scholarly journals In amateur athletes with type 1 diabetes, a 9-day period of cycling at moderate-to-vigorous intensity unexpectedly increased the time spent in hyperglycemia, which was associated with impairment in heart rate variability

2020 ◽  
Author(s):  
Elodie Lespagnol ◽  
Olivia Bocock ◽  
Joris Heyman ◽  
François-Xavier Gamelin ◽  
Serge Berthoin ◽  
...  

<b>Objective</b> <p>In type 1 diabetes, autonomic dysfunction may occur early as a decrease in heart rate variability (HRV). In nondiabetic populations, the positive effects of exercise training on HRV are well documented. However, exercise in individuals with type 1 diabetes, particularly if strenuous and prolonged, can lead to sharp glycemic variations, which can negatively impact HRV. This study explores the impact of a 9-day cycling tour on HRV in this population, with a focus on exercise-induced glycemic excursions<i>.</i></p> <p><b>Research Design and Methods</b></p> <p>Twenty amateur athletes with uncomplicated type 1 diabetes cycled 1500km. HRV and glycemic variability were measured by heart rate and continuous glucose monitoring. Linear mixed models were used to test the effects of exercise on HRV, considering concomitant glycemic excursions and subject characteristics as covariates.</p> <p><b>Results</b></p> <p>Nighttime HRV tended to decrease with the daily distance traveled. The more time the subjects spent in hyperglycemia, the lower the parasympathetic tone was. This result is striking given that hyperglycemic excursions progressively increased throughout the 9 days of the tour, and to a greater degree on the days a longer distance was traveled, while time spent in hypoglycemia surprisingly decreased. This phenomenon occurred despite no changes in insulin administration and a decrease in carbohydrate intake from snacks. </p> <p><b>Conclusions</b></p> <p><a>In sports enthusiasts with type 1 diabetes</a>, multiday prolonged exercise at moderate-to-vigorous intensity worsened hyperglycemia with the latter being negatively associated with parasympathetic cardiac tone. Considering the putative deleterious consequences on cardiac risks, future work should focus on understanding and managing exercise-induced hyperglycemia.</p>

2020 ◽  
Author(s):  
Elodie Lespagnol ◽  
Olivia Bocock ◽  
Joris Heyman ◽  
François-Xavier Gamelin ◽  
Serge Berthoin ◽  
...  

<b>Objective</b> <p>In type 1 diabetes, autonomic dysfunction may occur early as a decrease in heart rate variability (HRV). In nondiabetic populations, the positive effects of exercise training on HRV are well documented. However, exercise in individuals with type 1 diabetes, particularly if strenuous and prolonged, can lead to sharp glycemic variations, which can negatively impact HRV. This study explores the impact of a 9-day cycling tour on HRV in this population, with a focus on exercise-induced glycemic excursions<i>.</i></p> <p><b>Research Design and Methods</b></p> <p>Twenty amateur athletes with uncomplicated type 1 diabetes cycled 1500km. HRV and glycemic variability were measured by heart rate and continuous glucose monitoring. Linear mixed models were used to test the effects of exercise on HRV, considering concomitant glycemic excursions and subject characteristics as covariates.</p> <p><b>Results</b></p> <p>Nighttime HRV tended to decrease with the daily distance traveled. The more time the subjects spent in hyperglycemia, the lower the parasympathetic tone was. This result is striking given that hyperglycemic excursions progressively increased throughout the 9 days of the tour, and to a greater degree on the days a longer distance was traveled, while time spent in hypoglycemia surprisingly decreased. This phenomenon occurred despite no changes in insulin administration and a decrease in carbohydrate intake from snacks. </p> <p><b>Conclusions</b></p> <p><a>In sports enthusiasts with type 1 diabetes</a>, multiday prolonged exercise at moderate-to-vigorous intensity worsened hyperglycemia with the latter being negatively associated with parasympathetic cardiac tone. Considering the putative deleterious consequences on cardiac risks, future work should focus on understanding and managing exercise-induced hyperglycemia.</p>


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

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 ◽  
...  

Diabetes Care ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. 689-692 ◽  
Author(s):  
Marleen Olde Bekkink ◽  
Mats Koeneman ◽  
Bastiaan E. de Galan ◽  
Sebastian J. Bredie

2015 ◽  
Vol 7 (Suppl 1) ◽  
pp. A63 ◽  
Author(s):  
Ticiana da Silva ◽  
Luiz Rolim ◽  
Celso de Camargo Sallum Filho ◽  
Livia M Zimmermann ◽  
Fernando Malerbi ◽  
...  

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