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Characterization of Individualized Glycemic Excursions during a Standardized Bout of Hypoglycemia-Inducing Exercise and Subsequent Hypoglycemia Treatment-A Pilot Study

J. Brož, MD. Campbell, J. Urbanová, MA. Nunes, L. Brunerová, D. Rahelić, D. Janíčková Žďárská, A. Taniwall, M. Brabec, V. Berka, J. Michalec, J. Polák

. 2021 ; 13 (11) : . [pub] 20211121

Language English Country Switzerland

Document type Journal Article

Grant support
00064203 Ministry of Health, Czech Republic

The glycemic response to ingested glucose for the treatment of hypoglycemia following exercise in type 1 diabetes patients has never been studied. Therefore, we aimed to characterize glucose dynamics during a standardized bout of hypoglycemia-inducing exercise and the subsequent hypoglycemia treatment with the oral ingestion of glucose. Ten male patients with type 1 diabetes performed a standardized bout of cycling exercise using an electrically braked ergometer at a target heart rate (THR) of 50% of the individual heart rate reserve, determined using the Karvonen equation. Exercise was terminated when hypoglycemia was reached, followed by immediate hypoglycemia treatment with the oral ingestion of 20 g of glucose. Arterialized blood glucose (ABG) levels were monitored at 5 min intervals during exercise and for 60 min during recovery. During exercise, ABG decreased at a mean rate of 0.11 ± 0.03 mmol/L·min-1 (minimum: 0.07, maximum: 0.17 mmol/L·min-1). During recovery, ABG increased at a mean rate of 0.13 ± 0.05 mmol/L·min-1 (minimum: 0.06, maximum: 0.19 mmol/L·min-1). Moreover, 20 g of glucose maintained recovery from hypoglycemia throughout the 60 min postexercise observation window.

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$a The glycemic response to ingested glucose for the treatment of hypoglycemia following exercise in type 1 diabetes patients has never been studied. Therefore, we aimed to characterize glucose dynamics during a standardized bout of hypoglycemia-inducing exercise and the subsequent hypoglycemia treatment with the oral ingestion of glucose. Ten male patients with type 1 diabetes performed a standardized bout of cycling exercise using an electrically braked ergometer at a target heart rate (THR) of 50% of the individual heart rate reserve, determined using the Karvonen equation. Exercise was terminated when hypoglycemia was reached, followed by immediate hypoglycemia treatment with the oral ingestion of 20 g of glucose. Arterialized blood glucose (ABG) levels were monitored at 5 min intervals during exercise and for 60 min during recovery. During exercise, ABG decreased at a mean rate of 0.11 ± 0.03 mmol/L·min-1 (minimum: 0.07, maximum: 0.17 mmol/L·min-1). During recovery, ABG increased at a mean rate of 0.13 ± 0.05 mmol/L·min-1 (minimum: 0.06, maximum: 0.19 mmol/L·min-1). Moreover, 20 g of glucose maintained recovery from hypoglycemia throughout the 60 min postexercise observation window.
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