Similar magnitude of post-exercise hyperglycemia despite manipulating resistance exercise intensity in type 1 diabetes individuals

Individuals with type 1 diabetes suffer from impaired angiogenesis, decreased capillarization, and higher fatigability that influence their muscular system beyond the detriments caused by decreased glycemic control. In order to combat exacerbations of these effects, the American Diabetes Association recommends that individuals with type 1 diabetes participate in regular resistance exercise. However, traditional resistance exercise only induces hypertrophy when loads of ≥65% of an individual’s one repetition maximum are used. Combining blood flow restriction with resistance exercise may serve as a more efficient means for stimulating anabolic pathways that result in increased protein synthesis and angiogenesis at lower loads, while also promoting better glycemic control. The purpose of this paper is to provide a review on the literature surrounding the benefits of resistance exercise, specifically for individuals with type 1 diabetes, and postulate potential effects of combining resistance exercise with blood flow restriction in this clinical population.

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Ultrafast Ultrasound-Derived Muscle Strain Measure Correlates with Carotid Local Pulse Wave Velocity in Habitual Resistance-Trained Individuals

Applied Sciences ◽

10.3390/app11188783 ◽

2021 ◽

Vol 11 (18) ◽

pp. 8783

Author(s):

Hsin-Fu Lin ◽

Yi-Hung Liao ◽

Pai-Chi Li

Keyword(s):

Pulse Wave Velocity ◽

Resistance Exercise ◽

Strain Rate ◽

Wave Velocity ◽

Exercise Intensity ◽

Pulse Wave ◽

Muscle Stiffness ◽

Ultrasound Elastography ◽

Muscle Strain ◽

Post Exercise

Purpose: this study investigated the effects of the intensity of machine-based bicep curl resistance exercise on ultrafast ultrasound-derived muscle strain rate and carotid ultrafast pulse wave velocity (ufPWV), and examined the association between muscle strain rate, ufPWV, and established carotid function measures in habitual resistance-trained individuals. Methods: twenty-three young habitual resistance-trained males (age: 24 ± 1 year, body mass index = 24 ± 1 kg/m2) were recruited to participate in two bouts of acute bicep curl exercise. After one-repetition maximum determination (1RM), the participants were randomly assigned to engage in bicep curls at 40 or 80%1RM intensity (10 reps × five sets) by a crossover study design. The muscle strain rate of bicep muscle, carotid ufPWV during systole(ufPWV-sys), and diastole (ufPWV-dia) were obtained pre- and post-exercise. In addition, carotid function measures were calculated by obtained carotid diameter and central blood pressure changes. Results: compared with pre-exercise, the reduction in post-exercise muscle strain rate and its area under the curve of 80%1RM was greater than those of 40%1RM. Both ufPWV-sys and ufPWV-dia increased regardless of exercise intensity. Baseline bicep muscle strain rate correlated not only with ufPWV-sys (r = −0.71, p = 0.001), ufPWV-dia (r = −0.74, p = 0.001), but also carotid compliance (r = 0.49, p = 0.02), distensibility (r = 0.54, p = 0.01) and ß stiffness (r= −0.84, p < 0.0001). The ufPWVs also correlated with ß stiffness (r = 0.64–0.76, p = 0.01). Conclusion: muscle stiffness measured by ultrafast ultrasound elastography increases positively with resistance exercise intensity, and it appears to correlate with carotid ufPWV and established carotid function measures in habitual resistance-trained individuals.

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Alterations in Skeletal Muscle Repair in Young Adults with Type 1 Diabetes Mellitus

AJP Cell Physiology ◽

10.1152/ajpcell.00322.2021 ◽

2021 ◽

Author(s):

Athan G. Dial ◽

Grace K. Grafham ◽

Cynthia MF. Monaco ◽

Jennifer Voth ◽

Linda Brandt ◽

...

Keyword(s):

Electron Microscopy ◽

Skeletal Muscle ◽

Type 1 Diabetes ◽

Young Adults ◽

Gene Networks ◽

Vastus Lateralis ◽

Post Exercise ◽

Ultrastructural Damage ◽

The Impact

Though preclinical models of type 1 diabetes (T1D) exhibit impaired muscle regeneration, this has yet to be investigated in humans with T1D. Here we investigated the impact of damaging exercise (eccentric quadriceps contractions) in eighteen physically-active young adults with and without T1D. Pre- and post-exercise (48h and 96h), participants provided blood samples, vastus lateralis biopsies and performed maximal voluntary quadriceps contractions (MVC). Skeletal muscle sarcolemmal integrity, extracellular matrix content (ECM), and satellite cell (SC) content/proliferation were assessed by immunofluorescence. Transmission electron microscopy was used to quantify ultrastructural damage. MVC was comparable between T1D and controls before exercise. Post-exercise, MVC was decreased in both groups, but T1D subjects exhibited moderately lower strength recovery at both 48h and 96h. Serum creatine kinase, an indicator of muscle damage, was moderately higher in T1D participants at rest, and exhibited a small elevation 96h post-exercise. T1D participants showed lower SC content at all timepoints and demonstrated a moderate delay in SC proliferation after exercise. A greater number of myofibers exhibited sarcolemmal damage (disrupted dystrophin) and increased ECM (laminin) content in participants with T1D despite no differences between groups in ultrastructural damage as assessed by electron microscopy. Finally, transcriptomic analyses revealed dysregulated gene networks involving RNA translation and mitochondrial respiration, providing potential explanations for previous observations of mitochondrial dysfunction in similar T1D cohorts. Our findings indicate that skeletal muscle in young adults with moderately-controlled T1D is altered after damaging exercise; suggesting that longer recovery times following intense exercise may be necessary.

