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.
Highlights
The beneficial effects of physical activity and exercise are well described in individuals with type 1 diabetes [1,2]
CHO: carbohydrate; IDeg: insulin Degludec; BG: blood glucose; g: Gram. * indicates statistically significant difference (p < 0.05) in comparison of Min to 75 within the 100% IDeg arm. † indicates significance (p = 0.05) in comparisons of Min to Max within the 75% IDeg arm. This is the first study investigating the interaction between pre-exercise blood glucose levels and the amount of orally administered carbohydrates during moderate-intensity exercise, depending on the dose of basal insulin in individuals with type 1 diabetes running on multiple daily injections
Our study suggests that the mean amount of required carbohydrates is higher, depending on the blood glucose level at the beginning of the exercise session
Summary
The beneficial effects of physical activity and exercise are well described in individuals with type 1 diabetes [1,2]. Nutrients 2019, 11, 1287 insulin sensitivity, body mass index (BMI), waist circumference as well as quality of life [3]. Even in individuals with type 1 diabetes suffering from chronic kidney disease, leisure time physical activity is associated with a lower risk of mortality [4]. Supporting this evidence, current guidelines recommend 150 min per week of moderate-intensity physical exercise or 75 min per week of vigorous intensity physical exercise [1]. Insulin Glargine U-100 (Sanofi, FRA) and insulin Detemir
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