高强度间歇运动与中等强度持续运动对使用新型超长效胰岛素的1型糖尿病患者血糖稳态和激素反应的影响
Effects of High-Intensity Interval Exercise versus Moderate Continuous Exercise on Glucose Homeostasis and Hormone Response in Patients with Type 1 Diabetes Mellitus Using Novel Ultra-Long-Acting Insulin.
作者信息
Moser Othmar, Tschakert Gerhard, Mueller Alexander, Groeschl Werner, Pieber Thomas R, Obermayer-Pietsch Barbara, Koehler Gerd, Hofmann Peter
机构信息
Department of Internal Medicine, Division of Endocrinology & Metabolism, Medical University of Graz, Graz, Austria; Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria; Center of Sports Medicine & Sports Orthopedics, University Outpatient Clinic, University of Potsdam, Potsdam, Germany.
Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria.
出版信息
PLoS One. 2015 Aug 28;10(8):e0136489. doi: 10.1371/journal.pone.0136489. eCollection 2015.
INTRODUCTION
We investigated blood glucose (BG) and hormone response to aerobic high-intensity interval exercise (HIIE) and moderate continuous exercise (CON) matched for mean load and duration in type 1 diabetes mellitus (T1DM).
MATERIAL AND METHODS
Seven trained male subjects with T1DM performed a maximal incremental exercise test and HIIE and CON at 3 different mean intensities below (A) and above (B) the first lactate turn point and below the second lactate turn point (C) on a cycle ergometer. Subjects were adjusted to ultra-long-acting insulin Degludec (Tresiba/ Novo Nordisk, Denmark). Before exercise, standardized meals were administered, and short-acting insulin dose was reduced by 25% (A), 50% (B), and 75% (C) dependent on mean exercise intensity. During exercise, BG, adrenaline, noradrenaline, dopamine, cortisol, glucagon, and insulin-like growth factor-1, blood lactate, heart rate, and gas exchange variables were measured. For 24 h after exercise, interstitial glucose was measured by continuous glucose monitoring system.
RESULTS
BG decrease during HIIE was significantly smaller for B (p = 0.024) and tended to be smaller for A and C compared to CON. No differences were found for post-exercise interstitial glucose, acute hormone response, and carbohydrate utilization between HIIE and CON for A, B, and C. In HIIE, blood lactate for A (p = 0.006) and B (p = 0.004) and respiratory exchange ratio for A (p = 0.003) and B (p = 0.003) were significantly higher compared to CON but not for C.
CONCLUSION
Hypoglycemia did not occur during or after HIIE and CON when using ultra-long-acting insulin and applying our methodological approach for exercise prescription. HIIE led to a smaller BG decrease compared to CON, although both exercises modes were matched for mean load and duration, even despite markedly higher peak workloads applied in HIIE. Therefore, HIIE and CON could be safely performed in T1DM.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02075567 http://www.clinicaltrials.gov/ct2/show/NCT02075567.
引言
我们研究了1型糖尿病（T1DM）患者对有氧高强度间歇运动（HIIE）和中等强度持续运动（CON）的血糖（BG）及激素反应，这两种运动的平均负荷和持续时间相匹配。
材料与方法
7名受过训练的T1DM男性受试者在自行车测力计上进行了最大递增运动试验，以及在低于（A）和高于（B）第一个乳酸拐点以及低于第二个乳酸拐点（C）的3种不同平均强度下进行HIIE和CON运动。受试者使用超长效胰岛素德谷胰岛素（Tresiba/丹麦诺和诺德公司）进行调整。运动前给予标准化餐食，并根据平均运动强度将短效胰岛素剂量分别减少25%（A）、50%（B）和75%（C）。运动期间，测量BG、肾上腺素、去甲肾上腺素、多巴胺、皮质醇、胰高血糖素、胰岛素样生长因子-1、血乳酸、心率和气体交换变量。运动后24小时内，通过连续血糖监测系统测量组织间液葡萄糖。
结果
与CON相比，HIIE期间B组的BG下降明显更小（p = 0.024），A组和C组的BG下降也有变小的趋势。对于A、B和C组，HIIE和CON在运动后组织间液葡萄糖、急性激素反应和碳水化合物利用方面未发现差异。在HIIE中，A组（p = 0.006）和B组（p = 0.004）的血乳酸以及A组（p = 0.003）和B组（p = 0.003）的呼吸交换率均显著高于CON组，但C组无此差异。
结论
使用超长效胰岛素并采用我们的运动处方方法时，HIIE和CON期间及之后均未发生低血糖。与CON相比，HIIE导致的BG下降更小，尽管两种运动模式的平均负荷和持续时间相匹配，即便HIIE中应用的峰值工作量明显更高。因此，T1DM患者可以安全地进行HIIE和CON运动。
试验注册
ClinicalTrials.gov NCT02075567 http://www.clinicaltrials.gov/ct2/show/NCT02075567
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