Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Moser, O; Tschakert, G; Mueller, A; Groeschl, W; Pieber, TR; Koehler, G; Eckstein, ML; Bracken, RM; Hofmann, P.
Atypical blood glucose response to continuous and interval exercise in a person with type 1 diabetes: a case report.
J Med Case Rep. 2017; 11(1):176-176
Doi: 10.1186/s13256-017-1355-7
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- Führende Autor*innen der Med Uni Graz
- Moser Othmar
- Co-Autor*innen der Med Uni Graz
- Köhler Gerd
- Pieber Thomas
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- Abstract:
- Therapy must be adapted for people with type 1 diabetes to avoid exercise-induced hypoglycemia caused by increased exercise-related glucose uptake into muscles. Therefore, to avoid hypoglycemia, the preexercise short-acting insulin dose must be reduced for safety reasons. We report a case of a man with long-lasting type 1 diabetes in whom no blood glucose decrease during different types of exercise with varying exercise intensities and modes was found, despite physiological hormone responses. A Caucasian man diagnosed with type 1 diabetes for 24 years performed three different continuous high-intensity interval cycle ergometer exercises as part of a clinical trial (ClinicalTrials.gov identifier NCT02075567). Intensities for both modes of exercises were set at 5% below and 5% above the first lactate turn point and 5% below the second lactate turn point. Short-acting insulin doses were reduced by 25%, 50%, and 75%, respectively. Measurements taken included blood glucose, blood lactate, gas exchange, heart rate, adrenaline, noradrenaline, cortisol, glucagon, and insulin-like growth factor-1. Unexpectedly, no significant blood glucose decreases were observed during all exercise sessions (start versus end, 12.97 ± 2.12 versus 12.61 ± 2.66 mmol L-1, p = 0.259). All hormones showed the expected response, dependent on the different intensities and modes of exercises. People with type 1 diabetes typically experience a decrease in blood glucose levels, particularly during low- and moderate-intensity exercises. In our patient, we clearly found no decline in blood glucose, despite a normal hormone response and no history of any insulin insensitivity. This report indicates that there might be patients for whom the recommended preexercise therapy adaptation to avoid exercise-induced hypoglycemia needs to be questioned because this could increase the risk of severe hyperglycemia and ketosis.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Blood Glucose - drug effects
- Diabetes Mellitus, Type 1 - blood
- Diabetes Mellitus, Type 1 - drug therapy
- Diabetes Mellitus, Type 1 - physiopathology
- Dose-Response Relationship, Drug -
- Exercise Test -
- Glycated Hemoglobin A -
- High-Intensity Interval Training -
- Humans -
- Hypoglycemia - blood
- Hypoglycemia - drug therapy
- Hypoglycemic Agents - therapeutic use
- Insulin - therapeutic use
- Lactic Acid - blood
- Male -