Monitoring exercise-induced changes in glycemic control in type 2 diabetes.

PURPOSE: The present study determined the efficacy of the Continuous Glucose Monitoring System (CGMS) during moderate exercise and monitored the changes in whole-day glucose profiles using the CGMS in individuals with and without type 2 diabetes. METHODS: Six, obese, diet-treated individuals with and four age-matched individuals without type 2 diabetes were monitored using the CGMS for 3 d. Subjects cycled at 90% of a predetermined lactate threshold for 1 h at approximately 09:00 h on day 2, during which venous blood was sampled at 10-min intervals and immediately analyzed for glucose concentrations. RESULTS: Venous blood glucose and CGMS values declined during exercise in the diabetes (P < 0.001) but not the control group (P = 0.085). The CGMS overestimated blood glucose in the control (P = 0.003) and the diabetes (P = 0.045) groups during exercise. The number of data points outside of the 95% confidence intervals was <5% in both groups, showing that there is a statistically acceptable level of agreement between venous blood glucose and CGMS values during exercise. Moderate exercise improved whole-day average glucose concentrations (P = 0.007) and whole-day area under the glucose curve (P = 0.016) values (AUCglu), and the time spent within +/-10% of fasting venous glucose (FVG) increased in the diabetes group (P = 0.021). No such effects were seen in the control group. CONCLUSION: Using continuous glucose monitoring we were able to demonstrate that a period of moderate exercise improved whole-day glycemic control in obese individuals with type 2 diabetes. The CGMS should only be used as an adjunct and not as an alternative to frequent blood glucose sampling when examining the changes in glucose values during exercise in individuals with and without type 2 diabetes.

Precooling leg muscle improves intermittent sprint exercise performance in hot, humid conditions.

We used three techniques of precooling to test the hypothesis that heat strain would be alleviated, muscle temperature (Tmu) would be reduced, and as a result there would be delayed decrements in peak power output (PPO) during exercise in hot, humid conditions. Twelve male team-sport players completed four cycling intermittent sprint protocols (CISP). Each CISP consisted of twenty 2-min periods, each including 10 s of passive rest, 5 s of maximal sprint against a resistance of 7.5% body mass, and 105 s of active recovery. The CISP, preceded by 20 min of no cooling (Control), precooling via an ice vest (Vest), cold water immersion (Water), and ice packs covering the upper legs (Packs), was performed in hot, humid conditions (mean +/- SE; 33.7 +/- 0.3 degrees C, 51.6 +/- 2.2% relative humidity) in a randomized order. The rate of heat strain increase during the CISP was faster in Control than Water and Packs (P < 0.01), but it was similar to Vest. Packs and Water blunted the rise of Tmu until minute 16 and for the duration of the CISP (40 min), respectively (P < 0.01). Reductions in PPO occurred from minute 32 onward in Control, and an increase in PPO by approximately 4% due to Packs was observed (main effect; P < 0.05). The method of precooling determined the extent to which heat strain was reduced during intermittent sprint cycling, with leg precooling offering the greater ergogenic effect on PPO than either upper body or whole body cooling.

Lactate--a signal coordinating cell and systemic function.

Since its first documented observation in exhausted animal muscle in the early 19th century, the role of lactate (lactic acid) has fascinated muscle physiologists and biochemists. Initial interpretation was that lactate appeared as a waste product and was responsible in some way for exhaustion during exercise. Recent evidence, and new lines of investigation, now place lactate as an active metabolite, capable of moving between cells, tissues and organs, where it may be oxidised as a fuel or reconverted to form pyruvate or glucose. The questions now to be asked concern the effects of lactate at the systemic and cellular level on metabolic processes. Does lactate act as a metabolic signal to specific tissues, becoming a metabolite pseudo-hormone? Does lactate have a role in whole-body coordination of sympathetic/parasympathetic nerve system control? And, finally, does lactate play a role in maintaining muscle excitability during intense muscle contraction? The concept of lactate acting as a signalling compound is a relatively new hypothesis stemming from a combination of comparative, cell and whole-organism investigations. It has been clearly demonstrated that lactate is capable of entering cells via the monocarboxylate transporter (MCT) protein shuttle system and that conversion of lactate to and from pyruvate is governed by specific lactate dehydrogenase isoforms, thereby forming a highly adaptable metabolic intermediate system. This review is structured in three sections, the first covering pertinent topics in lactate's history that led to the model of lactate as a waste product. The second section will discuss the potential of lactate as a signalling compound, and the third section will identify ways in which such a hypothesis might be investigated. In examining the history of lactate research, it appears that periods have occurred when advances in scientific techniques allowed investigation of this metabolite to expand. Similar to developments made first in the 1920s and then in the 1980s, contemporary advances in stable isotope, gene microarray and RNA interference technologies may allow the next stage of understanding of the role of this compound, so that, finally, the fundamental questions of lactate's role in whole-body and localised muscle function may be answered.