2.1. Participants
T1DM, liver disease, hypoglycemia, chronic renal impairment, hypoglycemia unawareness, diabetes
DIABETIC RETINOPATHY, CHRONIC RENAL IMPAIRMENT, HYPOGLYCEMIA UNAWARENESS, LIVER DISEASE, HYPOGLYCEMIA, FOOT ULCERS, DIABETES
We conducted a randomized crossover study including 14 untrained adult patients with T1DM for at least one year, with HbA1c of less than 9% and a stable insulin regimen for the preceding 3 months. Patients with frequent hypoglycemia and those with hypoglycemia unawareness, patients on corticosteroid therapy, and those with chronic renal impairment (eGFR < 90 mL/min), active diabetic retinopathy, foot ulcers, and liver disease were excluded. The Ethical Committee of the Faculty of Medicine, University of Osijek, and the Ethical Committee of the Clinical Hospital Center Osijek approved the study protocol (R2-4787/2019 and 16 April 2019 respectively), and the investigation was conducted according to the Declaration of Helsinki. All patients gave their written informed consent before inclusion. Patients were randomized according to the type of exercise (aerobic and resistance exercise) with a recovery period of three days between group changes. Data on physical activity, diabetes glycemic stability, and hypoglycemia history were assessed before inclusion. All participants had an intermittently scanned continuous glucose monitoring (isCGM) FreeStyle Libre sensor placed 90 days prior to the study entry and were instructed to perform capillary blood glucose tests when measuring hypoglycemia with isCGM and to measure ketones in cases of blood glucose of >15 mmol/L. The study protocol was performed 48 h post sensor change to avoid any errors due to lower accuracy in the first 24 h or at the end of their useful lifespan. Interstitial glucose levels were monitored during a 24 h post-exercise period. Participants withheld from exercise for 24 h before or during the washout period. The study design scheme is presented in 