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For general inquiries including collaborations, please contact senior program manager Tanyana Jackiewicz:

Phone: (08) 6456 4616
Email: tanyana.jackiewicz@health.wa.gov.au

Postal address

Children's Diabetes Centre
Telethon Kids Institute
PO Box 855
West Perth Western Australia 6872
Australia

Nocturnal LOPEH prevention (Protein dosing to prevent late onset post-exercise hypoglycaemia in youth with type 1 diabetes)

It is widely known that exercise is beneficial to both physical and mental health.

However, when people with type 1 diabetes (T1D) perform aerobic or moderate intensity exercise (e.g. jogging, cycling and swimming), this can cause their blood glucose to drop below normal levels (hypoglycaemia) during and immediately after exercise.

In addition, when people with T1D exercise at moderate intensity in the late afternoon, they are at increased risk of hypoglycaemia at night, due to the reduced ability to respond to low blood glucose levels during sleep.

We also know that when people with T1D have a high protein meal, their blood glucose levels are elevated for up to five to six hours, unless additional insulin is given to prevent this rise.

Knowing this, we recently investigated the potential of a bed-time protein drink in reducing the risk of overnight hypoglycaemia caused by late afternoon moderate intensity exercise.

We chose to investigate protein as an additional preventive strategy because if successful, it could provide a two-pronged benefit for people with T1D. It would eliminate overnight late-onset post-exercise hypoglycaemia (LOPEH) without the weight gain associated with increased carbohydrate intake, and also aid muscle building and post-exercise muscle repair.

In this in-clinic study, involving six young people with T1D, we found that 50g protein reduced the risk of LOPEH; and was so effective that it resulted in high blood glucose levels (hyperglycaemia) overnight. 

As repeated prolonged hyperglycaemia is harmful to the long-term health of people with T1D, we now want to investigate two smaller amounts of protein, based on body weight, in preventing these overnight lows; without causing hyperglycaemia.

This study will enrol young people with type 1 diabetes, aged 12-25 years, who will visit the research unit four times; one-to-two weeks apart.

The first visit is to determine exercise fitness, and the following three visits involve exercising for 45 minutes and having the protein drink at home. All exercise testing is done in the research unit, but overnight monitoring of blood glucose levels is done at home using a continuous glucose monitoring system.

For more information, please email Niru Paramalingam, Nirubasini.Paramalingam@health.wa.gov.au.

Dishabituation in patients with impaired hypoglycaemia awareness study

Young people are needed for a new study looking at ways to improve hypoglycaemia awareness through exercise.

“Usually people with type 1 diabetes produce hormones like adrenaline that gives them the pale and shaky feeling when they have a hypo and provides a warning that they need to treat the hypo,” study lead Dr Mary Abraham said.

“However, almost 20 to 25 per cent of patients with type 1 diabetes cannot tell when they are going low and this is called being hypo unaware. They get hypos frequently as their bodies produce less adrenaline leading to the development of an impaired awareness of hypoglycaemia.”

Dr Abraham said the study was based on the premise that impaired hypo awareness was an adaptive response of the body to repeated hypos.

“Previous studies have shown that a strong stimulus can restore the hormone response and reverse effects of this impaired awareness,” she said. “This process is called dishabituation.

“In the current study we are testing if people, who are hypo unaware, are able to restore the adrenaline response by introducing a single burst of high-intensity exercise.”

We are looking for children and young adults aged 14 years and older who have type 1 diabetes, a HbA1C ≤ 9 per cent who are interested in high-intensity exercise. 

For more information, please contact research assistant Joanne O’Dea via Joanne.O'Dea@health.wa.gov.au or email Dr Mary Abraham  Mary.Abraham@health.wa.gov.au.