycemia After Prolonged Physical Activity
Abstract
Background: The prevention of postexercise nocturnal hypoglycemia after prolonged physical activity using sensor-augmented pump (SAP) therapy with predictive low-glucose management (PLGM) has not been well studied. We conducted a study at a pediatric diabetes camp to determine whether a SAP with PLGM reduces the frequency of nocturnal hypoglycemia after prolonged physical activity more effectively than a SAP with a carbohydrate intake algorithm.
Methods: During a 1-week sport camp, 20 children (aged 10-13 years) with type 1 diabetes (T1D) managed by SAP therapy either with (n=7) or without PLGM (n=13) were studied. The hypoglycemia management strategy and the continuous glucose monitoring (CGM)/PLGM settings were standardized.
The incidence, severity, and duration of hypoglycemia and carbohydrate intake were documented and compared. Results: The PLGM system was activated on 78% of all nights (once per night on average).
No difference was found between the SAP and PLGM groups in the mean overnight glucose curve or mean morning glucose (7.8 - 2 mmol/L vs. 7.4 - 3 mmol/L). There was no difference in the frequency and severity of hypoglycemia.
However, the SAP group consumed significantly more carbohydrates to prevent and treat hypoglycemia than those in the PLGM group; the values were 10-2 and 1-2gS (grams of saccharides or carbohydrates) (P < 0.0001) in the SAP and PLGM groups, respectively. Moreover, the SAP group spent a significantly longer time in hypoglycemia (64 - 2 min vs. 38 - 2 min, P < 0.05).
We observed a difference in the time distribution of nocturnal hypoglycemia (10 to 12 p.m. in the PLGM group and 3 to 7 a.m. in the SAP group, P < 0.05). Conclusion: With PLGM system, euglycemia after prolonged physical activity was largely maintained with a minimal carbohydrate intake.