Effects of moderate-to-vigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes

Kristen M Metcalf; Ajay Singhvi; Eva Tsalikian; Michael J Tansey; M Bridget Zimmerman; Dale W Esliger; Kathleen F Janz

doi:10.2337/dc13-1973

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Effects of moderate-to-vigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes

Journal article

Open access

Peer reviewed

Effects of moderate-to-vigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes

Kristen M Metcalf, Ajay Singhvi, Eva Tsalikian, Michael J Tansey, M Bridget Zimmerman, Dale W Esliger and Kathleen F Janz

Diabetes care, Vol.37(5), pp.1272-1278

2014

DOI: 10.2337/dc13-1973

PMCID: PMC3994939

PMID: 24574352

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Abstract

Physical activity (PA) provides many benefits to adolescents with type 1 diabetes; however, these individuals tend to have lower fitness and PA levels than their disease-free counterparts. The purpose of this study was to examine the acute temporal associations between moderate-to-vigorous intensity PA (MVPA) and hypoglycemia (continuous glucose monitor [CGM] reading ≤70 mg/dL). Nineteen participants (53% females) 14-20 years old with type 1 diabetes were recruited. Participant fitness was evaluated via indirect calorimetry using a maximal exercise test; body composition was measured using air displacement plethysmography. An accelerometer was worn continuously (3-5 days) and acceleration data used to estimate MVPA (minutes per day). Blood glucose values were simultaneously tracked using CGM. Controlling for sex, percent body fat (%BF), fitness, and concurrent MVPA, the likelihood of nighttime and next-day hypoglycemia due to MVPA was examined using logistic regression. Participants were of average fitness (females: 43.9 mL/kg/min; males: 49.8 mL/kg/min) and adiposity (females: 26.2%; males: 19.2%); 63.2% met the U.S. federal guideline of accumulating 60 min/day of MVPA. Hypoglycemia was 31% more likely in those who accumulated 30 min/day more MVPA in the previous afternoon than those with less (95% CI 1.05-1.63; P = 0.017). The results suggest that participating in afternoon MVPA increases the risk of overnight and next-day hypoglycemia, independent of sex, %BF, fitness, and concurrent MVPA. While promoting PA as a healthy behavior, it is important to educate adolescents with type 1 diabetes on prevention of hypoglycemia following PA.

Adipose Tissue - physiology

Humans

Male

Calorimetry, Indirect

Diabetes Mellitus, Type 1 - complications

Health Behavior

Hypoglycemia - prevention & control

Exercise Test

Hypoglycemia - etiology

Diabetes Mellitus, Type 1 - blood

Adolescent

Sex Factors

Female

Adiposity - physiology

Exercise - physiology

Blood Glucose - metabolism

Body Composition - physiology

Details

Title: Subtitle: Effects of moderate-to-vigorous intensity physical activity on overnight and next-day hypoglycemia in active adolescents with type 1 diabetes
Creators: Kristen M Metcalf - Corresponding author: Kristen M. Metcalf, kristen-metcalf@uiowa.edu
Ajay Singhvi
Eva Tsalikian
Michael J Tansey
M Bridget Zimmerman
Dale W Esliger
Kathleen F Janz
Resource Type: Journal article
Publication Details: Diabetes care, Vol.37(5), pp.1272-1278
DOI: 10.2337/dc13-1973
PMID: 24574352
PMCID: PMC3994939
NLM abbreviation: Diabetes Care
ISSN: 1935-5548
eISSN: 1935-5548
Publisher: United States
Grant note: UL1 TR000442 / NCATS NIH HHS 2-UL1-TR000442-06 / NCATS NIH HHS
Language: English
Date published: 2014
Academic Unit: Endocrinology and Diabetes; Stead Family Department of Pediatrics; Epidemiology; Biostatistics; Health, Sport, and Human Physiology
Record Identifier: 9983997301302771

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