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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

Authors

Ahmed Al-Qaissi

Maria Papageorgiou

Zeeshan Javed

Tim Heise

Alan S. Rigby

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Dr Andrew Garrett A.Garrett@hull.ac.uk
Senior Lecturer in Exercise and Environmental Physiology

David Hepburn

Eric S. Kilpatrick

Stephen L. Atkin

Thozhukat Sathyapalan



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.

Journal Article Type Article
Publication Date 2019-03
Journal Diabetes, Obesity and Metabolism
Print ISSN 1462-8902
Electronic ISSN 1463-1326
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 21
Issue 3
Pages 569-574
APA6 Citation Al-Qaissi, A., Papageorgiou, M., Javed, Z., Heise, T., Rigby, A. S., Garrett, A. T., …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
DOI https://doi.org/10.1111/dom.13555
Keywords Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/dom.13555

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