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A Low–Glycemic Index Meal and Bedtime Snack Prevents Postprandial Hyperglycemia and Associated Rises in Inflammatory Markers, Providing Protection From Early but Not Late Nocturnal Hypoglycemia Following Evening Exercise in Type 1 Diabetes

Campbell, Matthew, Walker, Mark, Trenell, Michael I., Stevenson, Emma J., Turner, Daniel, Bracken, Richard M., Shaw, James A. and West, Daniel J. (2014) A Low–Glycemic Index Meal and Bedtime Snack Prevents Postprandial Hyperglycemia and Associated Rises in Inflammatory Markers, Providing Protection From Early but Not Late Nocturnal Hypoglycemia Following Evening Exercise in Type 1 Diabetes. Diabetes Care, 37 (7). pp. 1845-1853. ISSN 0149-5992

Item Type: Article

Abstract

OBJECTIVE To examine the influence of the glycemic index (GI) of foods consumed after evening exercise on postprandial glycemia, metabolic and inflammatory markers, and nocturnal glycemic control in type 1 diabetes.

RESEARCH DESIGN AND METHODS On two evenings (∼1700 h), 10 male patients (27 ± 5 years of age, HbA1c 6.7 ± 0.7% [49.9 ± 8.1 mmol/mol]) were administered a 25% rapid-acting insulin dose with a carbohydrate bolus 60 min before 45 min of treadmill running. At 60 min postexercise, patients were administered a 50% rapid-acting insulin dose with one of two isoenergetic meals (1.0 g carbohdyrate/kg body mass [BM]) matched for macronutrient content but of either low GI (LGI) or high GI (HGI). At 180 min postmeal, the LGI group ingested an LGI snack and the HGI group an HGI snack (0.4 g carbohdyrate/kg BM) before returning home (∼2300 h). Interval samples were analyzed for blood glucose and lactate; plasma glucagon, epinephrine, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α); and serum insulin, cortisol, nonesterified fatty acid, and β-hydroxybutyrate concentrations. Interstitial glucose was recorded for 20 h postlaboratory attendance through continuous glucose monitoring.
RESULTS Following the postexercise meal, an HGI snack induced hyperglycemia in all patients (mean ± SD glucose 13.5 ± 3.3 mmol/L) and marked increases in TNF-α and IL-6, whereas relative euglycemia was maintained with an LGI snack (7.7 ± 2.5 mmol/L, P < 0.001) without inflammatory cytokine elevation. Both meal types protected all patients from early hypoglycemia. Overnight glycemia was comparable, with a similar incidence of nocturnal hypoglycemia (n = 5 for both HGI and LGI).

CONCLUSIONS Consuming LGI food with a reduced rapid-acting insulin dose following evening exercise prevents postprandial hyperglycemia and inflammation and provides hypoglycemia protection for ∼8 h postexercise; however, the risk of late nocturnal hypoglycemia remains.

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More Information

Depositing User: Leah Maughan

Identifiers

Item ID: 13026
Identification Number: https://doi.org/10.2337/dc14-0186
ISSN: 0149-5992
URI: http://sure.sunderland.ac.uk/id/eprint/13026
Official URL: http://dx.doi.org/10.2337/dc14-0186

Users with ORCIDS

ORCID for Matthew Campbell: ORCID iD orcid.org/0000-0001-5883-5041

Catalogue record

Date Deposited: 28 Jan 2021 14:35
Last Modified: 28 Jan 2021 14:35

Contributors

Author: Matthew Campbell ORCID iD
Author: Mark Walker
Author: Michael I. Trenell
Author: Emma J. Stevenson
Author: Daniel Turner
Author: Richard M. Bracken
Author: James A. Shaw
Author: Daniel J. West

University Divisions

Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

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