Impact of Type 1 Diabetes on 24-Hour Energy Expenditure and Metabolic Flexibility

Abstract

Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate, but the impact of T1D on other components of 24-hour energy expenditure (EE) and metabolic flexibility (MF) is not known. We measured 24-hour EE, its components and substrate oxidation rates in 11 patients with T1D and 12 nondiabetic, age and BMI matched controls (HC) using whole room calorimetry. MF was defined as the respiratory quotient (RQ) kinetic response after ingesting a standard high CHO breakfast. Briefly, the kinetics between the lowest RQ pre-breakfast and the highest RQ after breakfast were analyzed by a simple linear regression between time (1-minute resolution) and RQ units (RQUnits). Subjects with T1D had marginally higher 24-hour EE and higher 24-hour non-exercise EE, but sleeping EE and basal EE were not significantly different (Table 1). There were no differences in 24-h respiratory quotient (RQ) or sleeping RQ, but MF during the breakfast meal was significantly lower in T1D vs. HC (p=0.042). Among patients with T1D, MF was related to the glycemic response to breakfast. These data suggest that T1D is characterized by alterations in EE and MF. These results have implications for glycemic and weight management among patients with T1D. Disclosure E.A. Carnero: None. K.D. Corbin: None. C.P. Bock: None. S.R. Smith: None. R.E. Pratley: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk Inc., Pfizer Inc., Sanofi-Aventis, Takeda Development Center Americas, Inc..