title: The effect of midday moderate-intensity exercise on postexercise hypoglycemia risk in individuals with type 1 diabetes.
abstract: BACKGROUND
  Exercise increases the risk of hypoglycemia in type 1 diabetes.
  
  
  OBJECTIVE
  Recently we reported a biphasic increase in glucose requirements to maintain euglycemia after late-afternoon exercise, suggesting a unique pattern of delayed risk for nocturnal hypoglycemia. This study examined whether this pattern of glucose requirements occurs if exercise is performed earlier in the day.
  
  
  METHODS
  Ten adolescents with type 1 diabetes underwent a hyperinsulinemic euglycemic glucose clamp on 2 different occasions during which they either rested or performed 45 minutes of moderate-intensity exercise at midday. Glucose was infused to maintain euglycemia for 17 hours after exercise.
  
  
  METHODS
  The glucose infusion rate (GIR) to maintain euglycemia, glucose rates of appearance and disappearance, and levels of counterregulatory hormones were compared between conditions.
  
  
  RESULTS
  GIRs to maintain euglycemia were not significantly different between groups at baseline (9.8 ± 1.4 and 9.5 ± 1.6 g/h before the exercise and rest conditions, respectively) and did not change in the rest condition throughout the study. In contrast, GIR increased more than 3-fold during exercise (from 9.8 ± 1.4 to 30.6 ± 4.7 g/h), fell within the first hour of recovery, but remained elevated until 11 hours after exercise before returning to baseline levels.
  
  
  CONCLUSIONS
  The pattern of glucose requirements to maintain euglycemia in response to moderate-intensity exercise performed at midday suggests that the risk of exercise-mediated hypoglycemia increases during and for several hours after moderate-intensity exercise, with no evidence of a biphasic pattern of postexercise risk of hypoglycemia.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, School of Sport Science, Exercise, and Health, The University of Western Australia, Crawley, Western Australia 6009, Australia. raymond.davey@health.wa.gov.au
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Davey
authors.forename: Warwick
authors.initials: W
authors.lastname: Howe
authors.forename: Nirubasini
authors.initials: N
authors.lastname: Paramalingam
authors.forename: Luis D
authors.initials: LD
authors.lastname: Ferreira
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fournier
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000378:metabolism* / Q000628:therapy; D005260:Female; D005947:Glucose / Q000378:metabolism* / Q000627:therapeutic use; D015309:Glucose Clamp Technique; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D009043:Motor Activity; D010101:Oxygen Consumption; D012306:Risk; D013997:Time Factors; D014904:Western Australia / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D005947:Glucose