The Effect of Midday Moderate-Intensity Exercise on Postexercise Hypoglycemia Risk in Individuals With Type 1 Diabetes
The Effect of Midday Moderate-Intensity Exercise on Postexercise Hypoglycemia Risk in Individuals With Type 1 Diabetes
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DOI：
10.1210/jc.2013-1169
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发表时间：
2013-07-01
影响因子：
5.8
通讯作者：
Jones, Timothy W.
中科院分区：
文献类型：
--
作者：
Davey, Raymond J.;Howe, Warwick;Jones, Timothy W.
内容：运动增加了1型diabetes.Objective低血糖的风险：最近，我们报道了一个双相增加葡萄糖的需求，以维持eukaryosis后，下午晚些时候的运动，这表明一个独特的模式，延迟夜间低血糖的风险。本研究探讨是否发生这种模式的葡萄糖需求，如果运动是在一天早些时候进行的。设计，参与者和干预：10名青少年与1型糖尿病进行了高胰岛素正葡萄糖钳夹在2个不同的场合，在此期间，他们要么休息或进行45分钟的中等强度的运动在中午。主要观察指标：比较两组运动后葡萄糖输注率（GIR）、葡萄糖出现和消失率、反调节激素水平。基线时，两组间维持正常血糖的GIR无显著差异（运动和休息条件前分别为9.8 +/-1.4和9.5 +/-1.6 g/h），在整个研究期间休息条件下没有变化。相比之下，GIR在运动期间增加了3倍以上（从9.8 +/-1.4到30.6 +/-4.7 g/h），在恢复的第一个小时内下降，但在恢复到基线水平之前一直保持升高，直到运动后11小时。维持正常血糖的葡萄糖需求模式对中度-中午进行的强度运动表明，运动介导的低血糖风险在中等强度运动期间和运动后几个小时内增加，没有证据表明运动后低血糖风险存在双相模式。
Context: Exercise increases the risk of hypoglycemia in type 1 diabetes.Objective: Recently we reported a biphasic increase in glucose requirements to maintain euglycemia after late-afternoon exercise, suggesting a unique pattern of delayed risk for nocturnal hypoglycemia. This study examined whether this pattern of glucose requirements occurs if exercise is performed earlier in the day.Design, Participants, and Intervention: Ten adolescents with type 1 diabetes underwent a hyperinsulinemic euglycemic glucose clamp on 2 different occasions during which they either rested or performed 45 minutes of moderate-intensity exercise at midday. Glucose was infused to maintain euglycemia for 17 hours after exercise.Main Outcome Measures: The glucose infusion rate (GIR) to maintain euglycemia, glucose rates of appearance and disappearance, and levels of counterregulatory hormones were compared between conditions.Results: GIRs to maintain euglycemia were not significantly different between groups at baseline (9.8 +/- 1.4 and 9.5 +/- 1.6 g/h before the exercise and rest conditions, respectively) and did not change in the rest condition throughout the study. In contrast, GIR increased more than 3-fold during exercise (from 9.8 +/- 1.4 to 30.6 +/- 4.7 g/h), fell within the first hour of recovery, but remained elevated until 11 hours after exercise before returning to baseline levels.Conclusions: The pattern of glucose requirements to maintain euglycemia in response to moderate-intensity exercise performed at midday suggests that the risk of exercise-mediated hypoglycemia increases during and for several hours after moderate-intensity exercise, with no evidence of a biphasic pattern of postexercise risk of hypoglycemia.