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Insulin requirements vary more overnight in type 1 diabetes, study finds

DCUK NewsBot

DCUK NewsBot

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People with type 1 diabetes have significantly more variable overnight insulin requirements than during the day, a new study reports. Researchers at the University of Cambridge wanted to quantify how insulin requirements varied during closed-loop insulin delivery. A closed-loop system is where an insulin pump works in conjunction with a continuous glucose monitor (CGM). The two devices are connected to a program which works out how much insulin is needed in response to blood glucose readings from the CGM. 32 adults with type 1 diabetes were given insulin during a multicentre closed-loop trial, and researchers evaluated their overnight, daytime and total daily insulin amounts. The participants were monitored under free-living home conditions. They were monitored over 1,918 nights, 1,883 daytime periods and 1,564 total days characterised by closed-loop use during 85 per cent of the study period. Variability of overnight insulin requirements (50 to 300 per cent) were nearly twice as high as variability of total daily requirements (70 to 200 per cent), and higher than daytime insulin (50 to 200 per cent). The researchers concluded: "The main strength of the current study is the quantification of variability of insulin requirements derived from data collected over a prolonged period under free-living conditions reflecting participants' insulin needs in real-life. "The present analysis pinpoints the reasons why people with type 1 diabetes benefit from closed-loop insulin delivery and indicates that greatest benefit may apply overnight when insulin requirements are most variable and realtime adaptive insulin delivery is most desirable." The study team noted that several factors could have contributed to insulin requirements varying more overnight. These included evening meal composition, the effects of daytime exercise, variable insulin absorption, changes in insulin sensitivity induced by stress, and menstrual cycle phases in women. "This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia," the authors added. The findings appear in Diabetes Care.

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Something that Pratik Choudhary has been talking about for a while.
 
really interesting :)
 
that's interesting.... I wonder if they will do a similar study on type 2's and other types like 1.5 and 3c on full time insulin therapy and if they find the same thing or not? I do tend to hypo mostly at night. I guess they'd have to break up the group between those with sufficient insulin and those with insufficient insulin. My type 1 friend keeps telling me I should get a CGM to find out what is happening with me overnight. She gets concerned because I live alone. She also is trying to get me interested in pumping rather than the injections. I'm happy with injecting, but have no idea how my insulin works for me overnight. The other issue I have is I'm not even sure CGM is an option for me as here they only seem to say it is for type 1's.... but my type 1 friend is of the opinion I should be able to get one for a week at least because I'm on full time insulin therapy. I have a good idea how the insulin works for me during the day.... although CGM could give me better info.
 
BeccyB said:
Which would suggest that we should ALL have the option of using a pump so we can vary our basal rates!
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Which is exactly what a number of more senior Diabetologists in the UK have been saying...
 
It's crazy - if we had a popular condition such as cancer (I mean popular with the media etc not the patients obviously!) there would be an outcry at being denied the funding for pumps. The perception that diabetics don't deserve the help because 'we brought it on ourselves by being fat and lazy' means we can't get support from the general population
 
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