Hyperglycemia but not hyperinsulinemia is favorable for exercise in type 1 diabetes: A pilot study

Davide Romeres, Karen Olson, Rickey Carter, Claudio Cobelli, Chiara Dalla Man, Ananda Basu, Rita Basu

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

OBJECTIVE To distinguish the effects of hyperglycemia and hyperinsulinemia on exercise-inducedincreasesinRd and endogenousglucoseproduction (EGP)intype1diabetes. RESEARCH DESIGN AND METHODS We studied six participants without diabetes and six participants with type 1 diabetes on three visits in random order for the following: euglycemia, low insulin (EuLoI); euglycemia, high insulin (EuHiI); and hyperglycemia, low insulin (HyLoI). Glucose fluxes were measured using [6,6-2H2] glucose before, during, and after 60 min of exercise. RESULTS Rd increased (P < 0.01) with exercise within groups, while peak Rd during exercise was lower (P < 0.01) in participants with type 1 diabetes than participants without diabetes during all visits. In type 1 diabetes participants, EGP increased (P < 0.001) with exercise during EuLoI and HyLoI but not during EuHiI. This demonstrates that hyperinsulinemia, but not hyperglycemia, blunts the compensatory exercise-induced increase in EGP in type 1 diabetes. CONCLUSIONS The data from this pilot study indicate that 1) exercise-induced compensatory increase in EGP was inhibited in participants with type 1 diabetes with hyper-insulinemia but not with hyperglycemia; 2) in contrast, in participants without diabetes, exercise-induced increase in EGP was inhibited only during combined hyperinsulinemia and hyperglycemia. Taken together, these results suggest that low insulin coupled with euglycemia or modest hyperglycemia appear to be the most favorable milieu for type 1 diabetes during exercise.

Original languageEnglish (US)
Pages (from-to)2176-2182
Number of pages7
JournalDiabetes care
Volume43
Issue number9
DOIs
StatePublished - Sep 2020

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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