- Email: [email protected]
A Randomized Crossover Study to Assess Overnight Glucose Control with Single-Hormone and Dual-Hormone Artificial Pancreas Systems in Children with Type 1 Diabetes in a Diabetes Camp
170
Abstracts / Can J Diabetes 39 (2015) 169e171
3 Aging and Physical Activity: Effects on Human Skeletal Muscle Phenotype F. ST-JEAN PELLETIER 1, 2, C.H. PION 2, 3, F. LEMIEUX 1, 2, J.P. LEDUCGAUDET 1, 2, S. BARBAT-ARTIGAS 2, 3, N. SGARIOTO 1, P. GAUDREAU 4, R.T. HEPPLE 5, S. CHEVALIER 6, M. BELANGER 1, 2, J.A. MORAIS 6, M. AUBERTIN-LEHEUDRE 1, 2, 7, G. GOUSPILLOU 1, 2, 7 1 Département de Kinanthropologie, Faculté des Sciences, UQAM 2 Groupe de recherche en Activité Physique Adaptée 3 Département de Biologie, Faculté des Sciences, UQAM 4 Département de Médecine, UdeM, et Centre de Recherche du Centre Hospitalier de l’UdeM 5 Department of Kinesiology and Division of Critical Care Medicine, McGill University 6 Division of Geriatric Medicine, McGill University 7 Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal Background: Aging is associated with a progressive loss of muscle mass and strength, a biological process resulting from a reduction in muscle fibre size and number. It is commonly believed that type II (fast-twitch) fibres are preferentially affected during aging, while type I (slow-twitch, oxidative) fibres are relatively preserved. However, many controversies on this preferential type II atrophy and loss with aging exist. Furthermore, although physical activity is well known to impact muscle phenotype, it is rarely taken into account when investigating the effects of aging on skeletal muscle. Objective: To assess the effects of aging and physical activity on skeletal muscle fibre type, proportion and size in men. Methods: Men aged from 20 to 94 years were divided into 3 groups: young adult (YA), middle-aged (MA; 55-65 years) and 65 years and older (65+). Participants in the MA and 65+ groups were further divided into sub-groups: Active (ACT), sedentary (SED). A 65+ pre-frail (65+PF) group was also studied. The YA group was mostly active. Biopsies were performed in the vastus lateralis muscle to assess skeletal muscle phenotype using immunolabelling methods. Results: Participants in the 65+ SED and 65+ PF groups showed smaller general fibre size and lower type IIa fibre number than YA. Interestingly, the 65+ SED showed lower type IIa fibre proportion compared with YA and 65+ ACT. Compared with YA, MA-SED had a higher proportion of type IIa/IIx hybrid fibres, while 65+ SED and 65+ PF showed only trends for higher proportion of this fibre type. Conclusions: Overall our results indicate that aging-related changes in skeletal muscle phenotype are more complex than commonly acknowledged and that physical activity partly prevents aging-related changes in skeletal muscle phenotype in men.
4 Treatment of Hypoglycemia and Anthropometric and Metabolic Profiles in Adults with Type 1 Diabetes V. SAVARD, A. BERTRAND, V. GINGRAS, C. LEROUX, R. RABASA-LHORET Département de nutrition, Université de Montréal; Institut de recherches cliniques de Montréal Background: The mean frequency of hypoglycemic episodes in type 1 diabetes (T1D) is two per week, and those are usually treated with food intake. Objective: To assess the impact of the dietary composition of hypoglycemia treatment on the anthropometric and metabolic profiles of adults with T1D. Method: In a cross-sectional study, 110 adults with T1D completed a hypoglycemia and dietary journal over three days in order to collect data on hypoglycemic episodes and their dietary treatment (hypoglycemia: <4 mmol/L or between 4 and 5 mmol/L with symptoms and treatment). Anthropometric and metabolic profiles were determined. Mean glucose level, LBGI (low blood glucose
index) and HBGI (high blood glucose index) were obtained using a blind continuous glucose monitoring system. Results: Mean age and diabetes duration were 4413 and 2313 years, respectively. Participants who had at least one hypoglycemic episode (76%) had lower A1C (p¼0.007), mean glucose level (p<0.001), HBGI (p¼0.004), and percent fat mass (p¼0.03) (men only), and a higher LBGI (p<0.001) than those who had none. Nearly 80% of participants did not follow the current recommended guidelines for the treatment of hypoglycemia, and 72% of those over-treated hypoglycemia. Fat content of the dietary treatment was positively associated with BMI (R¼0.24; p¼0.03) and waist circumference (R¼0.36; p¼0.001). Conclusion: Hypoglycemia tends to be over-treated, and the dietary treatment containing fat may have a negative effect on BMI and waist circumference. This study highlights the need for educational measures that will improve the dietary treatment of hypoglycemia.
