Effects of Aerobic Exercise on Systemic Insulin Degludec Concentrations in People With Type 1 Diabetes

David Herzig, Michael Groessl, Mario Álvarez-Martínez, Gemma Reverter-Branchat, Christos T. Nakas, Christophe Kosinski, Christoph Stettler, Lia Bally

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is conflicting evidence on the effect of exercise on systemic insulin concentrations in adults with type 1 diabetes. Methods: This prospective single-arm study examined the effect of exercise on systemic insulin degludec (IDeg) concentrations. The study involved 15 male adults with type 1 diabetes (age 30.7 ± 8.0 years, HbA1c 6.9 ± 0.7%) on stable IDeg regimen. Blood samples were collected every 15 minutes at rest, during 60 minutes of cycling (66% VO 2max) and until 90 minutes after exercise termination. IDeg concentrations were quantified using high-resolution mass-spectrometry and analyzed applying generalized estimation equations. Results: Compared to baseline, systemic IDeg increased during exercise over time (P <.001), with the highest concentrations observed toward the end of the 60-minute exercise (17.9% and 17.6% above baseline after 45 minutes and 60 minutes, respectively). IDeg levels remained elevated until the end of the experiment (14% above baseline at 90 minutes after exercise termination, P <.001). Conclusions: A single bout of aerobic exercise increases systemic IDeg exposure in adults on a stable basal IDeg regimen. This finding may have important implications for future hypoglycemia mitigation strategies around physical exercise in IDeg-treated patients.

Original languageEnglish
JournalJournal of Diabetes Science and Technology
Early online date30 Sep 2021
DOIs
Publication statusE-pub ahead of print - 30 Sep 2021

Keywords

  • exercise
  • high-resolution mass spectrometry
  • insulin degludec
  • type 1 diabetes

ASJC Scopus subject areas

  • Bioengineering
  • Internal Medicine
  • Biomedical Engineering
  • Endocrinology, Diabetes and Metabolism

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