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Open AccessArticle

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)
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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