Optimal Insulin Correction Factor (ICF) for Post-exercise Hyperglycemia following High-Intensity Training in Adults with Type 1 Diabetes (T1D)—The FIT Study

Objective: To compare glucose control with hybrid closed loop (HCL) when challenged by moderate-intensity exercise (MIE), high-intensity intermittent exercise (HIE) and resistance exercise (RE) while profiling counter-regulatory hormones, lactate, ketones, and kinetic data in adults with type 1 diabetes. Methods: <a>Open-label multisite randomized crossover trial. </a><a>Adults with type 1 diabetes undertook 40 min of HIE, MIE, and RE in random order while using HCL (Medtronic 670G) with a temporary target set 2 hours prior to and during exercise and 15g carbohydrates if pre-exercise glucose was <126mg/dL, to prevent hypoglycemia.</a> Primary outcome was median (IQR) continuous glucose monitoring (CGM) time-in-range (TIR, 70-180 mg/dL) for 14 hours post-exercise commencement. Accelerometer data and venous glucose, ketones, lactate, and counter-regulatory hormones were measured for 280 min post-exercise commencement. Results: Median TIR was 81% [67, 93]%, 91% [80, 94]%, and 80% [73, 89]% for 0-14 hours post-exercise commencement for HIE, MIE and RE, respectively (n=30), with no difference between exercise types (MIE v HIE; p=0.11, MIE v RE p=0.11, HIE v RE p=0.90). Time-below-range was 0% for all exercise bouts. For HIE and RE compared with MIE, there were greater increases respectively in noradrenaline (p=0.01, p=0.004), cortisol (p<0.001, p=0.001), lactate (p£0.001, p£0.001) and heart rate (p=0.007, p=0.015). During HIE compared with MIE, there were greater increases in growth hormone (p=0.024). Conclusions: Under controlled conditions, HCL provided satisfactory glucose control with no difference between exercise type. Lactate, counter-regulatory hormones, and kinetic data differentiate type and intensity of exercise, and their measurement may help inform insulin needs during exercise. However, their potential utility as modulators of insulin dosing will be limited by the pharmacokinetics of subcutaneous insulin delivery.

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OXYGEN UPTAKE AND RESISTANCE EXERCISE METHODS: THE USE OF BLOOD FLOW RESTRICTION

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220182405180336 ◽

2018 ◽

Vol 24 (5) ◽

pp. 343-346

Author(s):

Adenilson Targino de Araújo Júnior ◽

Maria do Socorro Cirilo-Sousa ◽

Gabriel Rodrigues Neto ◽

Rodrigo Poderoso ◽

Geraldo Veloso Neto ◽

...

Keyword(s):

Blood Flow ◽

Oxygen Consumption ◽

High Intensity ◽

Blood Flow Restriction ◽

Level Of Evidence ◽

Post Exercise ◽

High Intensity Training ◽

Flow Restriction ◽

Low Intensity ◽

Intensity Training

ABSTRACT Introduction: The literature has shown that a gap is identified regarding the acute effects of blood flow restriction training on aerobic variables. Objective: to analyze oxygen consumption (VO2) during and after two resistance training sessions: traditional high intensity and low intensity with blood flow restriction. Methods: After one-repetition maximum tests, eight male participants (25.7±3 years) completed the two experimental protocols, separated by 72 hours, in a randomized order: a) high intensity training at 80% of 1RM (HIRE) and b) low intensity training at 20% of 1RM combined with blood flow restriction (LIRE + BFR). Three sets of four exercises (bench press, squat, barbell bent-over row and deadlift) were performed. Oxygen consumption and excess post-exercise oxygen consumption were measured. Results: the data showed statistically significant differences between the traditional high intensity training and low intensity training with blood flow restriction, with higher values for traditional training sessions, except for the last five minutes of the excess post-exercise oxygen consumption. Oxygen consumption measured during training was higher (p = 0.001) for the HIRE (20.32 ± 1.46 mL·kg-1·min-1) compared to the LIRE + BFR (15.65 ± 1.14 mL·kg-1·min-1). Conclusion: Oxygen uptakes rates during and after the exercise sessions were higher for the high intensity training methodology. However, when taking into account the volume of training provided by both methods, these differences were attenuated. Level of Evidence III - Non-consecutive studies, or studies without consistently applied reference stand.

