Trends of glucose, lactate and ketones during anaerobic and aerobic exercise in subjects with type 1 diabetes: The ACTION‐1 Study
Résumé
Background: Exercise is part of type 1 diabetes (T1D) management due to its cardiovascular and metabolic benefits. However, despite using continuous glucose monitoring, many patients are reluctant to exercise because of fear for hypoglycaemia.Aims: We assessed trends in glucose, lactate and ketones during anaerobic and aerobic exercise in people with T1D and compared incremental area under the curve (AUC) between both exercises.Methods: Twenty-one men with T1D (median [IQR]: age 29 years [28-38], BMI 24.4 kg/m2 [22.3-24.9], HbA1c 7.2% [6.7-7.8]), completed a cardiopulmonary exercise test (CPET) and a 60-minute aerobic exercise (AEX) at 60% VO2 peak on an ergometer bicycle within a 6-week period. Subjects consumed a standardised breakfast (6 kcal/kg, 20.2g CHO/100ml) before exercise without pre-meal insulin and basal insulin for pump users.Results: During CPET, glucose levels increased, peaking at 331mg/dL [257-392] 1-3h after exercise and reaching a nadir 6h after exercise at 176mg/dL [118-217]. Lactate levels peaked at 6.0mmol/L [5.0-6.6] (max 12.5mmol/L). During AEX, glucose levels also increased, peaking at 305mg/dL [245-336] 80 min after exercise and reaching a nadir 6h after exercise at 211mg/dL [116-222]. Lactate levels rose quickly to a median of 4.3mmol/L [2.7-6.7] after 10 min. Ketone levels were low during both tests (median ≤0.2mmol/L). Lactate, but not glucose or ketone AUC, was significantly higher in CPET compared to AEX (p=0.04).Conclusions: Omitting pre-meal insulin and also basal insulin in pump users, did prevent hypoglycaemia but induced hyperglycaemia due to a too high carbohydrate ingestion. No ketosis was recorded during or after the exercises.
Mots clés
Moderate Intensity Exercise
Multiple Daily Injections
PA
RE
RPE
Resistance Exercise
T1D
TAR
TBR
TIR
Time Above Range
Time Below Range
Time In Range
Type 1 Diabetes Mellitus
Type 1 diabetes mellitus
UZA
exercise
glucose
ketones
lactate
physical activity
rate of perceived exertion
real-time continuous glucose monitoring
(RT-)CGM
(Real-Time) Continuous Glucose Monitoring
(symptom limited maximal) CardioPulmonary Exercise Test
AEX
AUC
Aerobic Exercise Test
Area Under the Curve
CPET
CSII
Continuous Subcutaneous Insulin Infusion
HIE
Haemoglobin A1c
HbA1c
High Intensity Exercise
IPAQ-SF
IQR
InterQuartile Range
International Physical Activity Questionnaire Short Form
LT
Lactate Threshold
MDI
MIE