Acute effects of aerobic continuous, intermittent, and resistance exercise on glycemia in adolescents males with type 1 diabetes

Abstract

Objective: Increased levels of physical activity is often associated with reduced HbA1c in individuals with diabetes. However, the effect on glycemic control differs between different programs of exercise. The aim of this study was to compare the acute effects on glycemia of resistance and two aerobic continuous and intermittent exercise bouts in adolescent males with type 1 diabetes.Research design and methods: Eight active males with type 1 diabetes (17.5 ± 0.8 years, BMI: 20.8 ± 2.2 kg/m 2 , HbA1c: 7.2 ± 0.5% [54.9 ± 5.3 mmol/mol]) performed four experimental sessions-nonexercise (control), resistance exercise (RE) and two isocaloric continuous (CE) and intermittent (IE) cycling exercise trials-in a randomized order. Each session consisted of 45 min of exercise (except for the control modality) and 60 min of passive recovery. Venous blood was drawn for assessment of plasma glucose (PG). A two-way repeated-measures ANOVA was used for statistical comparisons.

Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes

“…The relationship between physical activity levels and glycemic control in adolescents with T1D is complex because the acute glycemic response to exercise is highly variable 6 and the directional change in glucose concentration is thought to be dependent on both exercise type and duration. 18,19 Most forms of prolonged exercise lower glucose levels in adolescents with T1D, which should reduce their TAR.…”

Resistance exercise in children and adolescents with type 1 diabetes: what clinicians need to know

“…56 This is usually temporary (up to 60 minutes) followed by hypoglycaemia as glucose is taken up to replenish muscle and liver glycogen stores. 57 Hyperglycaemia may also result from increased lactate production during RE 7 where glycolysis predominates, raising BG via gluconeogenic pathways. 27 When examining the glycaemic impact of RE, the exercise protocols used in the literature have generally consisted of three sets of 8-12 repetitions, using major muscle groups (5-7 exercises).…”

“…Särnblad et al 7 examined the glycaemic responses to non-fasted morning sessions of RE, AE, IE and no exercise, in a crossover trial using eight adolescent males with T1D. There were no significant BG changes during exercise or 60 minutes post exercise in the RE group (Figure 1), and no hypoglycaemia reported 4 hours post recovery.…”

“…When performing RE not under fasting basal conditions, certain strategies pre-exercise appear to aid BG stabilisation: reducing long-or intermediate-acting insulin by 10%, or pump basal rate by 50% (or 75% if BG is <5mmol/L) starting 1 hour before exercise for up to 105 minutes; plus 15-25g carbohydrate (or 0.5g/kg) immediately to 1 hour prior to exercise. 7,20,21 Shorter RE sessions (i.e. 30 minutes) started within 90 minutes of a meal should not require a reduction in pre-meal insulin but data on longer sessions are lacking 28 -in this situation adjusting pre-meal insulin to aim for a higher within-range starting BG would be prudent.…”

“…There is a need to increase the knowledge and confidence of the managing health care professional (HCP) to support this and deliver exercise advice in an informed way. However, literature looking specifically at RE in CYP with T1D is sparse, [7][8][9][10][11] with most data derived from studies including adults. [12][13][14][15][16][17][18][19][20][21][22][23][24][25]…”