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Pre-Exercise Blood Glucose Levels Determine the Amount of Orally Administered Carbohydrates during Physical Exercise in Individuals with Type 1 Diabetes—A Randomized Cross-Over Trial

1
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
2
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA18EN, UK
3
Exercise Physiology, Training and Training Therapy Research Group, Institute of Sports Science, University of Graz, 8010 Graz, Austria
4
Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, 55161 Mainz, Germany
5
Diabetes Research Group, Medical School, Swansea University, Swansea SA28AP, UK
*
Author to whom correspondence should be addressed.
These authors are contributed equally.
Nutrients 2019, 11(6), 1287; https://doi.org/10.3390/nu11061287
Received: 23 January 2019 / Revised: 27 February 2019 / Accepted: 4 March 2019 / Published: 6 June 2019
(This article belongs to the Special Issue Nutritional Therapy for Diabetes Mellitus)
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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. View Full-Text
Keywords: carbohydrates; exercise; type 1 diabetes; euglycemia; insulin carbohydrates; exercise; type 1 diabetes; euglycemia; insulin
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Moser, O.; Eckstein, M.L.; Mueller, A.; Birnbaumer, P.; Aberer, F.; Koehler, G.; Sourij, C.; Kojzar, H.; Pferschy, P.; Dietz, P.; Bracken, R.M.; Hofmann, P.; Sourij, H. Pre-Exercise Blood Glucose Levels Determine the Amount of Orally Administered Carbohydrates during Physical Exercise in Individuals with Type 1 Diabetes—A Randomized Cross-Over Trial. Nutrients 2019, 11, 1287.

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