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A Randomized Crossover Trial Comparing Glucose Control During Moderate-Intensity, High-Intensity, and Resistance Exercise With Hybrid Closed-Loop Insulin Delivery While Profiling Potential Additional Signals in Adults With Type 1 Diabetes

10.2337/figshare.16892092 ◽

2021 ◽

Author(s):

Barbora Paldus ◽

Dale Morrison ◽

Dessi P. Zaharieva ◽

Melissa H. Lee ◽

Hannah Jones ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glucose Control ◽

High Intensity ◽

Kinetic Data ◽

Closed Loop ◽

Crossover Trial ◽

Moderate Intensity ◽

Post Exercise ◽

Randomized Crossover Trial

Objective: To compare glucose control with hybrid closed loop (HCL) when challenged by moderate-intensity exercise (MIE), high-intensity intermittent exercise (HIE) and resistance exercise (RE) while profiling counter-regulatory hormones, lactate, ketones, and kinetic data in adults with type 1 diabetes. Methods: <a>Open-label multisite randomized crossover trial. </a><a>Adults with type 1 diabetes undertook 40 min of HIE, MIE, and RE in random order while using HCL (Medtronic 670G) with a temporary target set 2 hours prior to and during exercise and 15g carbohydrates if pre-exercise glucose was <126mg/dL, to prevent hypoglycemia.</a> Primary outcome was median (IQR) continuous glucose monitoring (CGM) time-in-range (TIR, 70-180 mg/dL) for 14 hours post-exercise commencement. Accelerometer data and venous glucose, ketones, lactate, and counter-regulatory hormones were measured for 280 min post-exercise commencement. Results: Median TIR was 81% [67, 93]%, 91% [80, 94]%, and 80% [73, 89]% for 0-14 hours post-exercise commencement for HIE, MIE and RE, respectively (n=30), with no difference between exercise types (MIE v HIE; p=0.11, MIE v RE p=0.11, HIE v RE p=0.90). Time-below-range was 0% for all exercise bouts. For HIE and RE compared with MIE, there were greater increases respectively in noradrenaline (p=0.01, p=0.004), cortisol (p<0.001, p=0.001), lactate (p£0.001, p£0.001) and heart rate (p=0.007, p=0.015). During HIE compared with MIE, there were greater increases in growth hormone (p=0.024). Conclusions: Under controlled conditions, HCL provided satisfactory glucose control with no difference between exercise type. Lactate, counter-regulatory hormones, and kinetic data differentiate type and intensity of exercise, and their measurement may help inform insulin needs during exercise. However, their potential utility as modulators of insulin dosing will be limited by the pharmacokinetics of subcutaneous insulin delivery.

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Effects of Sport-Specific, Intermittent High-Intensity Exercise on Post-Exercise Heart Rate Variability and Glycemia in Young Athletes with Type 1 Diabetes

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2013.08.151 ◽

2013 ◽

Vol 37 ◽

pp. S51 ◽

Cited By ~ 1

Author(s):

Lisa A. Miadovnik ◽

Michael C. Riddell ◽

Robert J. Gumieniak ◽

Chip P. Rowen ◽

Dessi P. Zaharieva ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

High Intensity ◽

High Intensity Exercise ◽

Exercise Heart Rate ◽

Young Athletes ◽

Post Exercise

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High-intensity training improves airway responsiveness in inactive nonasthmatic children: evidence from a randomized controlled trial

Journal of Applied Physiology ◽

10.1152/japplphysiol.00663.2011 ◽

2012 ◽

Vol 112 (7) ◽

pp. 1174-1183 ◽

Cited By ~ 7

Author(s):

Sara K. Rosenkranz ◽

Richard R. Rosenkranz ◽

Tanis J. Hastmann ◽

Craig A. Harms

Keyword(s):

