Dataset Information

Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes.

ABSTRACT:

Introduction

This study sought to compare the metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes (T1D).

Research design and methods

Thirteen individuals with T1D (hemoglobin; 7.0%±1.3% (52.6±13.9 mmol/mol), age; 36±15 years, duration diabetes; 15±12 years) performed a maximum of 45 min submaximal exercise (60%±6% V̇O_2max). Retrospectively identified exercise sessions that ended in hypoglycemia ((HypoEx) blood glucose (BG)≤3.9 mmol/L) were compared against a participant-matched euglycemic condition ((EuEx) BG≥4.0, BG≤10.0 mmol/L). Samples were compared for detailed physiological and hormonal parameters as well as metabolically profiled via large scale targeted ultra-high-performance liquid chromatography coupled to tandem mass spectrometry. Data were assessed using univariate and multivariate analysis techniques with false discovery rate adjustment. Significant results were considered at p≤0.05.

Results

Cardiorespiratory and counterregulatory hormone responses, whole-body fuel use and perception of fatigue during exercise were similar under conditions of hypoglycemia and euglycemia (BG 3.5±0.3 vs 5.8±1.1 mmol/L, respectively p<0.001). HypoEx was associated with greater adenosine salvage pathway activity (5'-methylthioadenosine, p=0.023 and higher cysteine and methionine metabolism), increased utilization of glucogenic amino acids (glutamine, p=0.021, alanine, aspartate and glutamate metabolism and homoserine/threonine, p=0.045) and evidence of enhanced β-oxidation (lower carnitine p<0.001, higher long-chain acylcarnitines).

Conclusions

Exposure to acute hypoglycemia during exercise potentiates alterations in subclinical indices of metabolic stress at the level of the metabolome. However, the physiological responses induced by dynamic physical exercise may mask the symptomatic recognition of mild hypoglycemia during exercise in people with T1D, a potential clinical safety concern that reinforces the need for diligent glucose management.

Trial registration number

DRKS00013509.

SUBMITTER: McCarthy O

PROVIDER: S-EPMC7536836 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes.

McCarthy Olivia O Pitt Jason J Churm Rachel R Dunseath Gareth J GJ Jones Charlotte C Bally Lia L Nakas Christos T CT Deere Rachel R Eckstein Max L ML Bain Stephen C SC Moser Othmar O Bracken Richard M RM

BMJ open diabetes research & care 20201001 1

<h4>Introduction</h4>This study sought to compare the metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes (T1D).<h4>Research design and methods</h4>Thirteen individuals with T1D (hemoglobin; 7.0%±1.3% (52.6±13.9 mmol/mol), age; 36±15 years, duration diabetes; 15±12 years) performed a maximum of 45 min submaximal exercise (60%±6% V̇O<sub>2max</sub>). Retrospectively identified exercise sessions that ended in hypoglycem ...[more]

PMID: 33020134

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Project description:Increases in power output and maximal oxygen consumption ( V˙O2 max) occur in response to sprint interval exercise (SIE), but common use of "all-out" intensities presents a barrier for many adults. Furthermore, lower-body SIE is not feasible for all adults. We compared physiological and perceptual responses to supramaximal, but "non-all-out" SIE between leg and arm cycling exercise. Twenty-four active adults (mean ± SD age: [25 ± 7] y; cycling V˙O2 max: [39 ± 7] mL·kg-1·min-1) performed incremental exercise using leg (LCE) and arm cycle ergometry (ACE) to determine V˙O2 max and maximal work capacity (Wmax). Subsequently, they performed four 20 s bouts of SIE at 130% Wmax on the LCE or ACE at cadence = 120-130 rev/min, with 2 min recovery between intervals. Gas exchange data, heart rate (HR), blood lactate concentration (BLa), rating of perceived exertion (RPE), and affective valence were acquired. Data showed significantly lower (p < 0.001) absolute mean ([1.24 ± 0.31] L·min-1 vs. [1.59 ± 0.34] L·min-1; d = 1.08) and peak V˙O2 ([1.79 ± 0.48] L·min-1 vs. [2.10 ± 0.44] L·min-1; d = 0.70) with ACE versus LCE. However, ACE elicited significantly higher (p < 0.001) relative mean ([62% ± 9%] V˙O2 max vs. [57% ± 7%] V˙O2 max, d = 0.63) and peak V˙O2 ([88% ± 10%] V˙O2 max vs. [75% ± 10%] V˙O2 max, d = 1.33). Post-exercise BLa was significantly higher ([7.0 ± 1.7] mM vs. [5.7 ± 1.5] mM, p = 0.024, d = 0.83) for LCE versus ACE. There was no significant effect of modality on RPE or affective valence (p > 0.42), and lowest affective valence recorded (2.0 ± 1.8) was considered "good to fairly good". Data show that non "all-out" ACE elicits lower absolute but higher relative HR and V˙O2 compared to LCE. Less aversive perceptual responses could make this non-all-out modality feasible for inactive adults.

Dataset Information

Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes.

Introduction

Research design and methods

Results

Conclusions

Trial registration number

Publications

Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes.

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