5 A Randomized Crossover Study to Assess Overnight Glucose Control with Single-Hormone and Dual-Hormone Artificial Pancreas Systems in Children with Type 1 Diabetes in a Diabetes Camp L. MATTEAU-PELLETIER 1, 2, A. HAIDAR 1, M. DALLAIRE 1, V. MESSIER 1, L. LEGAULT 3, R. RABASA-LHORET 1, 4 1 Institut de Recherches Cliniques de Montréal 2 Université Laval 3 Montreal Children’s Hospital, McGill University Health Center 4 Département de Nutrition, Université de Montréal, Objective: Closed-loop strategies, also known as the artificial pancreas, may become new tools in the therapeutic arsenal against nocturnal hypoglycemia affecting children with type 1 diabetes. We aimed to assess the efficacy of single-hormone (insulin; SCL) and dual-hormone (insulin and glucagon; DCL) closed-loop systems in controlling overnight glucose levels in children with type 1 diabetes. Method: In a randomized, crossover, open-label trial comparing overnight interventions with DCL, SCL and conventional continuous subcutaneous insulin infusion (CSII), we studied 33 children in a diabetes camp for 9 nights each (3 nights per intervention). In SCL intervention, adjustments of insulin basal rates were determined by an algorithm every 10 minutes based on interstitial glucose sensor. In DCL, intermittent glucagon micro-boluses can be further infused. Results: DCL decreased the time spent in hypoglycemia compared to SCL and CSII (% time spent <4.0 mmol/L for DCL 2.1%, SCL 4.7%, and CSII 6.7%; p ¼ NS for SCL vs. CSII, otherwise p<0.05). Both SCL and DCL were associated with higher time spent in target (% time spent between 4.0 and 8.0 mmol/L for DCL 63.2%, SCL 53.6%, CSII 32.7%; p<0.05). Hypoglycemia events (<3.1 mmol/L for 15 minutes) occurred with 11 patients with CSII compared to 4 with SCL and none with DCL. The mean glucose levels for the DCL, SCL and CSII were 7.6 mmol/L, 8.4 mmol/L, and 9.6 mmol/L, respectively (p¼NS SCL vs. DCL, p<0.01 otherwise). Conclusions: Closed-loop strategies substantially improve overnight control and reduce the mean glucose level. DCL is superior to SCL and CSII at reducing time spent in nocturnal hypoglycemia.
6 Access to Physical Activity Possibilities Improves the Frequency of its Practice: Effect of Level of Motivation A. CASTONGUAY*, P. MIQUELON, M. MICHAUD Department of Psychology, Université du Québec à Trois-Rivières Less than 30% of people with type 2 diabetes (T2D) practice physical activity (PA) sufficiently to meet the guidelines’ recommendations of 150 minutes of moderate PA weekly. Not only this
Abstracts / Can J Diabetes 39 (2015) 169e171
3 Aging and Physical Activity: Effects on Human Skeletal Muscle Phenotype F. ST-JEAN PELLETIER 1, 2, C.H. PION 2, 3, F. LEMIEUX 1, 2, J.P. LEDUCGAUDET 1, 2, S. BARBAT-ARTIGAS 2, 3, N. SGARIOTO 1, P. GAUDREAU 4, R.T. HEPPLE 5, S. CHEVALIER 6, M. BELANGER 1, 2, J.A. MORAIS 6, M. AUBERTIN-LEHEUDRE 1, 2, 7, G. GOUSPILLOU 1, 2, 7 1 Département de Kinanthropologie, Faculté des Sciences, UQAM 2 Groupe de recherche en Activité Physique Adaptée 3 Département de Biologie, Faculté des Sciences, UQAM 4 Département de Médecine, UdeM, et Centre de Recherche du Centre Hospitalier de l’UdeM 5 Department of Kinesiology and Division of Critical Care Medicine, McGill University 6 Division of Geriatric Medicine, McGill University 7 Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal Background: Aging is associated with a progressive loss of muscle mass and strength, a biological process resulting from a reduction in muscle fibre size and number. It is commonly believed that type II (fast-twitch) fibres are preferentially affected during aging, while type I (slow-twitch, oxidative) fibres are relatively preserved. However, many controversies on this preferential type II atrophy and loss with aging exist. Furthermore, although physical activity is well known to impact muscle phenotype, it is rarely taken into account when investigating the effects of aging on skeletal muscle. Objective: To assess the effects of aging and physical activity on skeletal muscle fibre type, proportion and size in men. Methods: Men aged from 20 to 94 years were divided into 3 groups: young adult (YA), middle-aged (MA; 55-65 years) and 65 years and older (65+). Participants in the MA and 65+ groups were further divided into sub-groups: Active (ACT), sedentary (SED). A 65+ pre-frail (65+PF) group was also studied. The YA group was mostly active. Biopsies were performed in the vastus lateralis muscle to assess skeletal muscle phenotype using immunolabelling methods. Results: Participants in the 65+ SED and 65+ PF groups showed smaller general fibre size and lower type IIa fibre number than YA. Interestingly, the 65+ SED showed lower type IIa fibre proportion compared with YA and 65+ ACT. Compared with YA, MA-SED had a higher proportion of type IIa/IIx hybrid fibres, while 65+ SED and 65+ PF showed only trends for higher proportion of this fibre type. Conclusions: Overall our results indicate that aging-related changes in skeletal muscle phenotype are more complex than commonly acknowledged and that physical activity partly prevents aging-related changes in skeletal muscle phenotype in men.
