Metcalf Kristen M, Singhvi Ajay, Tsalikian Eva, Tansey Michael J, Zimmerman M Bridget, Esliger Dale W, Janz Kathleen F
Corresponding author: Kristen M. Metcalf,
Diabetes Care. 2014;37(5):1272-8. doi: 10.2337/dc13-1973. Epub 2014 Feb 26.
Physical activity (PA) provides many benefits to adolescents with type 1 diabetes; however, these individuals tend to have lower fitness and PA levels than their disease-free counterparts. The purpose of this study was to examine the acute temporal associations between moderate-to-vigorous intensity PA (MVPA) and hypoglycemia (continuous glucose monitor [CGM] reading ≤70 mg/dL).
Nineteen participants (53% females) 14-20 years old with type 1 diabetes were recruited. Participant fitness was evaluated via indirect calorimetry using a maximal exercise test; body composition was measured using air displacement plethysmography. An accelerometer was worn continuously (3-5 days) and acceleration data used to estimate MVPA (minutes per day). Blood glucose values were simultaneously tracked using CGM. Controlling for sex, percent body fat (%BF), fitness, and concurrent MVPA, the likelihood of nighttime and next-day hypoglycemia due to MVPA was examined using logistic regression.
Participants were of average fitness (females: 43.9 mL/kg/min; males: 49.8 mL/kg/min) and adiposity (females: 26.2%; males: 19.2%); 63.2% met the U.S. federal guideline of accumulating 60 min/day of MVPA. Hypoglycemia was 31% more likely in those who accumulated 30 min/day more MVPA in the previous afternoon than those with less (95% CI 1.05-1.63; P = 0.017).
The results suggest that participating in afternoon MVPA increases the risk of overnight and next-day hypoglycemia, independent of sex, %BF, fitness, and concurrent MVPA. While promoting PA as a healthy behavior, it is important to educate adolescents with type 1 diabetes on prevention of hypoglycemia following PA.
体育活动（PA）对1型糖尿病青少年有诸多益处；然而，这些个体的健康水平和PA水平往往低于未患该疾病的同龄人。本研究的目的是探讨中等至剧烈强度PA（MVPA）与低血糖（连续血糖监测[CGM]读数≤70mg/dL）之间的急性时间关联。
招募了19名14 - 20岁的1型糖尿病参与者（53%为女性）。通过使用最大运动测试的间接量热法评估参与者的健康水平；使用空气置换体积描记法测量身体成分。连续佩戴加速度计（3 - 5天），并使用加速度数据估算MVPA（每天分钟数）。同时使用CGM跟踪血糖值。在控制性别、体脂百分比（%BF）、健康水平和同时进行的MVPA的情况下，使用逻辑回归分析MVPA导致夜间和次日低血糖的可能性。
参与者的健康水平（女性：43.9mL/kg/min；男性：49.8mL/kg/min）和肥胖程度（女性：26.2%；男性：19.2%）处于平均水平；63.2%的人达到了美国联邦每天累积60分钟MVPA的指南标准。与前一下午MVPA累积量较少的人相比，前一下午MVPA累积量每天多30分钟的人发生低血糖的可能性高31%（95%CI 1.05 - 1.63；P = 0.017）。
结果表明，参与下午的MVPA会增加夜间和次日低血糖的风险，且独立于性别、%BF、健康水平和同时进行的MVPA。在将PA作为一种健康行为推广的同时，对1型糖尿病青少年进行PA后预防低血糖的教育很重要。
