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Hybridmøtet 26. oktober om guidelines og type 1 diabetes

Kasuistikkene forslag til løsning fra Dr. Peter Adolfsson

 

Kasuistikk fra Stavanger Universitetssykehus

Kasuistikk fra Vestre Viken,Kongsberg Sykehus

Kasuistikk fra Aker Sykehus

Kasuistikk fra Ahus

Last ned karbohydrat-tabell

Guidelines: T1D and trening

 

 

Reduced mortality rate 

Moving from sedentary to physical activity thrice a week seems to reduce the mortality risk more than what happens with reducing HbA1c1

 

 

Competitive athlete

Being a competitive athlete with T1D can be challenging, but several strategies can be implemented to help glycaemic management
(Fig 2)7

 

 

Personalised diabetes management 

Each type of exercise has different outcome on glucose trend and requires personalized diabetes management2,3

 

 

Exercise management

Variability is observed in blood glucose responses to different forms of exercise in people with T1D (Fig 1)4

 

 

ISPAD exercise guidelines
 

  • The guidelines cover many broad aspects of exercise and diabetes for children and adolescents with T1D and T2D3
     
  • Describes insulin pump/MDI insulin adjustments and nutrition recommendations for before, immediately after and overnight for aerobic, mixed and anaerobic activity
     
  • Guidance on AID systems and exercise

 

Supporting materials

JDRF

GNL

YouTube

Sports & Diabetes

 

 

Preventing hypos

  • CGM devices can provide intermittently scanned or real-time glucose data before, during and after exercise5
     
  • Sensor glucose value should be interpreted together with the corresponding trend arrow

 

Evidence-based recommendations 

According to 37 evidence-based clinical practice recommendations in AACE guideline6:

  • CGM is recommended to everyone on insulin
     
  • Lifestyle and other factors should be considered
     
  • Real-time CGM is easier for anyone doing exercise

 

Tools & apps

Direct integration of CGM with smartwatch instead of transferring via smartphone 

Dexcom offers direct integration with Apple Watch on the G7

In AppEx, a sensor sends respective values to the app and an alarm is triggered in critical situations signalling the amount of carbs or insulin needed