A cornerstone in the management and treatment of people living with type 1 diabetes (T1D) is to engage in regular physical exercise for a variety of health and fitness reasons. Despite these well-established benefits, many people with T1D experience their challenging glycaemic condition as a high barrier to exercise. The challenge of managing glycaemia around exercise together with fear of hypoglycaemia (FOH) remain major barriers to exercise in T1D patients, meaning that many are discouraged from exercise. If people with T1D wish to engage in exercise in a safe manner, a certain level of pre-planning before exercise is required in terms of insulin dosing and target glucose concentration. Numerous research projects have been performed in the morning where participants exercise in the fasted state, for logistical reasons, because of easier insulin management in fasting conditions and a lower risk of hypoglycaemia during or after the exercise bout. However, in reality, advanced planning of exercise is not always possible, and many patients may also wish to exercise after their meal. Hence, it is important to take into account the impact of prandial state on blood glucose responses to exercise in patients with T1D. While evidence on the importance of timing of exercise and on the benefits of postprandial exercise for improving glucose control is available in patients with type 2 diabetes, less studies have been conducted in T1D despite this being of high clinical importance. Therefore, more insight is needed into the glycaemic and metabolic effects of different postprandial exercise modalities aiming to reduce the risk of hypoglycaemia and improve glucose control, both during and after exercise. Postprandial exercise can be a useful strategy to improve glycaemic control but research in T1DM is very scarce, with only few studies that have been conducted and optimal exercise regimens remaining unknown. Summarizing, prandial state is an important factor to take into account in exercise in people with T1D, with glycaemic responses that substantially vary between fasted or postprandial exercise. Performing exercise in the postprandial period is of high clinical relevance however there is a scarcity of research in this area. Therefore, more studies that examine the glycaemic and metabolic effects of different modalities of postprandial exercise in people with T1D are needed. All of this aiming to simplify exercise-associated countermeasures and improve (postprandial) glucose control, and thereby reduce barriers to PA in this population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Physical exercise performed 60 minutes after a standardized meal, of different modalities (4 different modalities will be examined, as described in the Arms)
Ghent University Hospital
Ghent, Belgium
Change in blood glucose during exercise
Change in BG during exercise, calculated based on the participants' BG at the start of exercise and the last value measured at the end of exercise. (If the exercise is stopped early because of hypoglycaemia, the last exercise glucose value will be used for analysis.)
Time frame: 30 minutes (i.e. during exercise)
Mean blood glucose during exercise and in the 30 min period after exercise.
Time frame: 180 minutes
Incremental area under the blood glucose curve (iAUC) during exercise and in the 30 min period after exercise.
Time frame: 180 minutes
Peak postprandial blood glucose (peak BG) concentration.
Time frame: 120 minutes
Mean interstitial glucose concentration during the overnight period (12:00 AM - 06:00 AM), and in the 24 hours following exercise.
Time frame: 24 hours
Incremental area under the interstitial glucose curve during the overnight period (12:00 AM - 06:00 AM), and in the 24 hours following exercise.
Time frame: 24 hours
Incidence of hypoglycaemia during exercise, in the 30 min period after exercise, up to the late postprandial period (240 minutes after the meal), in the overnight period (12:00 AM - 06:00 AM), and the 24 hours following exercise.
Time frame: 24 hours
Mean plasma lactate concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma free fatty acids concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma triglycerides concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma insulin concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma insulin area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma glucagon concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma glucagon area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma adrenaline concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma adrenaline area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma noradrenaline concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma noradrenaline area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma cortisol concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma cortisol area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Mean plasma growth hormone concentration during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
Plasma growth hormone area under the curve during exercise and in the recovery period after the exercise session.
Time frame: 180 minutes
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