Breaking Research -  Reducing Insulin Degludec Doses by 25% & Aerobic Exercise

Breaking Research – Reducing Insulin Degludec Doses by 25% & Aerobic Exercise

Oh coca here from one bloody drop calm and today I'm here at Swansea University and I'm with dr. Otteman Massa dr. masa is a Doug is a research and diabetus and sports in particular he has type 1 diabetes himself and he's something of a sports star today we're going to be talking about some groundbreaking research that dr. Massa has been doing about the use of a particular type of in single Degla deck but before we get there I just would like dr. Massa to introduce himself so welcome and thank you for joining us so dr. Massa please tell us a little bit about your sporting background and your diagnosis with diabetes and how that led you to doing and of this wonderful research thank you for the opportunity to talk a little bit about myself and also about the research we are doing here in Swansea University so after that ride I got diagnosed with diabetes around 10 years ago before this time at the triad lung had a very nice life was traveling around the world and did a whole lot of competitions and then I got diagnosed with type 1 diabetes which completely changed everything for me the situation I think the funny part was that I was already working in as a student in the field of type 1 diabetes and afterwards it was clear for me after finishing my PhD and MSE and sports science and physiology that I want to stay in the field that I want to do research that I want to to improve the quality of life in people with type 1 diabetes so at the opportunity to do a doctor degree in medical sciences and out of that and my background I had the opportunity to perform research as a combination of doing physical exercise performing sports and testing new insulins new technologies around exercise my primary aim was at this stage and it's still I would say it is still the still aim of my research just try to increase the quality of life in people with type 1 diabetes I understand that you've just released some new research about the use of a particular type of insulin dat'll deck which I think most of us would know as recibo yeah so this study came more or less out of the blue so the funny part was a recent consensus statement published in Lancet set when you are exercising regularly and you are running on insulin deck so that you should not reduce the insulin because this might end up in consuming disturbances I was reading this video with interest and I was wondering where does this opinion assumption come from so there were no data in the background existing on that we knew already because we performed a previous research using the insulin tech detect that it's extremely stable which is good for the patients this means low numbers of hypoglycemic episodes less kissimmee reliability so really good insulin but for us it was of interest how can we use this type of insulin around regularly exercise so what we did we asked a couple of participants to exercise for five days every day in the evening the first round with a full dose of insulin decklid X with the normal dose of the basal insulin then a few weeks break in between and afterwards doing the same again but we'd use the insulin by 25% we had the idea that we see lower numbers of hypoglycemic episodes less time spent in hypoglycemia when you reduce the insulin interestingly what we found out in this crossover design was that the time spent in utilizing near so this means for blood glucose levels between around 4 and 10 millimolar letters went up when you reduce the insulin this could mean for future research for us what we want to do is show when you are exercising regularly you should reduce your basal insulin also when you're using insulin Dec latech because this could mean over a longer time that your hba1c your long-term class limit control goes down so this means you have an improved fancy McKee control this could be something we could try to find with this insulin reduction in the future does that meaning that we need if I was using deadly data and I was exercising and I reduced my dose to something that I need to be exercising every single day or five days out of seven I think such a reduction of 25% and insulin deck the deck is needed for example when you're exercising one day are doing one day of exercising the next day so we always one day break in-between it would make sense to reduce the insulin deck-by-deck dose however in this study the people are really exercising every day on a row over five days without any break in between it's now difficult to say that immediately it means that everyone should reduce insulin deck attack when you are exercising for example three times a week however it might be or we could assume for example when you have exercising three times a week that you reduce your insulin declar deck those around five up to 10% this would make sense this could be a conclusion out of it we could draw from our results however as I said the 25% reduction is working quite well when you're really let me say four up to five times exercising a week for around thirty up to sixty minutes I think in your research you're looking at moderate intensity aerobic exercise do we have any clues as to what might happen if people were doing high-intensity an aerobic exercise with would we expect to see similar or don't we know yet so for this specific insulin we do not know yet what what we are expecting or what we know is when you are exercising with a very high intensity that during exercise the drop in the blood glucose concentration is less or even the glucose concentration goes slightly up however over a longer period for example the following 24 hours up to 48 hours of their exercise we saw that you have a higher number of hypotheses Inuk episodes during that time this is what we saw also when using insulin deck the deck in comparison of high-intensity interval exercise and continuous exercise that when you do and hit exercise that for the next 24 hours you have higher rates of hypocalcemic episodes what could that mean for insulin deck the deck it could mean when you're exercising with higher intensities over a longer period or perform hit that you would even need to reduce the insulin a little bit more however this is just an assumption from my side and we did not investigate yet what we are trying to do with our researches find a general recommendation which you can use as a starting point however it's a good recommendation for example clinicians can give afterwards that's saying okay try to start with a 25% reduction and after three days reevaluate and see if you need to reduce a little bit more or if you need to reduce a little bit less it's the first recommendation you can give at the end of the day it's an individual recommendation you have to find for yourself yeah and I think that's a brilliant way of person so thank you very much so which journal was it published in most recently it was published in diabetes would be the new metabolism and it just remains for me to congratulate you on such a fantastic piece of research and also to congratulate you because I understand that next week you're going to be presenting this paper at the v bi SD contest in Berlin yeah which is just incredible – congratulations thank you very much thank you

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