In:
American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 320, No. 3 ( 2021-03-01), p. E425-E437
Abstract:
Aerobic exercise in type 1 diabetes (T1D) causes rapid increase in glucose utilization due to muscle work during exercise, followed by increased insulin sensitivity after exercise. Better understanding of these changes is necessary for models of exercise in T1D. Twenty-six individuals with T1D underwent three sessions at three insulin rates (100%, 150%, 300% of basal). After 3-h run-in, participants performed 45 min aerobic exercise (moderate or intense). We determined area under the curve for endogenous glucose production (AUC EGP ) and rate of glucose disappearance (AUC Rd ) over 45 min from exercise start. A novel application of linear regression of R d across the three insulin sessions allowed separation of insulin-mediated from non-insulin-mediated glucose uptake before, during, and after exercise. AUC Rd increased 12.45 mmol/L (CI = 10.33–14.58, P 〈 0.001) and 13.13 mmol/L (CI = 11.01–15.26, P 〈 0.001) whereas AUC EGP increased 1.66 mmol/L (CI = 1.01–2.31, P 〈 0.001) and 3.46 mmol/L (CI = 2.81–4.11, P 〈 0.001) above baseline during moderate and intense exercise, respectively. AUC EGP increased during intense exercise by 2.14 mmol/L (CI = 0.91–3.37, P 〈 0.001) compared with moderate exercise. There was significant effect of insulin infusion rate on AUC Rd equal to 0.06 mmol/L per % above basal rate (CI = 0.05–0.07, P 〈 0.001). Insulin-mediated glucose uptake rose during exercise and persisted hours afterward, whereas non-insulin-mediated effect was limited to the exercise period. To our knowledge, this method of isolating dynamic insulin- and non-insulin-mediated uptake has not been previously employed during exercise. These results will be useful in informing glucoregulatory models of T1D. The study has been registered at www.clinicaltrials.gov as NCT03090451. NEW & NOTEWORTHY Separating insulin and non-insulin glucose uptake dynamically during exercise in type 1 diabetes has not been done before. We use a multistep process, including a previously described linear regression method, over three insulin infusion sessions, to perform this separation and can graph these components before, during, and after exercise for the first time.
Type of Medium:
Online Resource
ISSN:
0193-1849
,
1522-1555
DOI:
10.1152/ajpendo.00534.2020
Language:
English
Publisher:
American Physiological Society
Publication Date:
2021
detail.hit.zdb_id:
1477331-4
SSG:
12
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