Exercise for improving hypoglycaemia awareness
Usually people with type 1 diabetes (T1D) know when they are going low by showing symptoms like becoming pale and shaky. This is called hypoglycaemia awareness.
However, some people with T1D are not able to feel their symptoms and so they may be at a higher risk of having a severe hypo.
Avoiding hypos for several weeks can improve hypoglycaemia awareness, but this often means running blood glucose levels quite high for a while, which is not an ideal solution.
We want to see if introducing a home-based program of exercise (either continuous low-intensity, or intermittent high-intensity cycling, three times per week) is practical, can improve hypoglycaemia awareness, time spent in target range (3.9 to 10 mmol/L) and reduce hypoglycaemia in individuals with T1D who have impaired hypo awareness.
Who can participate?
We are looking for:
- individuals with type 1 diabetes aged 14-35 years,
- who have impaired awareness of hypoglycaemia
- do not regularly participate in high-intensity exercise
- own an iOS (Apple) or Android phone
- willing to use a Dexcom continuous glucose monitoring (CGM) system, and Garmin exercise-monitoring watch during the trial period
What does it involve?
If you take part in this study we will ask you to come to the research unit at PCH for two visits. The rest of the study can be completed at home. The entire study will run over 18 weeks in total.
The study is split into four phases. Phase 1 goes for two weeks and is to help you to become familiar with the continuous glucose monitoring system if you have not used it before. We will also show you how to use the stationary exercise bike that you will use throughout the study, ask you to complete some questionnaires about your hypoglycaemia awareness and physical activity, and provide you with a hypoglycaemia symptom diary to record your hypos.
Phase 2 goes for four weeks, and will be your first 4-week exercise program. At the start of Phase 2, we will visit you at home to deliver the same exercise bike that you used in Phase 1 and also show you how to use the exercise monitoring watch that we would like you to use throughout the study. A researcher may be in contact to ensure that the activity-watch is correctly recording your exercise sessions. In the last two weeks of Phase 2, we will ask you to complete another hypoglycaemia symptom diary and a few more questionnaires, and if you had just completed the intermittent high-intensity exercise program, you’ll be asked to complete a short interview (~10-15 minutes), with one of our researchers.
Phase 3 goes for eight weeks, and is a break or ‘washout’ period before you start your second 4-week exercise program. We would still like you to continue to use the Dexcom CGM system (and exercise watch), so we will provide you with a fresh supply of sensors, but ask that you only continue to complete the type and level of exercise that you did before starting in the study. In the last two weeks of this phase, we would again like you to complete another hypoglycaemia symptom diary.
Phase 4 of the study involves the second 4-week exercise program. It is identical to Phase 2, except that if you completed the intermittent high-intensity program first, you will complete the low-intensity program during this phase, and vice-versa.
At the end of Phase 4, the study is complete and we will return to your home to collect the exercise bike, activity watch and any unused sensors.
How can I find out more?
If you would like more information please download the study information sheets below:
If you have any further questions or would like to participate, please contact Dr Mary Abraham (Mary.Abraham@health.wa.gov.au), Dr Wayne Soon (Wayne.Soon@health.wa.gov.au), or call 6456 4532 to talk to a member of the research team.