Nutritional strategies to prevent hypoglycemia at exercise in diabetic adolescents

• Published in: Medicine and science in sports and exercise Vol. 44; no. 8; p. 1427
• Main Authors: Dubé, Marie-Christine, Lavoie, Carole, Galibois, Isabelle, Weisnagel, S John
• Format: Journal Article
• Language: English
• Published: United States 01.08.2012
• Subjects: Adolescent; Blood Glucose - metabolism; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - diet therapy; Diabetes Mellitus, Type 1 - physiopathology; Diet Therapy - methods; Exercise - physiology; Female; Humans; Hypoglycemia - physiopathology; Hypoglycemia - prevention & control; Male
• ISSN: 1530-0315
• DOI: 10.1249/MSS.0b013e3182500a35

Studies on nutritional strategies to prevent exercise-induced hypoglycemia in adolescents with type 1 diabetes are scarce. This study aimed to compare the effect of two food strategies on blood glucose (BG) during and after 60 min of moderate-intensity exercise. Subjects performed exercise 120 min after breakfast in three conditions: 1) standardized breakfast + preexercise placebo beverage (PL), 2) standardized breakfast + preexercise CHO beverage (8 mg of CHO·kg of body weight·min of exercise; CHO), or 3) protein-supplemented breakfast (8 mg of protein·kg of body weight·min of exercise added to the standardized breakfast) + preexercise placebo beverage (PROT). As soon as BG falls <4 mmol·L or symptomatic hypoglycemia occurred during exercise, the session was stopped and CHO tablets were provided to correct hypoglycemia. Ten subjects (age = 14.0 ± 1.5 yr) participated in all conditions. BG decreased by 6.0 ± 1.9, 1.0 ± 3.1, and 4.6 ± 1.9 mmol·L in PL, CHO, and PROT conditions, respectively (P < 0.05). The proportion of subjects reaching hypoglycemic values or sensations of hypoglycemia was significantly different between conditions with 4/10, 1/10, and 0/10 in the PL, CHO, and PROT conditions (P < 0.05). The preexercise CHO beverage induced the least dramatic BG decrease during exercise. The PROT breakfast induced an overall similar BG drop compared to PL, a larger BG drop compared to CHO, but a similar rate of hypoglycemia compared to CHO. Our results suggest that taking CHO supplement before unplanned exercise is still the best strategy to prevent exercise-induced hypoglycemia in an adolescent population. However, a protein supplement strategy may also have some benefits in limiting the rate of hypoglycemia during and immediately after exercise.