Total Cholesterol ◽

Body Fat ◽

High Intensity ◽

Vital Capacity ◽

Pulmonary Function Tests ◽

Airway Responsiveness ◽

Control Group ◽

Post Exercise ◽

High Intensity Training ◽

Intensity Training

Purpose: the relationship between physical activity and airway health in children is not well understood. The purpose of this study was to determine whether 8 wk of high-intensity exercise training would improve airway responsiveness in prepubescent, nonasthmatic, inactive children. Methods: 16 healthy, prepubescent children were randomized [training group (TrG) n = 8, control group (ConG) n = 8]. Prior to and following 8 wk of training (or no training), children completed pulmonary function tests (PFTs): forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow at 25–75% of vital capacity (FEF25–75), and exhaled nitric oxide (FENO). Children completed an incremental cycle V̇o2max test, eucapnic voluntary hyperventilation (EVH), anthropometric tests, and blood tests to determine fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Body fat percentage was determined using dual-energy X-ray absorptiometry pretraining and bioelectrical impedance pre- and posttraining. Results: there were no differences ( P > 0.05) in anthropometric measures or PFTs between TrG and ConG at baseline. In the TrG, there was a significant increase in V̇o2max (∼24%) and a decrease in total cholesterol (∼13%) and LDL cholesterol (∼35%) following training. There were improvements ( P < 0.05) in ΔFEV1 both postexercise (pre: −7.60 ± 2.10%, post: −1.10 ± 1.80%) and post-EVH (pre: −6.71 ± 2.21%, post: −1.41 ± 1.58%) with training. The ΔFEF25–75 pre-post exercise also improved with training (pre: −16.10 ± 2.10%, post: −6.80 ± 1.80%; P < 0.05). Lower baseline body fat percentages were associated with greater improvements in pre-post exercise ΔFEV1 following training ( r = −0.80, P < 0.05). Conclusion: these results suggest that in nonasthmatic prepubescent children, inactivity negatively impacts airway responsiveness, which can be improved with high-intensity training. Excess adiposity, however, may constrain these improvements.

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Restricted AccessA Randomized Crossover Trial Comparing Glucose Control During Moderate-Intensity, High-Intensity, and Resistance Exercise With Hybrid Closed-Loop Insulin Delivery While Profiling Potential Additional Signals in Adults With Type 1 Diabetes

10.2337/figshare.16892092.v1 ◽

2021 ◽

Author(s):

Barbora Paldus ◽

Dale Morrison ◽

Dessi P. Zaharieva ◽

Melissa H. Lee ◽

Hannah Jones ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glucose Control ◽

High Intensity ◽

Kinetic Data ◽

Closed Loop ◽

Crossover Trial ◽

Moderate Intensity ◽

Post Exercise ◽

Randomized Crossover Trial

Objective: To compare glucose control with hybrid closed loop (HCL) when challenged by moderate-intensity exercise (MIE), high-intensity intermittent exercise (HIE) and resistance exercise (RE) while profiling counter-regulatory hormones, lactate, ketones, and kinetic data in adults with type 1 diabetes. Methods: <a>Open-label multisite randomized crossover trial. </a><a>Adults with type 1 diabetes undertook 40 min of HIE, MIE, and RE in random order while using HCL (Medtronic 670G) with a temporary target set 2 hours prior to and during exercise and 15g carbohydrates if pre-exercise glucose was <126mg/dL, to prevent hypoglycemia.</a> Primary outcome was median (IQR) continuous glucose monitoring (CGM) time-in-range (TIR, 70-180 mg/dL) for 14 hours post-exercise commencement. Accelerometer data and venous glucose, ketones, lactate, and counter-regulatory hormones were measured for 280 min post-exercise commencement. Results: Median TIR was 81% [67, 93]%, 91% [80, 94]%, and 80% [73, 89]% for 0-14 hours post-exercise commencement for HIE, MIE and RE, respectively (n=30), with no difference between exercise types (MIE v HIE; p=0.11, MIE v RE p=0.11, HIE v RE p=0.90). Time-below-range was 0% for all exercise bouts. For HIE and RE compared with MIE, there were greater increases respectively in noradrenaline (p=0.01, p=0.004), cortisol (p<0.001, p=0.001), lactate (p£0.001, p£0.001) and heart rate (p=0.007, p=0.015). During HIE compared with MIE, there were greater increases in growth hormone (p=0.024). Conclusions: Under controlled conditions, HCL provided satisfactory glucose control with no difference between exercise type. Lactate, counter-regulatory hormones, and kinetic data differentiate type and intensity of exercise, and their measurement may help inform insulin needs during exercise. However, their potential utility as modulators of insulin dosing will be limited by the pharmacokinetics of subcutaneous insulin delivery.

Download Full-text