Abstract
To determine the effects of exercise on postprandial glucose metabolism and insulin action in type 1 diabetes (T1D), we applied the triple tracer technique to study 16 T1D subjects on insulin pump therapy before, during, and after 75 min of moderate-intensity exercise (50% VO<inf>2max</inf>) that started 120 min after a mixed meal containing 75 g of labeled glucose. Prandial insulin bolus was administered as per each subject’s customary insulin/carbohydrate ratio adjusted for meal time meter glucose and the level of physical activity. Basal insulin infusion rates were not altered. There were no episodes of hypoglycemia during the study. Plasma dopamine and norepinephrine concentrations rose during exercise. During exercise, rates of endogenous glucose production rose rapidly to baseline levels despite high circulating insulin and glucose concentrations. Interestingly, plasma insulin concentrations increased during exercise despite no changes in insulin pump infusion rates, implying increased mobilization of insulin from subcutaneous depots. Glucagon concentrations rose before and during exercise. Therapeutic approaches for T1D management during exercise will need to account for its effects on glucose turnover, insulin mobilization, glucagon, and sympathetic response and possibly other blood-borne feedback and afferent reflex mechanisms to improve both hypoglycemia and hyperglycemia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | E1106-E1115 |
| Journal | American Journal of Physiology - Endocrinology and Metabolism |
| Volume | 308 |
| Issue number | 12 |
| DOIs | |
| State | Published - Jun 15 2015 |
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Keywords
- Exercise
- Insulin mobilization
- Postprandial glucose kinetics
ASJC Scopus subject areas
- Physiology
- Physiology (medical)
- Endocrinology, Diabetes and Metabolism
Cite this
Exercise effects on postprandial glucose metabolism in type 1 diabetes : A triple-tracer approach. / Mallad, Ashwini; Hinshaw, Ling; Schiavon, Michele; Man, Chiara Dalla; Dadlani, Vikash; Basu, Rita; Lingineni, Ravi; Cobelli, Claudio; Johnson, Matthew L.; Carter, Rickey E.; Kudva, Yogish C; Basu, Ananda.
In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 308, No. 12, 15.06.2015, p. E1106-E1115.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Exercise effects on postprandial glucose metabolism in type 1 diabetes
T2 - A triple-tracer approach
AU - Mallad, Ashwini
AU - Hinshaw, Ling
AU - Schiavon, Michele
AU - Man, Chiara Dalla
AU - Dadlani, Vikash
AU - Basu, Rita
AU - Lingineni, Ravi
AU - Cobelli, Claudio
AU - Johnson, Matthew L.
AU - Carter, Rickey E.
AU - Kudva, Yogish C
AU - Basu, Ananda
PY - 2015/6/15
Y1 - 2015/6/15
N2 - To determine the effects of exercise on postprandial glucose metabolism and insulin action in type 1 diabetes (T1D), we applied the triple tracer technique to study 16 T1D subjects on insulin pump therapy before, during, and after 75 min of moderate-intensity exercise (50% VO2max) that started 120 min after a mixed meal containing 75 g of labeled glucose. Prandial insulin bolus was administered as per each subject’s customary insulin/carbohydrate ratio adjusted for meal time meter glucose and the level of physical activity. Basal insulin infusion rates were not altered. There were no episodes of hypoglycemia during the study. Plasma dopamine and norepinephrine concentrations rose during exercise. During exercise, rates of endogenous glucose production rose rapidly to baseline levels despite high circulating insulin and glucose concentrations. Interestingly, plasma insulin concentrations increased during exercise despite no changes in insulin pump infusion rates, implying increased mobilization of insulin from subcutaneous depots. Glucagon concentrations rose before and during exercise. Therapeutic approaches for T1D management during exercise will need to account for its effects on glucose turnover, insulin mobilization, glucagon, and sympathetic response and possibly other blood-borne feedback and afferent reflex mechanisms to improve both hypoglycemia and hyperglycemia.
AB - To determine the effects of exercise on postprandial glucose metabolism and insulin action in type 1 diabetes (T1D), we applied the triple tracer technique to study 16 T1D subjects on insulin pump therapy before, during, and after 75 min of moderate-intensity exercise (50% VO2max) that started 120 min after a mixed meal containing 75 g of labeled glucose. Prandial insulin bolus was administered as per each subject’s customary insulin/carbohydrate ratio adjusted for meal time meter glucose and the level of physical activity. Basal insulin infusion rates were not altered. There were no episodes of hypoglycemia during the study. Plasma dopamine and norepinephrine concentrations rose during exercise. During exercise, rates of endogenous glucose production rose rapidly to baseline levels despite high circulating insulin and glucose concentrations. Interestingly, plasma insulin concentrations increased during exercise despite no changes in insulin pump infusion rates, implying increased mobilization of insulin from subcutaneous depots. Glucagon concentrations rose before and during exercise. Therapeutic approaches for T1D management during exercise will need to account for its effects on glucose turnover, insulin mobilization, glucagon, and sympathetic response and possibly other blood-borne feedback and afferent reflex mechanisms to improve both hypoglycemia and hyperglycemia.
KW - Exercise
KW - Insulin mobilization
KW - Postprandial glucose kinetics
UR - http://www.scopus.com/inward/record.url?scp=84931039420&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84931039420&partnerID=8YFLogxK
U2 - 10.1152/ajpendo.00014.2015
DO - 10.1152/ajpendo.00014.2015
M3 - Article
C2 - 25898950
AN - SCOPUS:84931039420
VL - 308
SP - E1106-E1115
JO - American Journal of Physiology - Renal Fluid and Electrolyte Physiology
JF - American Journal of Physiology - Renal Fluid and Electrolyte Physiology
SN - 1931-857X
IS - 12
ER -