Nathan D M, Madnek S F, Delahanty L
Ann Intern Med. 1985 Apr;102(4):483-6. doi: 10.7326/0003-4819-102-4-483.
Five intensively treated, insulin-dependent diabetics exercised for 45 minutes after fasting while receiving basal insulin injections. Plasma glucose concentrations remained stable during exercise but then declined, resulting in clinical hypoglycemia 1 to 2 hours later. Efficacies of three pre-exercise snacks in preventing the hypoglycemia were compared in a randomized crossover design. Orange juice, whole milk, and skim milk, each containing 13 g of carbohydrate, all prevented postexercise hypoglycemia. However, the more rapidly absorbed snacks, orange juice and skim milk, caused a greater increase in plasma glucose concentrations and the area under the glucose curve during exercise. From the recognized glucose profiles that occur after consumption of different carbohydrates, snacks as well as exercise and insulin can now be programmed for intensively treated, insulin-dependent diabetics. Because plasma glucose levels remain stable during exercise done after fasting and only fall late after exercise, a "lente" carbohydrate snack, such as whole milk, is an appropriate pre-exercise snack.
五名接受强化治疗的胰岛素依赖型糖尿病患者在禁食后接受基础胰岛素注射，然后进行45分钟的运动。运动期间血浆葡萄糖浓度保持稳定，但随后下降，导致1至2小时后出现临床低血糖。采用随机交叉设计比较了三种运动前小吃预防低血糖的效果。橙汁、全脂牛奶和脱脂牛奶，每种都含有13克碳水化合物，均能预防运动后低血糖。然而，吸收更快的小吃，橙汁和脱脂牛奶，在运动期间导致血浆葡萄糖浓度和葡萄糖曲线下面积有更大的增加。根据食用不同碳水化合物后公认的葡萄糖曲线，现在可以为接受强化治疗的胰岛素依赖型糖尿病患者安排小吃以及运动和胰岛素。由于禁食后进行的运动期间血浆葡萄糖水平保持稳定，且仅在运动后较晚时间下降，“中效”碳水化合物小吃，如全脂牛奶，是合适的运动前小吃。
