METABOLIC RESPONSE OF NORMAL MAN AND INSULIN-INFUSED DIABETICS TO POSTPRANDIAL EXERCISE
METABOLIC RESPONSE OF NORMAL MAN AND INSULIN-INFUSED DIABETICS TO POSTPRANDIAL EXERCISE
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DOI：
10.1152/ajpendo.1982.242.5.e309
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发表时间：
1982-01-01
影响因子：
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通讯作者：
ZINMAN, B
中科院分区：
文献类型：
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作者：
NELSON, JD;POUSSIER, P;ZINMAN, B
体育锻炼经常在吸收膳食的过程中进行。对7名健康对照者早餐后30分钟进行45分钟中等运动（约为最大摄氧量的55%）的代谢反应进行了研究。9名胰岛素依赖型糖尿病患者以相同的方式进行了研究，其中胰岛素由闭环人工内分泌胰腺酶（AEP）控制。将这些反应与早餐期间不运动的反应进行比较。在对照组中，运动的开始迅速逆转了单独吃早餐时出现的空腹胰岛素和胰岛素（IRI）的升高，两者都恢复到空腹水平（100，80 . ±. 3毫克/分升; IRI，0.38 ±。0.10 ng/ml）。运动后，血糖出现小幅且短暂的增加（血糖，33 . ±. 6毫克/分升; IRI，0.81 ±。0.15 ng/ml）。在糖尿病患者中，之前过夜静脉注射胰岛素使空腹血糖正常化（98 . ±. 4 mg/dl），其早餐后波动与对照组相同，大多数测量底物也是如此。同样，通过运动，胰岛素水平迅速恢复到空腹水平，同时胰岛素输注率适当降低。游离IRI水平反映了AEP输注速率的变化，与单独早餐相比，运动期间胰岛素需求量减少30%（P < 0.05）。在接受AEP治疗的糖尿病患者和正常人中，对餐后运动的反应需要快速调节胰岛素输送。为了证明餐后运动对预编程开环胰岛素替代的影响，研究了4名糖尿病受试者在早餐期间进行运动和不进行运动，同时接受固定的开环胰岛素输注模式（6.1 . ±. 0.7 U超过140。+-。8分钟）。仅早餐的血糖反应完全正常化。早餐后30 min开始运动时，所有受试者均发生症状性低血糖。糖尿病患者对闭环胰岛素输注的反应为确定餐后运动的适当程控开环胰岛素输注模式提供了重要数据。
Physical exercise is often performed during absorption of meals. The metabolic response to 45 min of moderate exercise (approximately 55% of estimated maximal oxygen uptake) beinning 30 min after breakfast in 7 healthy controls was characterized. Nine insulin-dependent diabetics were studied in an identical manner, with glycemia controlled by a closed-loop artificial endocrine pancrease (AEP). Responses were compared to those during breakfast without exercise. In the controls, onset of exercise rapidly reversed the rise in both glycemia and insulin (IRI) that occurred with breakfast alone, both returning to fasting levels (glycemia, 80 .+-. 3 mg/dl; IRI, 0.38 .+-. 0.10 ng/ml). After exercise, small and transient increments occurred (glycemia, 33 .+-. 6 mg/dl; IRI, 0.81 .+-. 0.15 ng/ml). In the diabetics, prior overnight i.v. insulin normalized fasting glycemia (98 .+-. 4 mg/dl), and its postbreakfast excursion was identical to that of controls, as were those of most measured substrates. Similarly, with exercise, glycemia returned rapidly to fasting levels, accompanied by an appropriate decrease in insulin infusion rates. Free IRI levels mirrored changes in infusion rates by the AEP, with a decrease in insulin requirement of 30% during exercise as compared to breakfast alone (P < 0.05). In both diabetics treated with the AEP and in normals, the responses to postprandial exercise required rapid modulation of insulin delivery. To demonstrate the effect of postprandial exercise on preprogrammed open-loop insulin replacement, 4 diabetic subjects were studied during breakfast with and without exercise while receiving a fixed open-loop insulin infusion pattern (6.1 .+-. 0.7 U over 140 .+-. 8 min). The glycemic response to breakfast alone was entirely normalized. Symptomatic hypoglycemia occurred in all subjects when exercise was initiated 30 min after breakfast. The diabetic responses to closed-loop insulin infusion provide important data in defining the appropriate preprogrammed open-loop insulin infusion pattern for postprandial exercise.