Details

Autor(en) / Beteiligte

• Young, Gavin M
• Jacobs, Peter G
• Tyler, Nichole S
• Nguyen, Thanh-Tin P
• Castle, Jessica R
• Wilson, Leah M
• Branigan, Deborah
• Gabo, Virginia
• Guillot, Florian H
• Riddell, Michael C
• El Youssef, Joseph

Titel

Quantifying insulin-mediated and noninsulin-mediated changes in glucose dynamics during resistance exercise in type 1 diabetes

Ist Teil von

• American journal of physiology: endocrinology and metabolism, 2023-09, Vol.325 (3), p.E192-E206

Ort / Verlag

United States: American Physiological Society

Erscheinungsjahr

2023

Quelle

EZB-FREE-00999 freely available EZB journals

Beschreibungen/Notizen

• Exercise can cause dangerous fluctuations in blood glucose in people living with type 1 diabetes (T1D). Aerobic exercise, for example, can cause acute hypoglycemia secondary to increased insulin-mediated and noninsulin-mediated glucose utilization. Less is known about how resistance exercise (RE) impacts glucose dynamics. Twenty-five people with T1D underwent three sessions of either moderate or high-intensity RE at three insulin infusion rates during a glucose tracer clamp. We calculated time-varying rates of endogenous glucose production (EGP) and glucose disposal (R ) across all sessions and used linear regression and extrapolation to estimate insulin- and noninsulin-mediated components of glucose utilization. Blood glucose did not change on average during exercise. The area under the curve (AUC) for EGP increased by 1.04 mM during RE (95% CI: 0.65-1.43, < 0.001) and decreased proportionally to insulin infusion rate (0.003 mM per percent above basal rate, 95% CI: 0.001-0.006, = 0.003). The AUC for R rose by 1.26 mM during RE (95% CI: 0.41-2.10, = 0.004) and increased proportionally with insulin infusion rate (0.04 mM per percent above basal rate, CI: 0.03-0.04, < 0.001). No differences were observed between the moderate and high resistance groups. Noninsulin-mediated glucose utilization rose significantly during exercise before returning to baseline roughly 30-min postexercise. Insulin-mediated glucose utilization remained unchanged during exercise sessions. Circulating catecholamines and lactate rose during exercise despite relatively small changes observed in R . Results provide an explanation of why RE may pose a lower overall risk for hypoglycemia. Aerobic exercise is known to cause decreases in blood glucose secondary to increased glucose utilization in people living with type 1 diabetes (T1D). However, less is known about how resistance-type exercise impacts glucose dynamics. Twenty-five participants with T1D performed in-clinic weight-bearing exercises under a glucose clamp. Mathematical modeling of infused glucose tracer allowed for quantification of the rate of hepatic glucose production as well as rates of insulin-mediated and noninsulin-mediated glucose uptake experienced during resistance exercise.