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Effect of Exercise Intensity on Glucose Requirements to Maintain Euglycemia During Exercise in Type 1 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-4026 ◽

2016 ◽

Vol 101 (3) ◽

pp. 972-980 ◽

Cited By ~ 24

Author(s):

Vinutha B. Shetty ◽

Paul A. Fournier ◽

Raymond J. Davey ◽

Adam J. Retterath ◽

Nirubasini Paramalingam ◽

...

Keyword(s):

Type 1 Diabetes ◽

Exercise Intensity

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Effect of Exercise Intensity on Exogenous Glucose Requirements to Maintain Stable Glycemia At High Insulin Levels in Type 1 Diabetes

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa768 ◽

2020 ◽

Vol 106 (1) ◽

pp. e83-e93

Author(s):

Vinutha B Shetty ◽

Paul A Fournier ◽

Nirubasini Paramalingam ◽

Wayne Soon ◽

Heather C Roby ◽

...

Keyword(s):

Type 1 Diabetes ◽

Exercise Intensity ◽

High Intensity ◽

High Intensity Exercise ◽

Moderate Intensity ◽

Insulin Levels ◽

Glucose Levels ◽

Exogenous Glucose ◽

High Insulin

Abstract Context Under basal insulin levels, there is an inverted U relationship between exercise intensity and exogenous glucose requirements to maintain stable blood glucose levels in type 1 diabetes (T1D), with no glucose required for intense exercise (80% V̇O2 peak), implying that high-intensity exercise is not conducive to hypoglycemia. Objective This work aimed to test the hypothesis that a similar inverted U relationship exists under hyperinsulinemic conditions, with high-intensity aerobic exercise not being conducive to hypoglycemia. Methods Nine young adults with T1D (mean ± SD age, 22.6 ± 4.7 years; glycated hemoglobin, 61 ± 14 mmol/mol; body mass index, 24.0 ± 3.3 kg/m2, V̇O2 peak, 36.6 ± 8.0 mL·kg–1 min–1) underwent a hyperinsulinemic-euglycemic clamp to maintain stable glycemia (5-6 mmol·L−1), and exercised for 40 minutes at 4 intensities (35%, 50%, 65%, and 80% V̇O2peak) on separate days following a randomized counterbalanced study design. Main Outcome Measures Glucose infusion rates (GIR) and glucoregulatory hormones levels were measured. Results The GIR (± SEM) to maintain euglycemia was 4.4 ± 0.4 mg·kg–1 min–1 prior to exercise, and increased significantly by 1.8 ± 0.4, 3.0 ± 0.4, 4.2 ± 0.7, and 3.5 ± 0.7 mg·kg–1 min–1 during exercise at 35%, 50%, 65%, and 80% V̇O2 peak, respectively, with no significant differences between the 2 highest exercise intensities (P > .05), despite differences in catecholamine levels (P < .05). During the 2-hour period after exercise at 65% and 80% V̇O2 peak, GIRs did not differ from those during exercise (P > .05). Conclusions Under hyperinsulinemic conditions, the exogenous glucose requirements to maintain stable glycemia during and after exercise increase with exercise intensity then plateau with exercise performed at above moderate intensity ( > 65% V̇O2 peak). High-intensity exercise confers no protection against hypoglycemia.

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Acute Effects of Morning versus Afternoon Resistance Exercise on Glycemia in Type 1 Diabetes

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2017.08.177 ◽

2017 ◽

Vol 41 (5) ◽

pp. S64 ◽

Cited By ~ 2

Author(s):

Saeed Reza Toghi Eshghi ◽

Jane E. Yardley

Keyword(s):

Type 1 Diabetes ◽

Resistance Exercise ◽

Acute Effects

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Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

Diabetes Mellitus ◽

10.14341/dm2015254-60 ◽

2015 ◽

Vol 18 (2) ◽

pp. 54-60

Author(s):

Dmitry Nikitich Laptev ◽

Tamara Leonidovna Kuraeva ◽

Galina Vladimirovna Ryabykina ◽

Sergey Dmitrievich Polyakov ◽

Irina Timofeevna Korneeva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Autonomic Function ◽

Cardiac Autonomic Function ◽

Post Exercise ◽

St Segment ◽

Cardiovascular Morbidity And Mortality

Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM). Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9?18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test. Results. The prevalence of cardiovascular autonomic neuropathy (CAN) was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5%) patients with CAN (CAN+) compared with 9 (18.4%) patients without CAN (CAN-; p=0.042). During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4%) CAN+ patients compared with 1 (2%) CAN- patient (p=0.0003) and in the second minute in 5 (22.7%) CAN+ patients compared with 1 (2%) CAN- patient (p=0.0095). Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

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