Bally Lia, Kempf Patrick, Zueger Thomas, Speck Christian, Pasi Nicola, Ciller Carlos, Feller Katrin, Loher Hannah, Rosset Robin, Wilhelm Matthias, Boesch Chris, Buehler Tania, Dokumaci Ayse S, Tappy Luc, Stettler Christoph
Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Department of Radiology, University Hospital Centre and University of Lausanne, 1011 Lausanne, Switzerland.
Nutrients. 2017 Feb 21;9(2):164. doi: 10.3390/nu9020164.
This paper aims to compare the metabolic effects of glucose-fructose co-ingestion (GLUFRU) with glucose alone (GLU) in exercising individuals with type 1 diabetes mellitus. Fifteen male individuals with type 1 diabetes (HbA1c 7.0% ± 0.6% (53 ± 7 mmol/mol)) underwent a 90 min iso-energetic continuous cycling session at 50% VO while ingesting combined glucose-fructose (GLUFRU) or glucose alone (GLU) to maintain stable glycaemia without insulin adjustment. GLUFRU and GLU were labelled with C-fructose and C-glucose, respectively. Metabolic assessments included measurements of hormones and metabolites, substrate oxidation, and stable isotopes. Exogenous carbohydrate requirements to maintain stable glycaemia were comparable between GLUFRU and GLU ( = 0.46). Fat oxidation was significantly higher (5.2 ± 0.2 vs. 2.6 ± 1.2 mg·kg·min, < 0.001) and carbohydrate oxidation lower (18.1 ± 0.8 vs. 24.5 ± 0.8 mg·kg·min < 0.001) in GLUFRU compared to GLU, with decreased muscle glycogen oxidation in GLUFRU (10.2 ± 0.9 vs. 17.5 ± 1.0 mg·kg·min, < 0.001). Lactate levels were higher (2.2 ± 0.2 vs. 1.8 ± 0.1 mmol/L, = 0.012) in GLUFRU, with comparable counter-regulatory hormones between GLUFRU and GLU ( > 0.05 for all). Glucose and insulin levels, and total glucose appearance and disappearance were comparable between interventions. Glucose-fructose co-ingestion may have a beneficial impact on fuel metabolism in exercising individuals with type 1 diabetes without insulin adjustment, by increasing fat oxidation whilst sparing glycogen.
本文旨在比较1型糖尿病运动个体同时摄入葡萄糖和果糖（GLUFRU）与单独摄入葡萄糖（GLU）的代谢效应。15名1型糖尿病男性个体（糖化血红蛋白A1c为7.0%±0.6%（53±7 mmol/mol））在以50%最大摄氧量进行90分钟等能量持续骑行期间，分别摄入葡萄糖 - 果糖混合物（GLUFRU）或单独的葡萄糖（GLU），以在不调整胰岛素的情况下维持稳定血糖。GLUFRU和GLU分别用¹³C - 果糖和¹³C - 葡萄糖标记。代谢评估包括激素和代谢物测量、底物氧化以及稳定同位素分析。维持稳定血糖所需的外源性碳水化合物量在GLUFRU和GLU之间相当（P = 0.46）。与GLU相比，GLUFRU中的脂肪氧化显著更高（5.2±0.2对2.6±1.2毫克·千克⁻¹·分钟⁻¹，P < 0.001），碳水化合物氧化更低（18.1±0.8对24.5±0.8毫克·千克⁻¹·分钟⁻¹，P < 0.001），且GLUFRU中的肌肉糖原氧化减少（10.2±0.9对17.5±1.0毫克·千克⁻¹·分钟⁻¹，P < 0.001）。GLUFRU中的乳酸水平更高（2.2±0.2对1.8±0.1毫摩尔/升，P = 0.012），GLUFRU和GLU之间的对抗调节激素相当（所有P > 0.05）。干预之间的葡萄糖和胰岛素水平以及总葡萄糖出现和消失情况相当。同时摄入葡萄糖和果糖可能通过增加脂肪氧化同时节省糖原，对1型糖尿病运动个体在不调整胰岛素的情况下的燃料代谢产生有益影响。
