Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea, United Kingdom.
Diabetes Peptide and Protein Chemistry, Novo Nordisk A/S, Maaloev, Denmark.
Front Endocrinol (Lausanne). 2020 Oct 21;11:573275. doi: 10.3389/fendo.2020.573275. eCollection 2020.
International charities and health care organizations advocate regular physical activity for health benefit in people with type 1 diabetes. Clinical expert and international diabetes organizations' position statements support the management of good glycemia during acute physical exercise by adjusting exogenous insulin and/or carbohydrate intake. Yet research has detailed, and patients frequently report, variable blood glucose responses following both the same physical exercise session and insulin to carbohydrate alteration. One important source of this variability is insulin delivery to the circulation. With modern insulin analogs, it is important to understand how different insulins, their delivery methods, and inherent physiological factors, influence the reproducibility of insulin absorption from the injection site into circulation. Furthermore, contrary to the adaptive pancreatic response to exercise in the person without diabetes, the physiological and metabolic shifts with exercise may increase circulating insulin concentrations that may contribute to exercise-related hyperinsulinemia and consequent hypoglycemia. Thus, a furthered understanding of factors underpinning insulin delivery may offer more confidence for healthcare professionals and patients when looking to improve management of glycemia around exercise.
国际慈善机构和医疗保健组织倡导 1 型糖尿病患者定期进行身体活动以促进健康。临床专家和国际糖尿病组织的立场声明支持通过调整外源性胰岛素和/或碳水化合物摄入来管理急性体育锻炼期间的良好血糖水平。然而，研究已经详细描述了，并且患者经常报告，在进行相同的体育锻炼和胰岛素与碳水化合物改变后，血糖反应存在差异。这种可变性的一个重要来源是胰岛素输送到血液循环中。使用现代胰岛素类似物，了解不同的胰岛素、它们的输送方式以及内在的生理因素如何影响胰岛素从注射部位吸收到循环中的重现性非常重要。此外，与没有糖尿病的人运动时胰腺的适应性反应相反，运动时的生理和代谢变化可能会增加循环胰岛素浓度，这可能导致与运动相关的高胰岛素血症和随之而来的低血糖症。因此，当寻求改善运动相关的血糖管理时，更好地了解支持胰岛素输送的因素可以为医疗保健专业人员和患者提供更多信心。
