scholarly journals Characterization of Individualized Glycemic Excursions during a Standardized Bout of Hypoglycemia-Inducing Exercise and Subsequent Hypoglycemia Treatment—A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4165
Author(s):  
Jan Brož ◽  
Matthew D. Campbell ◽  
Jana Urbanová ◽  
Marisa A. Nunes ◽  
Ludmila Brunerová ◽  
...  

The glycemic response to ingested glucose for the treatment of hypoglycemia following exercise in type 1 diabetes patients has never been studied. Therefore, we aimed to characterize glucose dynamics during a standardized bout of hypoglycemia-inducing exercise and the subsequent hypoglycemia treatment with the oral ingestion of glucose. Ten male patients with type 1 diabetes performed a standardized bout of cycling exercise using an electrically braked ergometer at a target heart rate (THR) of 50% of the individual heart rate reserve, determined using the Karvonen equation. Exercise was terminated when hypoglycemia was reached, followed by immediate hypoglycemia treatment with the oral ingestion of 20 g of glucose. Arterialized blood glucose (ABG) levels were monitored at 5 min intervals during exercise and for 60 min during recovery. During exercise, ABG decreased at a mean rate of 0.11 ± 0.03 mmol/L·min−1 (minimum: 0.07, maximum: 0.17 mmol/L·min−1). During recovery, ABG increased at a mean rate of 0.13 ± 0.05 mmol/L·min−1 (minimum: 0.06, maximum: 0.19 mmol/L·min−1). Moreover, 20 g of glucose maintained recovery from hypoglycemia throughout the 60 min postexercise observation window.

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 436-P
Author(s):  
KYOUNGMIN PARK ◽  
QIAN LI ◽  
HYUNSEOK PARK ◽  
RONALD ST-LOUIS ◽  
JIALIN FU ◽  
...  
Keyword(s):  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O.L.G.A Gumeniuk ◽  
N Bolotova ◽  
A Averianov ◽  
I.U Chernenkov

Abstract   Diabetic cardiovascular autonomic neuropathy (CAN) encompasses damage to the autonomic nerve fibers innervating the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. Clinical symptoms associated with CAN include resting tachycardia, postural hypotension, dizziness, syncope, exercise intolerance, silent myocardial infarction. The earliest finding of CAN, even at the subclinical stage, is a decrease in heart rate variability (HRV) Purpose To study CAN prevalence and understand the diagnostic capabilities of HRV - tests of diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes. Methods 100 children with type 1 diabetes were assessed for CAN (age 15.2 yrs [9.0–17.8], duration 6.5 yrs [4.0–10.6], HbA1c 8.1% 6.3–9.7]). The degree of compensation of diabetes was estimated according to criteria ISPAD Consensus Guidelines, 2018. Optimal level (HbA1c <7.0%) of compensation was revealed in 62% of children (group I) and nonoptimal in 38% of children (group II). For evaluation of the CAN we used HRV - tests: RR 30:15 ratio, ΔRR quiet breath, ΔRR deep breath, BP response to standing. Results Diabetic cardiovascular autonomic neuropathy was diagnosed in 41 children: in group I – in 6 (29%) and in group II – 35 (71%) children (p=0.00001). The prevalence of DCN correlated with HbA1c level in children and adolescents (groups I and II): ΔRR quiet breath r=−0.47 & r=−0.9; ΔRR deep breath r=−0.65 & r=−0.85; RR30:15 r=−0.77 & r=−0.88 respectively. Prevalence of CAN increased parallel to type 1 diabetes duration (p<0.01). Conclusions Diabetic cardiovascular autonomic neuropathy in children with type 1 diabetes was diagnosed in 41%. Prevalence of diabetic cardiovascular autonomic neuropathy increases parallel to type 1 diabetes duration (p<0.01). In this study we found an association between HRV indexes and HbA1c level. This provides support for HRV - testing to assess diabetic cardiovascular autonomic neuropathy in children. Funding Acknowledgement Type of funding source: None


2006 ◽  
Vol 7 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Firat Kardelen ◽  
Gayaz Akcurin ◽  
Halil Ertug ◽  
Sema Akcurin ◽  
Iffet Bircan

Diabetes ◽  
2018 ◽  
Vol 67 (5) ◽  
pp. 936-945 ◽  
Author(s):  
Debora Vignali ◽  
Elisa Cantarelli ◽  
Carlotta Bordignon ◽  
Adriana Canu ◽  
Antonio Citro ◽  
...  
Keyword(s):  
T Cells ◽  

2014 ◽  
Vol 8 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Matthew Stenerson ◽  
Fraser Cameron ◽  
Darrell M. Wilson ◽  
Breanne Harris ◽  
Shelby Payne ◽  
...  

Author(s):  
Max L. Eckstein ◽  
Othmar Moser ◽  
Norbert J. Tripolt ◽  
Peter N. Pferschy ◽  
Anna A. M. Obermayer ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Daizhi Yang ◽  
Jinhua Yan ◽  
Hongrong Deng ◽  
Xubin Yang ◽  
Sihui Luo ◽  
...  

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3   years , body mass index 18.17 ± 1.81   kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.


Author(s):  
Mika P. Tarvainen ◽  
Sami Nikkonen ◽  
Juha E. Peltonen ◽  
Jyrki M. Aho ◽  
Anne S. Koponen ◽  
...  

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