4 Treatment of Hypoglycemia and Anthropometric and Metabolic Profiles in Adults with Type 1 Diabetes V. SAVARD, A. BERTRAND, V. GINGRAS, C. LEROUX, R. RABASA-LHORET Département de nutrition, Université de Montréal; Institut de recherches cliniques de Montréal Background: The mean frequency of hypoglycemic episodes in type 1 diabetes (T1D) is two per week, and those are usually treated with food intake. Objective: To assess the impact of the dietary composition of hypoglycemia treatment on the anthropometric and metabolic profiles of adults with T1D. Method: In a cross-sectional study, 110 adults with T1D completed a hypoglycemia and dietary journal over three days in order to collect data on hypoglycemic episodes and their dietary treatment (hypoglycemia: <4 mmol/L or between 4 and 5 mmol/L with symptoms and treatment). Anthropometric and metabolic profiles were determined. Mean glucose level, LBGI (low blood glucose
index) and HBGI (high blood glucose index) were obtained using a blind continuous glucose monitoring system. Results: Mean age and diabetes duration were 4413 and 2313 years, respectively. Participants who had at least one hypoglycemic episode (76%) had lower A1C (p¼0.007), mean glucose level (p<0.001), HBGI (p¼0.004), and percent fat mass (p¼0.03) (men only), and a higher LBGI (p<0.001) than those who had none. Nearly 80% of participants did not follow the current recommended guidelines for the treatment of hypoglycemia, and 72% of those over-treated hypoglycemia. Fat content of the dietary treatment was positively associated with BMI (R¼0.24; p¼0.03) and waist circumference (R¼0.36; p¼0.001). Conclusion: Hypoglycemia tends to be over-treated, and the dietary treatment containing fat may have a negative effect on BMI and waist circumference. This study highlights the need for educational measures that will improve the dietary treatment of hypoglycemia.
5 A Randomized Crossover Study to Assess Overnight Glucose Control with Single-Hormone and Dual-Hormone Artificial Pancreas Systems in Children with Type 1 Diabetes in a Diabetes Camp L. MATTEAU-PELLETIER 1, 2, A. HAIDAR 1, M. DALLAIRE 1, V. MESSIER 1, L. LEGAULT 3, R. RABASA-LHORET 1, 4 1 Institut de Recherches Cliniques de Montréal 2 Université Laval 3 Montreal Children’s Hospital, McGill University Health Center 4 Département de Nutrition, Université de Montréal, Objective: Closed-loop strategies, also known as the artificial pancreas, may become new tools in the therapeutic arsenal against nocturnal hypoglycemia affecting children with type 1 diabetes. We aimed to assess the efficacy of single-hormone (insulin; SCL) and dual-hormone (insulin and glucagon; DCL) closed-loop systems in controlling overnight glucose levels in children with type 1 diabetes. Method: In a randomized, crossover, open-label trial comparing overnight interventions with DCL, SCL and conventional continuous subcutaneous insulin infusion (CSII), we studied 33 children in a diabetes camp for 9 nights each (3 nights per intervention). In SCL intervention, adjustments of insulin basal rates were determined by an algorithm every 10 minutes based on interstitial glucose sensor. In DCL, intermittent glucagon micro-boluses can be further infused. Results: DCL decreased the time spent in hypoglycemia compared to SCL and CSII (% time spent <4.0 mmol/L for DCL 2.1%, SCL 4.7%, and CSII 6.7%; p ¼ NS for SCL vs. CSII, otherwise p<0.05). Both SCL and DCL were associated with higher time spent in target (% time spent between 4.0 and 8.0 mmol/L for DCL 63.2%, SCL 53.6%, CSII 32.7%; p<0.05). Hypoglycemia events (<3.1 mmol/L for 15 minutes) occurred with 11 patients with CSII compared to 4 with SCL and none with DCL. The mean glucose levels for the DCL, SCL and CSII were 7.6 mmol/L, 8.4 mmol/L, and 9.6 mmol/L, respectively (p¼NS SCL vs. DCL, p<0.01 otherwise). Conclusions: Closed-loop strategies substantially improve overnight control and reduce the mean glucose level. DCL is superior to SCL and CSII at reducing time spent in nocturnal hypoglycemia.
6 Access to Physical Activity Possibilities Improves the Frequency of its Practice: Effect of Level of Motivation A. CASTONGUAY*, P. MIQUELON, M. MICHAUD Department of Psychology, Université du Québec à Trois-Rivières Less than 30% of people with type 2 diabetes (T2D) practice physical activity (PA) sufficiently to meet the guidelines’ recommendations of 150 minutes of moderate PA weekly. Not only this