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Nutrients. 2019 Jun 6;11(6). pii: E1287. doi: 10.3390/nu11061287.

Pre-Exercise Blood Glucose Levels Determine the Amount of Orally Administered Carbohydrates during Physical Exercise in Individuals with Type 1 Diabetes-A Randomized Cross-Over Trial.

Author information

1
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. othmar.moser@swansea.ac.uk.
2
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA18EN, UK. othmar.moser@swansea.ac.uk.
3
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. max.eckstein@swansea.ac.uk.
4
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA18EN, UK. max.eckstein@swansea.ac.uk.
5
Exercise Physiology, Training and Training Therapy Research Group, Institute of Sports Science, University of Graz, 8010 Graz, Austria. alexander.mueller@uni-graz.at.
6
Exercise Physiology, Training and Training Therapy Research Group, Institute of Sports Science, University of Graz, 8010 Graz, Austria. philipp.birnbaumer@uni-graz.at.
7
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. felix.aberer@medunigraz.at.
8
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. gerd.koehler@klinikum-graz.at.
9
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. caren.sourij@medunigraz.at.
10
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. harald.kojzar@medunigraz.at.
11
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. peter.pferschy@medunigraz.at.
12
Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, 55161 Mainz, Germany. pdietz@uni-mainz.de.
13
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA18EN, UK. r.m.bracken@swansea.ac.uk.
14
Diabetes Research Group, Medical School, Swansea University, Swansea SA28AP, UK. r.m.bracken@swansea.ac.uk.
15
Exercise Physiology, Training and Training Therapy Research Group, Institute of Sports Science, University of Graz, 8010 Graz, Austria. peter.hofmann@uni-graz.at.
16
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria. ha.sourij@medunigraz.at.

Abstract

The aim of the study was to assess the amount of orally administered carbohydrates needed to maintain euglycemia during moderate-intensity exercise in individuals with type 1 diabetes. Nine participants with type 1 diabetes (four women, age 32.1 ± 9.0 years, BMI 25.5 ± 3.9 kg/m2, HbA1c 55 ± 7 mmol/mol (7.2 ± 0.6%)) on insulin Degludec were randomized to cycle for 55 min at moderate intensity (63 ± 7% VO2peak) for five consecutive days on either 75% or 100% of their regular basal insulin dose. The impact of pre-exercise blood glucose concentration on the carbohydrate requirement was analyzed by one-way ANOVA stratified for pre-exercise blood glucose quartiles. The effect of the basal insulin dose on the amount of orally administered carbohydrates was evaluated by Wilcoxon matched-pairs signed-rank test. The amount of orally administered carbohydrates during the continuous exercise sessions was similar for both trial arms (75% or 100% basal insulin) with median [IQR] of 36 g (9-62 g) and 36 g (9-66 g) (p = 0.78). The amount of orally administered carbohydrates was determined by pre-exercise blood glucose concentration for both trial arms (p = 0.03). Our study elucidated the importance of pre-exercise glucose concentration related orally administered carbohydrates to maintain euglycemia during exercise in individuals with type 1 diabetes.

KEYWORDS:

carbohydrates; euglycemia; exercise; insulin; type 1 diabetes

PMID:
31174360
DOI:
10.3390/nu11061287
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