Acute changes in glucose induced by continuous or intermittent exercise in children and adolescents with type 1 diabetes.

Objective: To estimate the rate of change during exercise and during recovery in moderate-continuous exercise (MCE) and high-intensity intermittent exercise (HIIE) in children and adolescents with type 1 diabetes (T1D). Methods: Participants performed 2 sessions of exercise: thirty minutes of continuous activity on a cycle ergometer (60% of VO2max) and thirty minutes (60% VO2max) interspersed with five bouts of maximum intensity lasting ten seconds every five minutes. Capillary blood glucose was measured before and after each test. The glucose rate of change in exercise (RoCE) was calculated (final blood glucose - onset blood glucose/exercise time), and the glucose rate of change in recovery (RoCR) (blood glucose 30 minutes after exercise - end of exercise blood glucose/recovery time). Results: The study included thirty-one participants (aged 13 ± 1.88 years). A lower blood glucose reduction was observed in the HIIE group, as well as better recovery values before, after, and thirty minutes after the test, respectively (333.14 ± 69.53, 226.19 ± 68.05 and 201.77 ± 66.84 versus 211.36 ± 91.03, 155.98 ± 82,68 and 165.76 ± 72.94). Covariance analyses showed a significant difference in glycemic variation between continuous and intermittent protocols immediately after exercise (-2.90 versus -2.08) and during the recovery period (-0.677 versus -0.389). Conclusion: HIIE led to a lower glucose reduction rate per minute during exercise and better recovery in the first 30 minutes after exercise compared to MCE in children and adolescents with T1D.

Acute response of intermittent and continuous aerobic exercises on blood glucose of adolescents with type I diabetes / Resposta aguda do exercício aeróbio intermitente e contínuo na glicemia de adolescentes com diabetes tipo 1

The purpose of the study was to investigate the acute effect of continuous and intermittent aerobic exercise on blood glucose of adolescents with type 1 diabetes. A cross-sectional analysis of eight adolescents with type 1 diabetes mellitus between 10 to 15 years . Variables such as body mass, height, body mass index z score, glycated hemoglobin and cardiorespiratory fitness were assessed. There were two tests on a cycle ergometer: 30 minutes of continuous exercise and 30 minutes of intermittent exercise. Blood glucose was measured before and after the exercises and lactate concentration was measured at the end of the exercise. Student's t test and Pearson's correlation were used, considering p<0.05. In the continuous exercise protocol, there was a significant difference in pre and post-exercise blood glucose levels (p = 0.048), whereas the intermittent exercise protocol did not show statistically significant differences in blood glucose. Higher concentrations of lactate were found after the intermittent exercises (p = 0.036). There was a strong correlation between glycemic control and body mass index z score (r = 0.893 p = 0.041). Regarding the other variables, there were no significant correlations. The reduction in blood glucose was lower after intermittent aerobic exercises, compared with continuous exercises, which could be an interesting strategy to prevent acute exercise-induced hypoglycemia.

O objetivo desse estudo foi verificar a influência aguda do exercício aeróbio contínuo e intermitente na glicemia de adolescentes diabéticos tipo 1. Estudo transversal, que avaliou oito adolescentes com Diabetes Mellitus Tipo 1, entre 10 a 15 anos. Avaliaram-se a massa corporal, estatura, índice de massa corporal score z, hemoglobina glicada e capacidade cardiorrespiratória. Realizaram-se dois testes em cicloergômetro, 30 minutos de exercícios contínuos e 30 minutos intermitentes. A glicemia foi mensurada antes e após a realização dos exercícios e a concentração de lactato mensurado ao final do exercício. Utilizou-se o teste T de student, e correlação de Pearson, considerando-se p<0,05. Observou-se diferença significativa entre os valores de glicemia antes e após o exercício contínuo (p=0,048), no intermitente não houve diferença significativa na glicemia pré- e pós-exercício (p=0,160). Maiores concentrações de lactato foram encontradas após os exercícios intermitentes (p=0,036). Há forte correlação entre o controle glicêmico avaliado por meio do teste de hemoglobina glicada e o índice de massa corporal score z (r=0,893 p=0,041). Com relação às outras variáveis não houve correlações significativas. O declínio na glicemia é menor ao realizar exercícios aeróbios intermitentes comparados com exercícios contínuos, o que pode ser uma interessante estratégia para prevenção de hipoglicemia aguda induzida pelos exercícios.

Physical Activity Levels of Adolescents with Type 1 Diabetes Physical Activity in T1D.

The aim of this study was to evaluate the level of physical activity and cardiorespiratory fitness in teenagers with type 1 diabetes mellitus (T1D) in comparison with healthy scholar participants. Total of 154 teenagers (T1D = 45 and CON = 109). Height, weight, cardiorespiratory fitness (VO2max), and the level of physical activity by the Bouchard's Physical Activity Record were measured, and glycated hemoglobin (HbA1c) in T1D. The VO2max was lower in the T1D (38.38 ± 7.54) in comparison with the CON (42.44 ± 4.65; p < .05). The VO2max had correlation with the amount of time of moderate-to-vigorous physical activity (r = .63; p = .0001) and an inverse correlation with sedentary activities (r= -0.46; p = .006). In the T1D the levels of HbA1c had an inverse correlation with the amount of time of moderate-to-vigorous physical activity (r= -0.34; p = .041) and correlation with the BMI z-score (r = .43; p = .017). Only 37,8% of the participants in the T1D reached the adequate amount of daily moderate-to-vigorous intensity physical activity, in the CON 81,7% reached the WHO's recommendation. CONCLUSION: T1D had less cardiorespiratory capacity then healthy controls, the teenagers of T1D with lower BMI z-score and that dedicated a greater time in moderate-to-vigorous intensity physical activity demonstrated a better glycemic control.