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Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

Lookup NU author(s): Dr Guy Taylor, Kieran Smith, Tess Capper, Jadine Scragg, Dr Ayat Bashir, Dr Anneliese Flatt, Professor Emma Stevenson, Professor James Shaw, Dr Daniel West

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by American Diabetes Association Inc., 2020.

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Abstract

© 2020 by the American Diabetes Association.To investigate the impact of residual b-cell function on continuous glucose monitoring (CGM) outcomes following acute exercise in people with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Thirty participants with T1D for ‡3 years were recruited. First, participants wore a blinded CGM unit for 7 days of free-living data capture. Second, a 3-h mixed-meal test assessed stimulated C-peptide and glucagon. Peak C-peptide was used to allocate participants into undetectable (Cpepund <3 pmol/L), low (Cpeplow 3–200 pmol/L), or high (Cpephigh >200 pmol/L) C-peptide groups. Finally, participants completed 45 min of incline treadmill walking at 60% VO2peak followed by a further 48-h CGM capture. RESULTS CGM parameters were comparable across groups during the free-living observation week.Inthe12-and24-hpostexerciseperiods(12hand24h),the Cpephigh grouphada significantly greater amount of time spent with glucose 3.9–10 mmol/L (12 h, 73.5 ± 27.6%; 24 h, 76.3 ± 19.2%) compared with Cpeplow (12 h, 43.6 ± 26.1%, P = 0.027; 24 h, 52.3 ± 25.0%, P = 0.067) or Cpepund (12 h, 40.6 ± 17.0%, P = 0.010; 24 h, 51.3 ± 22.3%, P = 0.041). Time spent in hyperglycemia (12 h and 24 h glucose >10 and >13.9 mmol/L, P < 0.05) and glycemic variability (12 h and 24 h SD, P < 0.01) were significantly lower in the Cpephigh group compared with Cpepund and Cpeplow.Change in CGM outcomes from pre-exercise to 24-h postexercise was divergent: Cpepund and Cpeplow experienced worsening (glucose 3.9–10 mmol/L:-9.1% and-16.2%, respectively), with Cpephigh experiencing improvement (+12.1%) (P = 0.017). CONCLUSIONS Residual b-cell function may partially explain the interindividual variation in the acute glycemic benefits of exercise in individuals with T1D. Quantifying C-peptide could aid in providing personalized and targeted support for exercising patients.


Publication metadata

Author(s): Taylor GS, Smith K, Capper TE, Scragg JH, Bashir A, Flatt A, Stevenson EJ, McDonald TJ, Oram RA, Shaw JA, West DJ

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2020

Volume: 43

Issue: 10

Pages: 2362-2370

Print publication date: 21/09/2020

Online publication date: 03/08/2020

Acceptance date: 28/06/2020

Date deposited: 30/06/2020

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association Inc.

URL: https://doi.org/10.2337/dc20-0300

DOI: 10.2337/dc20-0300

PubMed id: 32747405


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