Risk of exercise-induced hypoglycaemia in patients with type 2 diabetes on intensive insulin therapy:: Comparison of insulin glargine with NPH insulin as basal insulin supplement

Aim: Hypoglycaemia is the most common adverse event associated with intensive conventional insulin therapy (ICT). This study compared the risk of exercise-related hypoglycaemia in type 2 diabetes patients receiving either basal insulin glargine or NPH insulin. Methods: In a prospective trial, 122 ICT patients (glargine n = 60, NPH n = 62) had a standardized treadmill test, monitored by capillary lactate concentration. Blood glucose (BG) profiles were performed the day before, during and the day after the exercise test, with the patients on a strict carbohydrate-defined diet. All patients had been on a stable ICT scheme for at least three months and had an HbA1c below 7.5%. Results: BG at the beginning of the exercise test, BG decline and lowest BG during the test were comparable between the two groups. The episodes of mild hypoglycaemia (BG < 3.3 mmol/l) and amounts of additional carbohydrate intake due to mild symptoms of hypoglycaemia (BG 3.3-5.0 mmol/l) were not significantly different. No episodes of hypoglycaemia occurred during several hours after the exercise. Conclusions: Moderate physical activity can be recommended for well-controlled type 2 diabetes patients receiving ICT, independently of glargine or NPH as basal insulin and without risk of exercise-induced hypoglycaemia. (C) 2008 Elsevier Ireland Ltd. All rights reserved.