Evidence map›Paper›PMID 36879098›Full record

Trial reportDiabetologia2023

No insulin degludec dose adjustment required after aerobic exercise for people with type 1 diabetes: the ADREM study.

Linda C A Drenthen, Mandala Ajie, Evertine J Abbink, Laura Rodwell, Dick H J Thijssen, Cees J Tack, Bastiaan E de Galan

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetologia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Linda C A DrenthenDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands. linda.drenthen@radboudumc.nl.ORCID http://orcid.org/0000-0002-3020-7948
Mandala AjieDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID https://orcid.org/0000-0003-0310-7842
Evertine J AbbinkDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
Laura RodwellDepartment for Health Evidence, Section Biostatistics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Dick H J ThijssenDepartment of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID https://orcid.org/0000-0002-7707-5567
Cees J TackDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID https://orcid.org/0000-0003-0322-1653
Bastiaan E de GalanDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.ORCID https://orcid.org/0000-0002-1255-7741
Radboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisIt is generally recommended to reduce basal insulin doses after exercise to reduce the risk of post-exercise nocturnal hypoglycaemia. Based on its long t

methodsThe ADREM study (Adjustment of insulin Degludec to Reduce post-Exercise (nocturnal) hypoglycaeMia in people with diabetes) was a randomised controlled, crossover study in which we compared 40% dose reduction (D40), or postponement and 20% dose reduction (D20-P), with no dose adjustment (CON) in adults with type 1 diabetes at elevated risk of hypoglycaemia, who performed a 45 min aerobic exercise test in the afternoon. All participants wore blinded continuous glucose monitors for 6 days, measuring the incidence of (nocturnal) hypoglycaemia and subsequent glucose profiles.

resultsWe recruited 18 participants (six women, age 38 ± 13 years, HbA CONCLUSIONS/

interpretationPost-exercise adjustment of degludec does not mitigate the risk of subsequent nocturnal hypoglycaemia in people with type 1 diabetes. Although reducing degludec reduced next-day time below range, this did not translate into fewer hypoglycaemic events, while postponing degludec should be avoided because of increased time above range. Altogether, these data do not support degludec dose adjustment after a single exercise bout.

trial registrationEudraCT number 2019-004222-22

fundingThe study was funded by an unrestricted grant from Novo Nordisk, Denmark.

Indexed as

Diabetes Mellitus, Type 1HypoglycemiaAdultBlood GlucoseCross-Over StudiesExerciseFemaleHumansHypoglycemic AgentsInsulin GlargineInsulin, Long-ActingMaleMiddle AgedBlood GlucoseHypoglycemic Agentsinsulin degludecInsulin GlargineInsulin, Long-ActingDose adjustmentExerciseHypoglycaemiaInsulin treatmentType 1 diabetes mellitus

Identifiers

PMID36879098
PMCPMC9988601
OpenAlexW4323348240

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.