Bibliographic Details
| Title: |
Glycemic Management Around Postprandial Exercise in People With Type 1 Diabetes: Challenge Accepted. |
| Authors: |
Helleputte, Simon, Stautemas, Jan, Jansseune, Laura, Backer, Tine De, Marlier, Joke, Lapauw, Bruno, Calders, Patrick |
| Source: |
Journal of Clinical Endocrinology & Metabolism; Aug2024, Vol. 109 Issue 8, p2039-2052, 14p |
| Subject Terms: |
TYPE 1 diabetes, GLYCEMIC index, BLOOD sugar, EXERCISE physiology, BODY mass index, HYPOGLYCEMIA |
| Abstract: |
Context The precise glycemic impact and clinical relevance of postprandial exercise in type 1 diabetes (T1D) has not been clarified yet. Objective This work aimed to examine acute, subacute, and late effects of postprandial exercise on blood glucose (BG). Methods A randomized, controlled trial comprised 4 laboratory visits, with 24-hour follow-up at home. Participants included adults with T1D (n = 8), aged 44 ± 13 years, with body mass index of 24 ± 2.1. Intervention included 30 minutes of rest (CONTROL), walking (WALK), moderate-intensity (MOD), or intermittent high-intensity (IHE) exercise performed 60 minutes after a standardized meal. Main outcome measures included BG change during exercise/control (acute), and secondary outcomes included the subacute (≤2 h after) and late glycemic effects (≤24 h after). Results Exercise reduced postprandial glucose (PPG) excursion compared to CONTROL , with a consistent BG decline in all patients for all modalities (mean declines −45 ± 24, −71 ± 39, and −35 ± 21 mg/dL, during WALK , MOD , and IHE, respectively (P <.001). For this decline, clinical superiority was demonstrated separately for each exercise modality vs CONTROL. Noninferiority of WALK vs MOD was not demonstrated, noninferiority of WALK vs IHE was demonstrated, and equivalence of IHE vs MOD was not demonstrated. Hypoglycemia did not occur during exercise. BG increased in the hour after exercise (more than after CONTROL ; P <.001). More than half of participants showed hyperglycemia after exercise necessitating insulin correction. There were more nocturnal hypoglycemic events after exercise vs CONTROL (P <.05). Conclusion Postprandial exercise of all modalities is effective, safe, and feasible if necessary precautions are taken (ie, prandial insulin reductions), as exercise lowered maximal PPG excursion and caused a consistent and clinically relevant BG decline during exercise while there was no hypoglycemia during or shortly after exercise. However, there seem to be 2 remaining challenges: subacute postexercise hyperglycemia and nocturnal hypoglycemia. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Clinical Endocrinology & Metabolism is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
