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Impact of pre-exercise rapid-acting insulin reductions on ketogenesis following running in Type 1 diabetes.
MedLine Citation:
PMID:  21219433     Owner:  NLM     Status:  In-Process    
AIM: This study examined the effects of reductions to pre-exercise rapid-acting insulin dose on changes in blood beta-hydroxybutyrate, glucose, acid-base balance and counter-regulatory hormone responses to prolonged running in individuals with Type 1 diabetes.
METHODS: Following ethical approval, seven participants with Type 1 diabetes (34±2 years, BMI 27±1 kg/m(2) ) completed this study. After preliminary testing, participants attended the laboratory four times, each time consuming a 1.12 MJ meal (60 g carbohydrate, 2 g fat, 2 g protein), with randomized amounts of their rapid-acting insulin: Full dose (mean 7.3±0.2 units), 75% dose (mean 5.4±0.1 units), 50% dose (mean 3.7±0.1 units) or 25% dose (mean 1.8±0.1 units). After 2-h rest, participants completed 45 min running at 70±1% peak rate of oxygen consumption (VO(2peak) ). Blood metabolites and hormones were recorded over the 2-h rest and 3-h recovery. Data were analysed using repeated-measures ANOVA.
RESULTS:   Serum insulin peaked at 60 min in all conditions and was lowest after 25% insulin dose compared with full dose (P=0.03). After the 25% insulin dose immediately pre-exercise glucose concentration was higher than after the full or 50% dose (P<0.05). Resting beta-hydroxybutyrate gradually decreased during 2-h rest (P<0.05) with a similar post-exercise peak of beta-hydroxybutyrate at 3 h (P>0.05). Post-exercise blood pH increased for 5 min to a similar extent with all insulin doses , but the rise with the 25% dose was less compared with the full dose (P=0.01). Blood lactate and plasma catecholamines increased after running similarly with all insulin reduction conditions (P<0.05). Blood glucose area under the curve (BG(auc) ) after the 25% insulin dose was greater than after the 75% dose (P=0.02).
CONCLUSION: Ketogenesis following running was not influenced by reductions in pre-exercise rapid-acting insulin dose. This important preparatory strategy aids preservation of blood glucose but poses no greater risk to exercise-induced ketone body formation.
R M Bracken; D J West; J W Stephens; L P Kilduff; S Luzio; S C Bain
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  28     ISSN:  1464-5491     ISO Abbreviation:  Diabet. Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  218-22     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Sports and Exercise Science Research Centre, School of Engineering, Swansea University, Singleton Park, Swansea, UK.
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