Division of Pediatric Endocrinology, Diabetes and Metabolism, Nemours Children's Health System, Jacksonville, Florida, USA.
Department of Clinical and Applied Movement Sciences, University of North Florida, Jacksonville, Florida, USA.
Horm Res Paediatr. 2019;92(4):245-253. doi: 10.1159/000505328. Epub 2020 Jan 31.
Puberty is associated with a deterioration of blood glucose control in children with type 1 diabetes (T1D). The literature suggests that exercise improves homeostasis in adults with diabetes, but lack of time often precludes the performance of exercise. Besides, in earlier work, supplementation with glutamine, a nonessential amino acid, when administered prior to exercise, decreased overnight post-exercise blood glucose in adolescents with long-standing T1D, suggesting that glutamine increased insulin sensitivity or enhanced tissue glucose uptake. The purpose of the current study therefore was to determine the feasibility of a novel form of exercise ("exercise snacks," that is, short bouts of exercise spread throughout the day) with or without a supplemental amino acid, glutamine, and its impact on blood glucose homeostasis and body composition in adolescents with T1D.
Twelve sedentary adolescents with T1D (HbA1c 8.1 ± 0.6%) performed exercise snacks (6 × 1 min of resistance-based activities) 3 times daily for 3 months; in addition, they were randomized to consume a drink containing either placebo or glutamine (0.5 g/kg/day). Continuous glucose monitoring, HbA1c, and dual X-ray absorptiometry were obtained before and after 3 months of each intervention.
Exercise snacks were easy to perform and well tolerated and were associated with a 2.2% loss of body fat mass when both groups were analyzed together (p = 0.015) after 3 months, whereas the change in lean body mass was not significant (p = 0.21). Metabolic control (HbA1c and glucose sensor data) was unchanged as result of the intervention regardless of group, and total daily insulin dose did not decrease.
Short bouts of exercise are sustainable over a 3-month period and can improve body composition in adolescents with poorly controlled T1D. Although metabolic control was unchanged as a result of the intervention regardless of group, this was a short-term intervention, hence assessment of metabolic impact will require long-term study.
青春期会导致 1 型糖尿病（T1D）患儿血糖控制恶化。文献表明，运动可改善糖尿病成人的内稳态，但由于时间限制，往往无法进行运动。此外，在早期研究中，在运动前给予非必需氨基酸谷氨酰胺补充剂可降低长期 T1D 青少年运动后夜间的血糖水平，这表明谷氨酰胺提高了胰岛素敏感性或增强了组织葡萄糖摄取。因此，本研究旨在确定一种新形式的运动（“运动零食”，即全天分散进行的短时间运动）的可行性，以及添加补充氨基酸谷氨酰胺及其对 T1D 青少年血糖稳态和身体成分的影响。
12 名久坐不动的 T1D 青少年（HbA1c 8.1±0.6%）每天进行 3 次运动零食（6×1 分钟的基于阻力的活动），持续 3 个月；此外，他们被随机分为两组，分别饮用含有安慰剂或谷氨酰胺（0.5 g/kg/天）的饮料。在每个干预措施前后 3 个月均进行连续血糖监测、HbA1c 和双能 X 线吸收法检测。
运动零食易于进行且耐受性良好，两组患者在 3 个月后，总体体脂量下降了 2.2%（p=0.015），而瘦体重的变化不显著（p=0.21）。无论干预组如何，代谢控制（HbA1c 和葡萄糖传感器数据）均未因干预而改变，总日胰岛素剂量也未减少。
短时间的运动可持续进行 3 个月，并可改善血糖控制不佳的 T1D 青少年的身体成分。尽管无论干预组如何，代谢控制均未因干预而改变，但这是一项短期干预，因此需要长期研究来评估代谢影响。
