@article{9c3da9d435d34cea8c6620dc2348c921,
title = "Hyperglycemia but not hyperinsulinemia is favorable for exercise in type 1 diabetes: A pilot study",
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.",
author = "Davide Romeres and Karen Olson and Rickey Carter and Claudio Cobelli and Man, {Chiara Dalla} and Ananda Basu and Rita Basu",
note = "Funding Information: The authors thank Barbara Norby, Brent McConahey, and Michael Slama (Endocrine Research Unit, Mayo Clinic) and the staff of the Mayo Clinic CRTU for their contributions in the conduct of the study. Funding. This study was supported by National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases grants R01-DK-90541 and R01-DK-29953 to R.B. and R01-DK-85516 and DP3-DK-106785 to A.B., by National Center for Advancing Translational Science grant UL1 TR000135, and by the Italian Minister for Education under the initiative “Departments of Excellence” (Law 232/2016). Funding Information: Acknowledgments. The authors thank Barbara Norby, Brent McConahey, and Michael Slama (Endocrine Research Unit, Mayo Clinic) and the staff of the Mayo Clinic CRTU for their contributions in the conduct of the study. Funding. This study was supported by National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases grants R01-DK-90541 and R01-DK-29953 to R.B. and R01-DK-85516 and DP3-DK-106785 to A.B., by National Center for Advancing Translational Science grant UL1 TR000135, and by the Italian Minister for Education under the initiative “Departments of Excellence” (Law 232/2016). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. D.R. assisted with the study, analyzed the data, and wrote the manuscript. K.O. helped in the conduct of the study. R.C. analyzed the data and edited the manuscript. C.C.helpedinthedesignofthestudy,analyzedthe data, and edited the manuscript. C.D.M. analyzed the data. A.B. and R.B. designed and conducted the studies, analyzed the data, and wrote the manuscript. R.B. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were presented in abstract form at the 78th Scientific Sessions of the American Diabetes Association, Orlando, FL, 22–26 June 2018. Publisher Copyright: {\textcopyright} 2020 by the American Diabetes Association.",
year = "2020",
month = sep,
doi = "10.2337/dc20-0611",
language = "English (US)",
volume = "43",
pages = "2176--2182",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "9",
}