Goulet-Gélinas Lucas, Saade Marie-Béatrice, Suppère Corinne, Fortin Andréanne, Messier Virginie, Taleb Nadine, Tagougui Sémah, Shohoudi Azadeh, Legault Laurent, Henderson Mélanie, Rabasa-Lhoret Rémi
Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, Quebec, Canada; Department of Nutrition, Faculty of Medicine, Université de Montréal, 2405 Chemin de La Côte-Sainte-Catherine, Montreal, Quebec, Canada.
Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, Quebec, Canada; Research Center of Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, Quebec, Canada.
Nutr Metab Cardiovasc Dis. 2021 Apr 9;31(4):1238-1246. doi: 10.1016/j.numecd.2020.12.011. Epub 2020 Dec 17.
During aerobic physical activity (PA), hypoglycemia is common in people with type 1 diabetes (T1D). Few studies have compared the effectiveness of different carbohydrate (CHO) intake strategies to prevent PA-induced hypoglycemia. Our objective was to compare the efficacy of two CHO intake strategies, same total amount but different CHO intake timing, to maintain glucose levels in the target range (4.0-10.0 mmol/L) during PA in people with T1D.
An open-label, randomized, crossover study in 33 participants (21 adults; 12 adolescents). Participants practiced 60 min PA sessions (ergocyle) at 60% VO 3.5 h after lunch comparing an intake of 0.5 g of CHO per kg of body weight applied in a pre-PA single CHO intake (SCI) or in a distributed CHO intake (DCI) before and during PA. The percentage of time spent in glucose level target range during PA was not different between the two strategies (SCI: 75 ± 35%; DCI: 87 ± 26%; P = 0.12). Hypoglycemia (<4.0 mmol/L) occurred in 4 participants (12%) with SCI compared to 6 participants (18%) with DCI (P = 0.42). The SCI strategy led to a higher increase (P = 0.01) and variability of glucose levels (P = 0.04) compared with DCI.
In people living with T1D, for a 60 min moderate aerobic PA in the post-absorptive condition, a 0.5 g/kg CHO intake helped most participants maintain acceptable glycemic control with both strategies. No clinically significant difference was observed between the SCI and DCI strategies. ClinicalTrials.gov Identifier: NCT03214107 (July 11, 2017).
在有氧体育活动（PA）期间，1型糖尿病（T1D）患者低血糖很常见。很少有研究比较不同碳水化合物（CHO）摄入策略预防PA诱发低血糖的效果。我们的目的是比较两种CHO摄入策略（总量相同但CHO摄入时间不同）在T1D患者PA期间将血糖水平维持在目标范围（4.0 - 10.0 mmol/L）的疗效。
对33名参与者（21名成年人；12名青少年）进行了一项开放标签、随机、交叉研究。参与者在午餐后3.5小时以60%的最大摄氧量进行60分钟的PA训练（功率自行车），比较在PA前单次CHO摄入（SCI）或在PA前及PA期间分次CHO摄入（DCI），每次摄入0.5克CHO/千克体重。两种策略在PA期间血糖水平处于目标范围的时间百分比无差异（SCI：75±35%；DCI：87±26%；P = 0.12）。SCI组有4名参与者（12%）发生低血糖（<4.0 mmol/L），DCI组有6名参与者（18%）发生低血糖（P = 0.42）。与DCI相比，SCI策略导致血糖水平升高幅度更大（P = 0.01）且血糖水平变异性更大（P = 0.04）。
对于T1D患者，在吸收后状态下进行60分钟中等强度有氧PA时，0.5克/千克CHO摄入通过两种策略帮助大多数参与者维持了可接受的血糖控制。SCI和DCI策略之间未观察到临床显著差异。ClinicalTrials.gov标识符：NCT03214107（2017年7月11日）。
