Glucose and counterregulatory responses to exercise in adults with type 1 diabetes and impaired awareness of hypoglycemia using closed-loop insulin delivery: a randomized crossover study Academic Article uri icon


  • OBJECTIVE:To evaluate exercise-related glucose and counterregulatory responses (CRR) in adults with type 1 diabetes with impaired awareness of hypoglycemia (IAH) using hybrid closed-loop (HCL) insulin delivery to maintain glucose homeostasis. RESEARCH DESIGN AND METHODS:Twelve participants undertook 45-min high-intensity intermittent exercise (HIIE) and moderate-intensity exercise (MIE) in random order. The primary outcome was continuous glucose monitoring (CGM) time in range (70-180 mg/dL) for 24-h post-exercise commencement. RESULTS:CGM time in range was similar for HIIE and MIE (median 79.5% [interquartile range 73.2, 87.6] vs. 76.1% [70.3, 83.9], P = 0.37), and time with levels <54mg/dL post-exercise commencement was 0%. HIIE induced greater increases in cortisol (P = 0.002), noradrenaline (P = 0.005), and lactate (P = 0.002), with no differences in adrenaline, dopamine, growth hormone, or glucagon responses. CONCLUSIONS:IAH adults using HCL undertaking HIIE and MIE exhibit heterogeneity in CRR. Novel findings were a preserved cortisol response and variable catecholamine responses to HIIE.


  • Lee, Melissa H
  • Vogrin, Sara
  • Paldus, Barbora
  • Jayawardene, Dilshani
  • Jones, Hannah M
  • McAuley, Sybil A
  • Obeyesekere, Varuni
  • Gooley, Judith
  • La Gerche, André
  • MacIsaac, Richard J
  • Sundararajan, Vijaya
  • Jenkins, Alicia J
  • Ward, Glenn M
  • O’Neal, David N

publication date

  • 2019