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 L.; Sathyapalan, Thozhukat

Abstract

Objective
This study aimed to explore the effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes.

Research Design
A 3‐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 under three environmental conditions: i) temperature: 15°C and humidity: 10%, ii) temperature: 30°C and humidity: 10%, and iii) temperature: 30°C and humidity: 60%, controlled in an environmental chamber. Euglycaemic glucose clamp technique ensured a 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 (30oC) under 10% fixed humidity resulted in a greater GIRmax (p=0.04), a later tGIR.max (p=0.049) compared to lower temperature (15oC). 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 temperature 15oC and humidity 10% compared to temperature 30oC and humidity 60%.

Conclusions
High ambient temperature resulted in greater insulin peak effect compared to low ambient temperature, with the contribution of high relative humidity only apparent at high ambient temperature. This suggests that patients with type 1 diabetes mellitus entering higher environmental temperatures with or without high humidity could experience more hypoglycaemic events.

Citation

Al-Qaissi, A., Papageorgiou, M., Javed, Z., Heise, T., Rigby, A. S., Garrett, A. T., Hepburn, D., Kilpatrick, E. S., Atkin, S. L., & Sathyapalan, T. (2019). Environmental effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes mellitus. Diabetes, Obesity and Metabolism, 21(3), 569-574. https://doi.org/10.1111/dom.13555

• Journal Article Type: Article
• Acceptance Date: Oct 8, 2018
• Online Publication Date: Oct 12, 2018
• Publication Date: 2019-03
• Deposit Date: Oct 13, 2018
• Publicly Available Date: Oct 13, 2019
• Journal: Diabetes, Obesity and Metabolism
• Print ISSN: 1462-8902
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 3
• Pages: 569-574
• DOI: https://doi.org/10.1111/dom.13555
• Keywords: Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology
• Public URL: https://hull-repository.worktribe.com/output/1116946
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/dom.13555
• Contract Date: Oct 13, 2018