title: Effects of High-Intensity Interval Exercise versus Moderate Continuous Exercise on Glucose Homeostasis and Hormone Response in Patients with Type 1 Diabetes Mellitus Using Novel Ultra-Long-Acting Insulin.
abstract: BACKGROUND
  We investigated blood glucose (BG) and hormone response to aerobic high-intensity interval exercise (HIIE) and moderate continuous exercise (CON) matched for mean load and duration in type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  Seven trained male subjects with T1DM performed a maximal incremental exercise test and HIIE and CON at 3 different mean intensities below (A) and above (B) the first lactate turn point and below the second lactate turn point (C) on a cycle ergometer. Subjects were adjusted to ultra-long-acting insulin Degludec (Tresiba/ Novo Nordisk, Denmark). Before exercise, standardized meals were administered, and short-acting insulin dose was reduced by 25% (A), 50% (B), and 75% (C) dependent on mean exercise intensity. During exercise, BG, adrenaline, noradrenaline, dopamine, cortisol, glucagon, and insulin-like growth factor-1, blood lactate, heart rate, and gas exchange variables were measured. For 24 h after exercise, interstitial glucose was measured by continuous glucose monitoring system.
  
  
  RESULTS
  BG decrease during HIIE was significantly smaller for B (p = 0.024) and tended to be smaller for A and C compared to CON. No differences were found for post-exercise interstitial glucose, acute hormone response, and carbohydrate utilization between HIIE and CON for A, B, and C. In HIIE, blood lactate for A (p = 0.006) and B (p = 0.004) and respiratory exchange ratio for A (p = 0.003) and B (p = 0.003) were significantly higher compared to CON but not for C.
  
  
  CONCLUSIONS
  Hypoglycemia did not occur during or after HIIE and CON when using ultra-long-acting insulin and applying our methodological approach for exercise prescription. HIIE led to a smaller BG decrease compared to CON, although both exercises modes were matched for mean load and duration, even despite markedly higher peak workloads applied in HIIE. Therefore, HIIE and CON could be safely performed in T1DM.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02075567 http://www.clinicaltrials.gov/ct2/show/NCT02075567.
authors: Department of Internal Medicine, Division of Endocrinology & Metabolism, Medical University of Graz, Graz, Austria; Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria; Center of Sports Medicine & Sports Orthopedics, University Outpatient Clinic, University of Potsdam, Potsdam, Germany.
authors: Othmar
authors: O
authors: Moser
authors: Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria.
authors: Gerhard
authors: G
authors: Tschakert
authors: Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria.
authors: Alexander
authors: A
authors: Mueller
authors: Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria.
authors: Werner
authors: W
authors: Groeschl
authors: Department of Internal Medicine, Division of Endocrinology & Metabolism, Medical University of Graz, Graz, Austria.
authors: Thomas R
authors: TR
authors: Pieber
authors: Department of Internal Medicine, Division of Endocrinology & Metabolism, Medical University of Graz, Graz, Austria.
authors: Barbara
authors: B
authors: Obermayer-Pietsch
authors: Department of Internal Medicine, Division of Endocrinology & Metabolism, Medical University of Graz, Graz, Austria.
authors: Gerd
authors: G
authors: Koehler
authors: Institute of Sports Sciences, Exercise Physiology & Training Research Group, University of Graz, Graz, Austria.
authors: Peter
authors: P
authors: Hofmann
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy; D015444:Exercise; D006706:Homeostasis / Q000187:drug effects*; D006728:Hormones / Q000097:blood*; D006801:Humans; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D019344:Lactic Acid / Q000097:blood; D008297:Male
chemical_list: D001786:Blood Glucose; D006728:Hormones; D049528:Insulin, Long-Acting; D019344:Lactic Acid