title: Influence of physical activity on metabolic state within a 3-h interruption of continuous subcutaneous insulin infusion in patients with type 1 diabetes.
abstract: BACKGROUND
  The aim of this study was to evaluate the influence of physical activity on blood glucose, insulinemia, and ketone bodies level during interruption of insulin delivery.
  
  
  METHODS
  We enrolled 12 patients with type 1 diabetes (men with an average age of 33.4±8.66 years, body mass index of 25.7±3.75 mg/m(2), and glycated hemoglobin of 8.4±0.95%). The test was performed after overnight fasting at the usual insulin dosage. The delivery of insulin by the pump was stopped for 3 h, and blood samples were obtained in 30-min intervals for determination of blood glucose, insulinemia, β-hydroxybutyrate, non-esterified fatty acids, and acid-base balance parameters. A test with (EXE) or without (CON) physical exercise (moderate aerobic exercise) was performed in each patient at random in the course of 2 weeks. Results are presented as median (first quartile; third quartile).
  
  
  RESULTS
  Groups CON and EXE did not differ in blood levels of insulin during the test. Regarding time course of glycemia, we found differences only in min 270 for CON versus EXE of 15.2 (13.6; 16.7) and 13.9 (9.1;16.5) mmol/L, respectively (P=0.038). Concerning blood levels of β-hydroxybutyrate, we found significant differences in min 180-300 of the test: CON of 419 (354; 541), 485 (344; 580), and 107 (63; 156) μmol/L versus EXE of 690 (631; 723), 703 (562; 871), and 241 (113; 507) μmol/L (P<0.01). Comparable results were found in values of total ketone bodies and free fatty acids.
  
  
  CONCLUSIONS
  The influence of physical activity during a 3-h interruption of insulin pump treatment is evident, especially in the increase in plasma levels of non-esterified fatty acids and ketone bodies. Correction bolus leads to a rapid increase in insulinemia; however, normalization of blood glucose and ketone bodies is achieved within another 90 min.
authors: Department of Medicine I, Charles University Hospital, Alej svobody 80, Plzen, Czech Republic. jankovec@fnplzen.cz
authors: Zdenek
authors: Z
authors: Jankovec
authors: Michal
authors: M
authors: Krcma
authors: Jitka
authors: J
authors: Gruberova
authors: Jana
authors: J
authors: Komorousova
authors: Jitka
authors: J
authors: Tomesova
authors: Michal
authors: M
authors: Zourek
authors: Zdenek
authors: Z
authors: Rusavy
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood; D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000378:metabolism*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D006801:Humans; D015918:Infusion Pumps, Implantable; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D007657:Ketone Bodies / Q000097:blood; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007657:Ketone Bodies; D020155:3-Hydroxybutyric Acid