Metabolic control level and glucose variability in adolescents with type 1 diabetes during low and high-intensity exercise.

OBJECTIVE: The main purpose of this study was to characterize the determinants of metabolic changes in young type 1 diabetes (T1DM) and to determine glycemic variability during low and high-intensity exercise. PATIENTS AND METHODS: 20 young male T1DM patients were divided into two subgroups characterized by levels of glycated hemoglobin (HbA1c): HbA1c<7.3% (better HbA1c subgroup, n=10) and with levels HbA1c>7.3% (worse HbA1c subgroup, n=10). All participants performed a maximal oxygen uptake test and two efforts of various intensities (45 minutes of aerobic exercise and 30 minutes of mixed aerobic-anaerobic intensity exercise). Continuous glucose monitors (CGM) were used to control the glucose concentration. RESULTS: Changes in biomarkers describing the metabolic response were similar in both groups. A comparison of applied efforts exhibited that maximal capacity effort resulted in the highest values of blood glucose (BG) at the end (150.9-160.6 mg/dl) and 1 hour after the exercise (140.2-161.3 mg/dl). BG concentration before, during, 1 hour, and 24 hours after each exercise was insignificantly higher in the worse Hb1Ac group. CONCLUSIONS: HbA1c levels are insufficient to confirm whether the applied effort is performed in acceptable glycemic values. The CGM monitors allow for precise control of BG variations and accurate planning of physical activity by adjusting the insulin and carbohydrate consumption dose.

Changes in the acid-base balance and lactate concentration in the blood in amateur ultramarathon runners during a 100-km run.

The aim of this study was to analyse the acid-base balance and partial pressure of blood gases of participants during a 100-km run. Fourteen experienced amateur ultramarathon runners (age: 43.36±11.83 years; height: 175.29±6.98 cm; weight: 72.12±7.36 kg) completed the 100-km run. Blood samples were taken before the run; after 25, 50, 75, and 100 km; and 12 and 24 hours after the run. There were significant differences (p<0.05) between the mean values registered for acid-alkaline balance, buffering alkalies, and current bicarbonate in each segment of the run, especially during the third, fourth, and fifth segments of the run (i.e., between 50 and 100 km), and there were only significant differences associated with buffering alkalies and current bicarbonate during the recovery. However, all the changes were within the physiological norm. A significant decrease in the compressibility of oxygen was observed after 100 km (from 92.80±15.67 to 88.36±13.71 mmHg) and continued during the recovery to 75.06±8.60 mmHg 12 h after the run. Also there was a decrease in saturation to a mean value of 93.78±3.10 at 12 h after the run. Generally the amateurs runners are able to adjust their running speed so as not to provoke a significant acid-base imbalance or lactate acid accumulation.