Glucose or Intermittent High-Intensity Exercise in Glargine/Glulisine Users with T1DM

DUBÉ, MARIE-CHRISTINE1,2; LAVOIE, CAROLE3; WEISNAGEL, S. JOHN1,2

Medicine & Science in Sports & Exercise: January 2013 - Volume 45 - Issue 1 - p 3–7
doi: 10.1249/MSS.0b013e31826c6ad3
Clinical Sciences

Introduction: The effects of glargine/glulisine insulin regimen on exercise blood glucose (BG) and strategies to limit exercise-induced hypoglycemia are not well documented. Intermittent high-intensity exercise has been proposed to prevent hypoglycemia, but its effect in participants with type 1 diabetes using glargine/glulisine is unknown.

Methods: The study used a repeated-measures design with three randomly ordered exercise conditions. Eleven participants completed 60 min of moderate-intensity exercise at 50% V˙O2peak for all conditions. These conditions varied as follows: participants ingested 0 g of glucose preexercise (0G + MOD), 30 g of glucose preexercise (30G + MOD), or 0 g of glucose preexercise but performed brief high-intensity intervals interspersed every 2 min (0G + MOD/INT) during exercise. If BG fell <4 mmol·L−1, a 20% dextrose solution was started to maintain BG between 4 and 5 mmol·L−1.

Results: Consuming 30 g of glucose before exercise (30G + MOD) resulted in a higher preexercise BG (11.7 ± 2.7 mmol·L−1) compared with 0 g of glucose before exercise (0G + MOD, 7.8 ± 4.0, and 0G + MOD/INT, 9.2 ± 3.5mmol·L−1), P < 0.05. A dextrose infusion was required in 7/11, 4/11, and 1/11 participants for 0G + MOD, 0G + MOD/INT, 30G + MOD conditions, respectively, P < 0.02. The duration and the quantity of dextrose infused were greatest in the 0G + MOD condition, moderate in the to 0G + MOD/INT condition, and minimal in the 30G + MOD condition, P < 0.01.

Conclusion: Our results suggest that both moderate-intensity exercise with a 30-g preexercise glucose beverage or interspersed with intermittent high-intensity sprints may be safe strategies to prevent hypoglycemia in glargine/glulisine users.

1Diabetes Research Unit, Université Laval Medical Center, Quebec City, QC, CANADA; 2Molecular Endocrinology and Genomics, Université Laval Medical Center, Quebec City, QC, CANADA; and 3Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, QC, CANADA

Address for correspondence: S. J. Weisnagel, M.D., Diabetes Research Unit, CRCHUL, room TR-27, 2705 boul. Laurier, Quebec, QC G1V 4G2, Canada; E-mail: john.weisnagel@crchul.ulaval.ca.

Submitted for publication March 2012.

Accepted for publication July 2012.

©2013The American College of Sports Medicine