Nutritional Strategies to Prevent Hypoglycemia at Exercise in Diabetic Adolescents

DUBE, M.-C.,C. LAVOIE, I. GALIBOIS, and S. J. WEISNAGEL. Nutritional Strategies to Prevent Hypoglycemia at Exercise in Diabetic Adolescents. Med. Sci. Sports Exerc., Vol. 44, No. 8, pp. 1427-1432, 2012. Studies on nutritional strategies to prevent exercise-induced hypoglycemia in adolescents with type 1 diabetes are scarce. Objective: This study aimed to compare the effect of two food strategies on blood glucose (BG) during and after 60 min of moderate-intensity exercise. Methods: Subjects performed exercise 120 min after breakfast in three conditions: 1) standardized breakfast + preexercise placebo beverage (PL), 2) standardized breakfast + preexercise CHO beverage (8 mg of CHO center dot kg(-1) of body weight(.)min(-1) of exercise; CHO), or 3) protein-supplemented breakfast (8 mg of protein.kg(-1) of body weight(.)min(-1) of exercise added to the standardized breakfast) + preexercise placebo beverage (PROT). As soon as BG falls <4 mmol(.)L(-1) or symptomatic hypoglycemia occurred during exercise, the session was stopped and CHO tablets were provided to correct hypoglycemia. Results: Ten subjects (age - 14.0 +/- 1.5 yr) participated in all conditions. BG decreased by 6.0 +/- 1.9, 1.0 +/- 3.1, and 4.6 +/- 1.9 mmol(.)L(-1) in PL, CHO, and PROT conditions, respectively (P < 0.05). The proportion of subjects reaching hypoglycemic values or sensations of hypoglycemia was significantly different between conditions with 4/10, 1/10, and 0/10 in the PL, CHO, and PROT conditions (P < 0.05). Conclusions: The preexercise CHO beverage induced the least dramatic BG decrease during exercise. The PROT breakfast induced an overall similar BG drop compared to PL, a larger BG drop compared to CHO, but a similar rate of hypoglycemia compared to CHO. Our results suggest that taking CHO supplement before unplanned exercise is still the best strategy to prevent exercise-induced hypoglycemia in an adolescent population. However, a protein supplement strategy may also have some benefits in limiting the rate of hypoglycemia during and immediately after exercise.