Kapitza Christoph, Hövelmann Ulrike, Nosek Leszek, Kurth Heinz-Joerg, Essenpreis Matthias, Heinemann Lutz
Profil Institut für Stoffwechselforschung GmbH, Neuss, Germany.
J Diabetes Sci Technol. 2010 Jan 1;4(1):123-31. doi: 10.1177/193229681000400116.
Exercise is associated with an increased risk of hypoglycemic or hyperglycemic events. The aim of this study was to assess glucose changes during and after physical exercise in patients with type 1 diabetes managed by continuous subcutaneous insulin infusion before and after a 14-day moderate or intense exercise program.
Sixteen male patients [hemoglobin A1c 7.3 +/- 0.8% (mean +/- standard deviation), age 39 +/- 11 years, body mass index 26.0 +/- 2.7 kg/m(2)] were enrolled in this single-center, randomized, open-label study. They underwent exercise challenges before and after a 14-day moderate (group A, n = 8) and intense (group B) exercise program. Changes in glucose levels were monitored continuously by means of a microdialysis technique.
Patients in group A trained less intensively than the patients in group B. The treadmill exercise led to a comparable level of challenge in both patient groups. Neither heart rate nor energy consumption differed within the groups or between the groups. Patients in both groups had a comparable basal insulin infusion rate. Prandial insulin doses were higher pretraining than posttraining in both groups. Identical amounts of additional carbohydrates were consumed by the patients in both groups during the 21 h after the exercise challenge. Glucose profiles recorded showed a wide variability. No differences in the glucose profiles with respect to the training intensity could be observed within and between the groups. Patients in group A tended to spend a shorter period of time in hypoglycemia after the exercise challenge posttraining compared to pretraining, but not the patients in group B. The number of hypoglycemic episodes was not different between the groups.
The patients with type 1 diabetes exhibit the expected wide variability in glucose profiles before, during, and after physical exercise. Use of continuous glucose monitoring allows handling of this situation without running into the risk of acute metabolic deteriorations.
运动与低血糖或高血糖事件风险增加相关。本研究的目的是评估在14天的中度或剧烈运动计划前后，采用持续皮下胰岛素输注治疗的1型糖尿病患者在运动期间及运动后的血糖变化。
16名男性患者[糖化血红蛋白7.3±0.8%（均值±标准差），年龄39±11岁，体重指数26.0±2.7kg/m²]参与了这项单中心、随机、开放标签研究。他们在14天的中度（A组，n = 8）和剧烈（B组）运动计划前后接受运动挑战。通过微透析技术持续监测血糖水平变化。
A组患者的训练强度低于B组患者。跑步机运动在两组患者中带来了相当程度的挑战。组内及组间的心率和能量消耗均无差异。两组患者的基础胰岛素输注率相当。两组患者餐前胰岛素剂量训练前均高于训练后。运动挑战后的21小时内，两组患者摄入的额外碳水化合物量相同。记录的血糖曲线显示出很大的变异性。组内及组间均未观察到训练强度对血糖曲线有差异。与训练前相比，A组患者训练后运动挑战后处于低血糖状态的时间倾向于缩短，但B组患者并非如此。两组间低血糖发作次数无差异。
1型糖尿病患者在运动前、运动期间和运动后的血糖曲线呈现出预期的广泛变异性。使用持续血糖监测能够应对这种情况，而不会面临急性代谢恶化的风险。
