Similar risk of exercise‐related hypoglycaemia for insulin degludec to that for insulin glargine in patients with type 1 diabetes: a randomized cross‐over trial

We compared changes in blood glucose (BG) and risk of hypoglycaemia during and after exercise in 40 patients with type 1 diabetes (T1D) treated with insulin degludec (IDeg) or insulin glargine (IGlar) in a randomized, open‐label, two‐period, crossover trial. After individual titration and a steady‐state period, patients performed 30 min of moderate‐intensity cycle ergometer exercise (65% peak rate of oxygen uptake). BG, counter‐regulatory hormones and hypoglycaemic episodes were measured frequently during and for 24 h after exercise. BG changes during exercise were similar with IDeg and IGlar [estimated treatment difference (ETD) for maximum BG decrease: 0.14 mmol/l; 95% confidence interval (CI) −0.15, 0.42; p = 0.34], as was mean BG (ETD −0.16 mmol/l; 95% CI −0.36, 0.05; p = 0.13). No hypoglycaemic episodes occurred during exercise. Post‐exercise mean BG, counter‐regulatory hormone response and number of hypoglycaemic episodes in 24 h after starting exercise were similar with IDeg (18 events in 13 patients) and IGlar (23 events in 15 patients). This clinical trial showed that, in patients with T1D treated with a basal‐bolus regimen, the risk of hypoglycaemia induced by moderate‐intensity exercise was low with IDeg and similar to that with IGlar.