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

DUBE, M.-C., C. LAVOIE, and S. J. WEISNAGEL. Glucose or Intermittent High-Intensity Exercise in Glargine/Glulisine Users with T1DM. Med. Sci. Sports Exerc., Vol. 45, No. 1, pp. 3-7, 2013. 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) over dotO(2peak) 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.