Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.
University Hospital, Krakow, Poland.
J Diabetes Investig. 2021 Aug;12(8):1377-1385. doi: 10.1111/jdi.13490. Epub 2021 Feb 3.
AIMS/INTRODUCTION: Regular physical activity for adults with type 1 diabetes mellitus improves cardiorespiratory fitness (CF) and quality of life. The aim of our study was to evaluate clinical and biochemical features that might be associated with CF in a homogenous group of adults with type 1 diabetes mellitus who are all treated with a personal insulin pump (continuous subcutaneous insulin infusion).
We assessed CF in 62 patients (74.2% of whom were men) who fulfilled the eligibility criteria. To determine maximal oxygen consumption, the march-running test on the treadmill was carried out. Two hours before the test, the patients consumed a defined meal covered by a dose of rapid acting insulin analog that was reduced by 25% from their regular dose. Basal insulin infusion was reduced by 50% for an hour. Additionally, the Perceived Stress Scale-10 questionnaire was used to measure the perception of stress.
There was no episode of severe hypoglycemia during or after the test. In the final model, independent predictors of maximal oxygen consumption were sex, body fat percentage, lactate at 20 min after CF test and Perceived Stress Scale-10 score. Of interest, neither short-term (continuous glucose monitoring) nor long-term (glycosylated hemoglobin) metabolic control parameters were predictors of CF.
In our selected homogenous group of patients with type 1 diabetes mellitus treated with personal insulin pumps, higher CF was associated with a lower percentage of body fat, male sex, higher lactate level after the CF test and the Perceived Stress Scale-10 score. The proposed protocol in our cohort proved to be safe with regard to glycemic control.
目的/引言：对于 1 型糖尿病患者来说，定期进行身体活动可以改善心肺功能（CF）和生活质量。我们的研究目的是评估在一组同质的 1 型糖尿病患者中，与 CF 相关的临床和生化特征，这些患者都接受个人胰岛素泵（持续皮下胰岛素输注）治疗。
我们评估了 62 名符合条件的患者（其中 74.2%为男性）的 CF。为了确定最大耗氧量，我们在跑步机上进行了跑步测试。在测试前两小时，患者摄入了一顿规定的餐食，并使用快速作用胰岛素类似物覆盖，剂量比常规剂量减少 25%。基础胰岛素输注减少了 50%，持续一小时。此外，还使用了 10 项感知压力量表来测量压力感。
在测试过程中和测试后没有发生严重低血糖事件。在最终模型中，最大耗氧量的独立预测因子是性别、体脂百分比、CF 测试后 20 分钟的乳酸水平和 10 项感知压力量表得分。有趣的是，无论是短期（连续血糖监测）还是长期（糖化血红蛋白）代谢控制参数都不是 CF 的预测因子。
在我们选择的接受个人胰岛素泵治疗的 1 型糖尿病同质患者群体中，更高的 CF 与较低的体脂百分比、男性、CF 测试后更高的乳酸水平和 10 项感知压力量表得分相关。我们的研究队列中提出的方案在血糖控制方面被证明是安全的。
