Environmental effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes mellitus

Ahmed Al-Qaissi, Maria Papageorgiou, Zeeshan Javed, Tim Heise, Alan S. Rigby, Andrew T. Garrett, David Hepburn, Eric S. Kilpatrick, Stephen Atkin, Thozhukat Sathyapalan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: This study aimed to explore the effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes. Materials and methods: A three-way, cross-over, randomised study was performed in adults with type 1 diabetes mellitus (n = 10). The pharmacodynamics profile of a single dose of short-acting insulin (insulin lispro) was investigated, using a controlled environmental chamber, under three environmental conditions: (a) temperature: 15°C and humidity: 10%; (b) temperature: 30°C and humidity: 10%; and (c) temperature: 30°C and humidity: 60%. A euglycaemic glucose clamp technique ensured constant blood glucose of 100 mg/dL (5.5 mmol/L). The following pharmacodynamic endpoints were calculated: maximum glucose infusion rate (GIRmax), time to GIRmax (tGIRmax), total area under the curve (AUC) for GIR from 0-6 hours (AUCGIR.0-6h), and partial AUCs (AUCGIR.0-1h, AUCGIR.0-2h and AUCGIR.2-6h). Results: Higher temperature (30°C) under 10% fixed humidity conditions resulted in greater GIRmax (P = 0.04) and a later tGIR.max (P = 0.049) compared to lower temperature (15°C). Humidity did not affect any pharmacodynamic parameter. When the combined effects of temperature and humidity were explored, tGIR.max (P = 0.008) occurred earlier, with a lower late insulin pharmacodynamic effect (AUCGIR.2-6h; P = 0.017) at a temperature of 15°C and humidity of 10% compared to a temperature of 30°C and humidity of 60%. Conclusions: High ambient temperature resulted in a greater insulin peak effect compared to low ambient temperature, with the contribution of high relative humidity apparent only at high ambient temperature. This suggests that patients with type 1 diabetes mellitus who are entering higher environmental temperatures, with or without high humidity, could experience more hypoglycaemic events.

Original languageEnglish
JournalDiabetes, Obesity and Metabolism
DOIs
Publication statusAccepted/In press - 1 Jan 2018

Fingerprint

Humidity
Type 1 Diabetes Mellitus
Insulin
Temperature
Glucose Clamp Technique
Area Under Curve
Insulin Lispro
Short-Acting Insulin
Hypoglycemic Agents
Cross-Over Studies
Blood Glucose

Keywords

  • ambient temperature
  • environmental conditions
  • insulin pharmacodynamics
  • relative humidity
  • type 1 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Environmental effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes mellitus. / Al-Qaissi, Ahmed; Papageorgiou, Maria; Javed, Zeeshan; Heise, Tim; Rigby, Alan S.; Garrett, Andrew T.; Hepburn, David; Kilpatrick, Eric S.; Atkin, Stephen; Sathyapalan, Thozhukat.

In: Diabetes, Obesity and Metabolism, 01.01.2018.

Research output: Contribution to journalArticle

Al-Qaissi, Ahmed ; Papageorgiou, Maria ; Javed, Zeeshan ; Heise, Tim ; Rigby, Alan S. ; Garrett, Andrew T. ; Hepburn, David ; Kilpatrick, Eric S. ; Atkin, Stephen ; Sathyapalan, Thozhukat. / Environmental effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes mellitus. In: Diabetes, Obesity and Metabolism. 2018.
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AU - Rigby, Alan S.

AU - Garrett, Andrew T.

AU - Hepburn, David

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N2 - Objective: This study aimed to explore the effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes. Materials and methods: A three-way, cross-over, randomised study was performed in adults with type 1 diabetes mellitus (n = 10). The pharmacodynamics profile of a single dose of short-acting insulin (insulin lispro) was investigated, using a controlled environmental chamber, under three environmental conditions: (a) temperature: 15°C and humidity: 10%; (b) temperature: 30°C and humidity: 10%; and (c) temperature: 30°C and humidity: 60%. A euglycaemic glucose clamp technique ensured constant blood glucose of 100 mg/dL (5.5 mmol/L). The following pharmacodynamic endpoints were calculated: maximum glucose infusion rate (GIRmax), time to GIRmax (tGIRmax), total area under the curve (AUC) for GIR from 0-6 hours (AUCGIR.0-6h), and partial AUCs (AUCGIR.0-1h, AUCGIR.0-2h and AUCGIR.2-6h). Results: Higher temperature (30°C) under 10% fixed humidity conditions resulted in greater GIRmax (P = 0.04) and a later tGIR.max (P = 0.049) compared to lower temperature (15°C). Humidity did not affect any pharmacodynamic parameter. When the combined effects of temperature and humidity were explored, tGIR.max (P = 0.008) occurred earlier, with a lower late insulin pharmacodynamic effect (AUCGIR.2-6h; P = 0.017) at a temperature of 15°C and humidity of 10% compared to a temperature of 30°C and humidity of 60%. Conclusions: High ambient temperature resulted in a greater insulin peak effect compared to low ambient temperature, with the contribution of high relative humidity apparent only at high ambient temperature. This suggests that patients with type 1 diabetes mellitus who are entering higher environmental temperatures, with or without high humidity, could experience more hypoglycaemic events.

AB - Objective: This study aimed to explore the effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes. Materials and methods: A three-way, cross-over, randomised study was performed in adults with type 1 diabetes mellitus (n = 10). The pharmacodynamics profile of a single dose of short-acting insulin (insulin lispro) was investigated, using a controlled environmental chamber, under three environmental conditions: (a) temperature: 15°C and humidity: 10%; (b) temperature: 30°C and humidity: 10%; and (c) temperature: 30°C and humidity: 60%. A euglycaemic glucose clamp technique ensured constant blood glucose of 100 mg/dL (5.5 mmol/L). The following pharmacodynamic endpoints were calculated: maximum glucose infusion rate (GIRmax), time to GIRmax (tGIRmax), total area under the curve (AUC) for GIR from 0-6 hours (AUCGIR.0-6h), and partial AUCs (AUCGIR.0-1h, AUCGIR.0-2h and AUCGIR.2-6h). Results: Higher temperature (30°C) under 10% fixed humidity conditions resulted in greater GIRmax (P = 0.04) and a later tGIR.max (P = 0.049) compared to lower temperature (15°C). Humidity did not affect any pharmacodynamic parameter. When the combined effects of temperature and humidity were explored, tGIR.max (P = 0.008) occurred earlier, with a lower late insulin pharmacodynamic effect (AUCGIR.2-6h; P = 0.017) at a temperature of 15°C and humidity of 10% compared to a temperature of 30°C and humidity of 60%. Conclusions: High ambient temperature resulted in a greater insulin peak effect compared to low ambient temperature, with the contribution of high relative humidity apparent only at high ambient temperature. This suggests that patients with type 1 diabetes mellitus who are entering higher environmental temperatures, with or without high humidity, could experience more hypoglycaemic events.

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