The Effect of Starting Blood Glucose Levels on Serum Electrolyte Concentrations during and after Exercise in Type 1 Diabetes.

Fear of hypoglycemia is a major exercise barrier for people with type 1 diabetes (PWT1D). Consequently, although guidelines recommend starting exercise with blood glucose (BG) concentration at 7-10 mmol/L, PWT1D often start higher, potentially affecting hydration and serum electrolyte concentrations. To test this, we examined serum and urine electrolyte concentrations during aerobic exercise (cycling 45 min at 60%VOpeak) in 12 PWT1D (10F/2M, mean ± SEM: age 29 ± 2.3 years, VOpeak 37.9 ± 2.2 mL·kg·min) with starting BG levels: 8-10 (MOD), and 12-14 (HI) mmol/L. Age, sex, and fitness-matched controls without diabetes (CON) completed one exercise session with BG in the normal physiological range. Serum glucose was significantly higher during exercise and recovery in HI versus MOD ( = 0.0002 and < 0.0001, respectively) and in MOD versus CON ( < 0.0001). During exercise and recovery, MOD and HI were not significantly different in serum insulin ( = 0.59 and = 0.63), sodium ( = 0.058 and = 0.08), potassium ( = 0.17 and = 0.16), calcium ( = 0.75 and 0.19), and magnesium = 0.24 and = 0.09). Our findings suggest that exercise of moderate intensity and duration with higher BG levels may not pose an immediate risk to hydration or serum electrolyte concentrations for PWT1D.