Substrate source utilization during moderate intensity exercise with glucose ingestion in Type 1 diabetic patients.
Substrate oxidation and the respective contributions of exogenous glucose, glucose released from the liver, and muscle glycogen oxidation were measured by indirect respiratory calorimetry combined with tracer technique in eight control subjects and eight diabetic patients (5 men and 3 women in both groups) of similar age, height, body mass, and maximal oxygen uptake, over a 60-min exercise period on cycle ergometer at 50.8% (SD 4.0) maximal oxygen uptake [131.0 W (SD 38.2)]. The subjects and patients ingested a breakfast (containing approximately 80 g of carbohydrates) 3 h before and 30 g of glucose (labeled with 13C) 15 min before the beginning of exercise. The diabetic patients also received their usual insulin dose [Humalog = 9.1 U (SD 0.9); Humulin N = 13.9 U (SD 4.4)] immediately before the breakfast. Over the last 30 min of exercise, the oxidation of carbohydrate [1.32 g/min (SD 0.48) and 1.42 g/min (SD 0.63)] and fat [0.33 g/min (SD 0.10) and 0.30 g/min (SD 0.10)] and their contribution to the energy yield were not significantly different in the control subjects and diabetic patients. Exogenous glucose oxidation was also not significantly different in the control subjects and diabetic patients [6.3 g/30 min (SD 1.3) and 5.2 g/30 min (SD 1.6), respectively]. In contrast, the oxidation of plasma glucose and oxidation of glucose released from the liver were significantly lower in the diabetic patients than in control subjects [14.5 g/30 min (SD 4.3) and 9.3 g/30 min (SD 2.8) vs. 27.9 g/30 min (SD 13.3) and 21.6 g/30 min (SD 12.8), respectively], whereas that of muscle glycogen was significantly higher [28.1 g/30 min (SD 15.5) vs. 11.6 g/30 min (SD 8.1)]. These data indicate that, compared with control subjects, in diabetic patients fed glucose before exercise, substrate oxidation and exogenous glucose oxidation overall are similar but plasma glucose oxidation is lower; this is associated with a compensatory higher utilization of muscle glycogen.
Robitaille
M
M
Département de chimie-biologie et des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada G9A 5H7.
Dubé
M-C
MC
Weisnagel
S J
SJ
Prud'homme
D
D
Massicotte
D
D
Péronnet
F
F
Lavoie
C
C
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001944:Breath Tests; D002153:Calorimetry, Indirect; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D006003:Glycogen / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D050356:Lipid Metabolism; D008099:Liver / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D018482:Muscle, Skeletal / Q000378:metabolism* / Q000503:physiopathology; D010084:Oxidation-Reduction; D010101:Oxygen Consumption; D013997:Time Factors
D001786:Blood Glucose; D002247:Carbon Isotopes; D007004:Hypoglycemic Agents; D007328:Insulin; D002245:Carbon Dioxide; D006003:Glycogen; D005947:Glucose