Modeling the acute effects of exercise on insulin kinetics in type 1 diabetes

Frank, Spencer; Jbaily, Abdulrahman; Lb, Hinshaw; Basu, Rita; Basu, Ananda; Szeri, Andrew J.

doi:10.1007/s10928-018-9611-z

Cited by 9 publications

(8 citation statements)

References 47 publications

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“…Ample evidence suggests that physical activity can help prevent and treat insulin resistance and type 2 diabetes [6]. Physical activity lowers glucose levels in the blood by activating GLUT-4 vesicles, which transport glucose into the cells [7,8]. In a recent review of studies conducted using a variety of designs, Bird and Hawley summarize numerous investigations, based on different physical activity durations and intensity levels and their effects on insulin sensitivity and glycemic control.…”

Section: Introductionmentioning

confidence: 99%

Strength Training and Insulin Resistance: The Mediating Role of Body Composition

Niemann

Tucker

Bailey

et al. 2020

Journal of Diabetes Research

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The main objective of the present study was to assess the association between participation in strength training and insulin resistance. Another goal was to assess the influence of several potential confounding variables on the strength training and insulin resistance relationship. Lastly, the influence of waist circumference, fat-free mass (kg), body fat percentage, and the fat-free mass index on the association between strength training and insulin resistance was assessed. This cross-sectional study included 6,561 randomly selected men and women in the U.S. Data were collected using the precise protocol established by NHANES. HOMA-IR was used as the outcome variable to index insulin resistance. Both time spent strength training and frequency of strength training bouts were used as exposure variables. There was not a statistically significant relationship between strength training and insulin resistance in women. However, before and after controlling for 11 potential confounding variables, men who reported no strength training had significantly higher levels of HOMA-IR compared to men who reported moderate or high levels of strength training (F=9.87, P<0.0001). Odds ratios were also assessed. Men reporting no strength training had 2.42 times the odds of having insulin resistance compared to men reporting moderate levels of strength training (95% CI: 1.19-4.93). Similarly, men reporting no strength training had 2.50 times the odds of having insulin resistance compared to men reporting high levels of strength training (95% CI: 1.25-5.00). In conclusion, there was a strong relationship between strength training and insulin resistance in U.S. men, but not in U.S. women. Differences in waist circumference, fat-free mass (kg), body fat percentage, and the fat-free mass index, as well as demographic and lifestyle measures, do not appear to mediate the relationship. The present study was not a clinical trial.

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Section: Introductionmentioning

confidence: 99%

Strength Training and Insulin Resistance: The Mediating Role of Body Composition

Niemann

Tucker

Bailey

et al. 2020

Journal of Diabetes Research

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“…Our findings support the hypothesis of a true exercise-induced increase in systemic insulin levels. While results from previous studies were somewhat inconsistent, such heterogeneity may be related to differences in insulin regimens, exercise protocols, and in particular analytical approaches [6,[13][14][15]. In contrast, the current results can be deemed robust due to the highly specific mass-spectrometric approach used.…”

Section: Discussionmentioning

confidence: 58%

Effects of Aerobic Exercise on Systemic Insulin Degludec Concentrations in People with Type 1 Diabetes

Herzig

Groessl

Álvarez-Martínez

et al. 2021

J Diabetes Sci Technol

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Background: There is conflicting evidence on the effect of exercise on systemic insulin concentrations in adults with type 1 diabetes. Methods: This prospective single-arm study examined the effect of exercise on systemic insulin degludec (IDeg) concentrations. The study involved 15 male adults with type 1 diabetes (age 30.7 ± 8.0 years, HbA1c 6.9 ± 0.7%) on stable IDeg regimen. Blood samples were collected every 15 minutes at rest, during 60 minutes of cycling (66% VO2max) and until 90 minutes after exercise termination. IDeg concentrations were quantified using high-resolution mass-spectrometry and analyzed applying generalized estimation equations. Results: Compared to baseline, systemic IDeg increased during exercise over time ( P < .001), with the highest concentrations observed toward the end of the 60-minute exercise (17.9% and 17.6% above baseline after 45 minutes and 60 minutes, respectively). IDeg levels remained elevated until the end of the experiment (14% above baseline at 90 minutes after exercise termination, P < .001). Conclusions: A single bout of aerobic exercise increases systemic IDeg exposure in adults on a stable basal IDeg regimen. This finding may have important implications for future hypoglycemia mitigation strategies around physical exercise in IDeg-treated patients.

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“…High circulating insulin concentrations and skeletal muscle contraction exert additive effects on GLUT-4 translocation, resulting in heightened peripheral glucose uptake and decline in glycemia [26]. Exercise-induced increases in muscle perfusion [27] further increase insulin-mediated glucose disposal and, consequently, induce a drop in glycemia. Additional metabolic effects of higher insulin concentrations include the suppression of adipose tissue lipolysis and, therefore, fat oxidation in the skeletal muscle [28].…”

Section: Physiology Of Exercise In Type 1 Diabetesmentioning

confidence: 99%

Carbohydrate Intake in the Context of Exercise in People with Type 1 Diabetes

et al. 2019

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Although the benefits of regular exercise on cardiovascular risk factors are well established for people with type 1 diabetes (T1D), glycemic control remains a challenge during exercise. Carbohydrate consumption to fuel the exercise bout and/or for hypoglycemia prevention is an important cornerstone to maintain performance and avoid hypoglycemia. The main strategies pertinent to carbohydrate supplementation in the context of exercise cover three aspects: the amount of carbohydrates ingested (i.e., quantity in relation to demands to fuel exercise and avoid hypoglycemia), the timing of the intake (before, during and after the exercise, as well as circadian factors), and the quality of the carbohydrates (encompassing differing carbohydrate types, as well as the context within a meal and the associated macronutrients). The aim of this review is to comprehensively summarize the literature on carbohydrate intake in the context of exercise in people with T1D.

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Modeling the acute effects of exercise on insulin kinetics in type 1 diabetes

Cited by 9 publications

References 47 publications

Strength Training and Insulin Resistance: The Mediating Role of Body Composition

Strength Training and Insulin Resistance: The Mediating Role of Body Composition

Effects of Aerobic Exercise on Systemic Insulin Degludec Concentrations in People with Type 1 Diabetes

Carbohydrate Intake in the Context of Exercise in People with Type 1 Diabetes

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