2266-PUB: Effects of Combined Exercise Protocols on Glucose Variability in Patients with Autoimmune Diabetes on CSII Therapy
Authors: CIGNARELLI ANGELO , LISCO GIUSEPPE , GIOIA LUDOVICO DI , NATALICCHIO ANNALISA , PERRINI SEBASTIO , LAVIOLA LUIGI , GIORGINO FRANCESCO 
Published: June 2019

Physical exercise may profoundly affect glucose variability (GV) in insulinopenic diabetes leading to both hypo- and hyperglycemia and feeling of discomfort reported by the patients after work out. Even if combined training reportedly reduces GV, an ideal training protocol is still not established in these patients. The aim of this study was to evaluate the effects of different combinations of continuous aerobic exercise (CON) and high intensity interval training (HIIT) on GV during a 24-h period after work out. A cross-over study was conducted on 14 outpatients [male 50%, mean age 31.9 (8.1) y, BMI 22.1 (2.5) Kg/m2] with either T1D (n=10) or LADA (n=4) on continuous subcutaneous insulin infusion (CSII) therapy [4 (3.9) y]. Data from flash glucose monitoring were collected for 72 h before work out. After different sequences of HIIT and CON work out (HIIT followed by CON, HIIT-CON; and CON followed by HIIT, CON-HIIT), 24-h glucose profiles were acquired. Several indices of GV and predictors of hypo-/hyperglycemia were analyzed. Indices of GV revealed no statistically significant difference when compared to baseline GV [mean -0.38 (1.85) vs. -0.43 (1.66); SD 0.02 (1.06) vs. -0.04 (0.94); CONGA: -0.18 (1.63) vs. -0.36 (1.69); MAG -0.12 (0.44) vs. -0.21 (0.47); MAGE 0.73 (1.65) vs. 1.11 (0.84); LBGI: 1.28 (6.83) vs. 1.71 (5.43); HBGI -0.18 (5.34) vs. -1.03 (4.89); HIIT-CON delta vs. baseline and CON-HIIT delta vs. baseline, respectively]. Moreover, time spent in &lt;70 mg/dl and in &gt;180 mg/dl 24 h after either HIIT-CON or CON-HIIT training was comparable to baseline [for &lt;70 mg/dL: baseline 10.4% (11.6), HIIT-CON 13.3% (13.9), CON-HIIT 12.4% (10.2); for &gt;180 mg/dl: baseline 27.2% (22.7), HIIT-CON 22.6% (21.1), CON-HIIT 22.2% (16.8)]. The comparison between HIIT-CON and CON-HIIT also showed no differences in GV. Thus, a standardized combined work out (either HIIT-CON or CON-HIIT) avoids late glycemic fluctuations and dangerous hypo-/hyperglycemia in T1D and LADA patients on CSII therapy.

Disclosure
A. Cignarelli: Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S. G. Lisco: None. L. Di Gioia: None. A. Natalicchio: Other Relationship; Self; Novo Nordisk Inc., Sanofi-Aventis. S. Perrini: None. L. Laviola: Advisory Panel; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc. Board Member; Self; AstraZeneca, Roche Diabetes Care, Sanofi-Aventis. Speaker's Bureau; Self; Medtronic, Mundipharma, Takeda Pharmaceutical Company Limited. F. Giorgino: Advisory Panel; Self; Aegerion Pharmaceuticals, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, MedImmune, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Roche Diabetes Care, Sanofi. Consultant; Self; Roche Diabetes Care, Sanofi. Research Support; Self; Eli Lilly and Company, LifeScan, Inc., Takeda Pharmaceutical Company Limited. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, Sanofi.