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Nutrients 2017, 9(2), 164; doi:10.3390/nu9020164

Metabolic Effects of Glucose-Fructose Co-Ingestion Compared to Glucose Alone during Exercise in Type 1 Diabetes

1
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
2
Department of Radiology, University Hospital Centre and University of Lausanne, 1011 Lausanne, Switzerland
3
Centre for Biomedical Imaging (CIBM), Signal Processing Core, 1015 Lausanne, Switzerland
4
Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland
5
Department of Cardiology, Interdisciplinary Center for Sports Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
6
Department of Clinical Research and Department of Radiology, University of Bern, 3010 Bern, Switzerland
*
Author to whom correspondence should be addressed.
Received: 19 January 2017 / Revised: 9 February 2017 / Accepted: 15 February 2017 / Published: 21 February 2017
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Abstract

This paper aims to compare the metabolic effects of glucose-fructose co-ingestion (GLUFRU) with glucose alone (GLU) in exercising individuals with type 1 diabetes mellitus. Fifteen male individuals with type 1 diabetes (HbA1c 7.0% ± 0.6% (53 ± 7 mmol/mol)) underwent a 90 min iso-energetic continuous cycling session at 50% VO2max while ingesting combined glucose-fructose (GLUFRU) or glucose alone (GLU) to maintain stable glycaemia without insulin adjustment. GLUFRU and GLU were labelled with 13C-fructose and 13C-glucose, respectively. Metabolic assessments included measurements of hormones and metabolites, substrate oxidation, and stable isotopes. Exogenous carbohydrate requirements to maintain stable glycaemia were comparable between GLUFRU and GLU (p = 0.46). Fat oxidation was significantly higher (5.2 ± 0.2 vs. 2.6 ± 1.2 mg·kg−1·min−1, p < 0.001) and carbohydrate oxidation lower (18.1 ± 0.8 vs. 24.5 ± 0.8 mg·kg−1·min−1 p < 0.001) in GLUFRU compared to GLU, with decreased muscle glycogen oxidation in GLUFRU (10.2 ± 0.9 vs. 17.5 ± 1.0 mg·kg−1·min−1, p < 0.001). Lactate levels were higher (2.2 ± 0.2 vs. 1.8 ± 0.1 mmol/L, p = 0.012) in GLUFRU, with comparable counter-regulatory hormones between GLUFRU and GLU (p > 0.05 for all). Glucose and insulin levels, and total glucose appearance and disappearance were comparable between interventions. Glucose-fructose co-ingestion may have a beneficial impact on fuel metabolism in exercising individuals with type 1 diabetes without insulin adjustment, by increasing fat oxidation whilst sparing glycogen. View Full-Text
Keywords: carbohydrates; glucose; fructose; type 1 diabetes; exercise; glycaemia; substrate oxidation carbohydrates; glucose; fructose; type 1 diabetes; exercise; glycaemia; substrate oxidation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Bally, L.; Kempf, P.; Zueger, T.; Speck, C.; Pasi, N.; Ciller, C.; Feller, K.; Loher, H.; Rosset, R.; Wilhelm, M.; Boesch, C.; Buehler, T.; Dokumaci, A.S.; Tappy, L.; Stettler, C. Metabolic Effects of Glucose-Fructose Co-Ingestion Compared to Glucose Alone during Exercise in Type 1 Diabetes. Nutrients 2017, 9, 164.

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