Augustana Faculty, University of Alberta, 4901-46th Avenue, Camrose, AB T4V 2R3, Canada.
Physical Activity and Diabetes Laboratory, Alberta Diabetes Institute, 112 Street, Edmonton, AB T6G 2T9, Canada.
Int J Environ Res Public Health. 2023 Jan 24;20(3):2109. doi: 10.3390/ijerph20032109.
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.
低血糖恐惧是 1 型糖尿病患者（PWT1D）进行运动的主要障碍。因此，尽管指南建议在血糖（BG）浓度为 7-10mmol/L 时开始运动，但 PWT1D 通常会以更高的浓度开始运动，这可能会影响水合作用和血清电解质浓度。为了检验这一点，我们检测了 12 名 PWT1D（10 名女性/2 名男性，平均 ± SEM：年龄 29 ± 2.3 岁，峰值摄氧量 37.9 ± 2.2mL·kg·min）在开始 BG 水平为 8-10mmol/L（MOD）和 12-14mmol/L（HI）时进行有氧运动（以 60%峰值摄氧量骑行 45 分钟）期间的血清和尿液电解质浓度。与 MOD 相比，HI 组在运动和恢复期间的血清葡萄糖明显更高（=0.0002 和 <0.0001），MOD 组与 CON 组相比也明显更高（<0.0001）。在运动和恢复期间，MOD 和 HI 组的血清胰岛素（=0.59 和 =0.63）、钠（=0.058 和 =0.08）、钾（=0.17 和 =0.16）、钙（=0.75 和 0.19）和镁（=0.24 和 0.09）无显著差异。我们的研究结果表明，对于 PWT1D，中等强度和持续时间的运动，即使 BG 水平较高，也不会立即对水合作用或血清电解质浓度造成风险。
