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Postexercise Glycemic Control in Type 1 Diabetes Is Associated With Residual β-Cell Function

Lookup NU author(s): Dr Guy Taylor, Kieran Smith, Tess Capper, Jadine Scragg, Dr Ayat Bashir, Dr Anneliese Flatt, Professor Emma Stevenson, Professor James Shaw, Dr Daniel WestORCiD



This is the of an article that has been published in its final definitive form by American Diabetes Association Inc., 2020.

For re-use rights please refer to the publisher's terms and conditions.


© 2020 by the American Diabetes Association.To investigate the impact of residual b-cell function on continuous glucose monitoring (CGM) outcomes following acute exercise in people with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS Thirty participants with T1D for ‡3 years were recruited. First, participants wore a blinded CGM unit for 7 days of free-living data capture. Second, a 3-h mixed-meal test assessed stimulated C-peptide and glucagon. Peak C-peptide was used to allocate participants into undetectable (Cpepund <3 pmol/L), low (Cpeplow 3–200 pmol/L), or high (Cpephigh >200 pmol/L) C-peptide groups. Finally, participants completed 45 min of incline treadmill walking at 60% VO2peak followed by a further 48-h CGM capture. RESULTS CGM parameters were comparable across groups during the free-living observation week.Inthe12-and24-hpostexerciseperiods(12hand24h),the Cpephigh grouphada significantly greater amount of time spent with glucose 3.9–10 mmol/L (12 h, 73.5 ± 27.6%; 24 h, 76.3 ± 19.2%) compared with Cpeplow (12 h, 43.6 ± 26.1%, P = 0.027; 24 h, 52.3 ± 25.0%, P = 0.067) or Cpepund (12 h, 40.6 ± 17.0%, P = 0.010; 24 h, 51.3 ± 22.3%, P = 0.041). Time spent in hyperglycemia (12 h and 24 h glucose >10 and >13.9 mmol/L, P < 0.05) and glycemic variability (12 h and 24 h SD, P < 0.01) were significantly lower in the Cpephigh group compared with Cpepund and Cpeplow.Change in CGM outcomes from pre-exercise to 24-h postexercise was divergent: Cpepund and Cpeplow experienced worsening (glucose 3.9–10 mmol/L:-9.1% and-16.2%, respectively), with Cpephigh experiencing improvement (+12.1%) (P = 0.017). CONCLUSIONS Residual b-cell function may partially explain the interindividual variation in the acute glycemic benefits of exercise in individuals with T1D. Quantifying C-peptide could aid in providing personalized and targeted support for exercising patients.

Publication metadata

Author(s): Taylor GS, Smith K, Capper TE, Scragg JH, Bashir A, Flatt A, Stevenson EJ, McDonald TJ, Oram RA, Shaw JA, West DJ

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2020

Volume: 43

Issue: 10

Pages: 2362-2370

Print publication date: 21/09/2020

Online publication date: 03/08/2020

Acceptance date: 28/06/2020

Date deposited: 30/06/2020

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association Inc.


DOI: 10.2337/dc20-0300

PubMed id: 32747405


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