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Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes

Olivia McCarthy, Jason Pitt, MAX L. ECKSTEIN, OTHMAR MOSER, Steve Bain Orcid Logo, Richard Bracken Orcid Logo

Medicine & Science in Sports & Exercise, Volume: 53, Issue: 7, Pages: 1326 - 1333

Swansea University Authors: Olivia McCarthy, Jason Pitt, Steve Bain Orcid Logo, Richard Bracken Orcid Logo

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DOI (Published version): 10.1249/mss.0000000000002613

Abstract

Purpose This study aimed to investigate the influence of residual β-cell function on counterregulatory hormonal responses to hypoglycemia during acute physical exercise in people with type 1 diabetes (T1D). A secondary aim was to explore relationships between biomarkers of pancreatic β-cell function...

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Published in: Medicine & Science in Sports & Exercise
ISSN: 0195-9131 1530-0315
Published: Ovid Technologies (Wolters Kluwer Health) 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa57228
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-11-05T17:24:07.0195541</datestamp><bib-version>v2</bib-version><id>57228</id><entry>2021-06-28</entry><title>Pancreatic &#x3B2;-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes</title><swanseaauthors><author><sid>4fea3e19b39712dea1d051d317614572</sid><firstname>Olivia</firstname><surname>McCarthy</surname><name>Olivia McCarthy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>0103027605e3ccd2909f4170d9d2c96f</sid><firstname>Jason</firstname><surname>Pitt</surname><name>Jason Pitt</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>5399f4c6e6a70f3608a084ddb938511a</sid><ORCID>0000-0001-8519-4964</ORCID><firstname>Steve</firstname><surname>Bain</surname><name>Steve Bain</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-06-28</date><deptcode>STSC</deptcode><abstract>Purpose This study aimed to investigate the influence of residual &#x3B2;-cell function on counterregulatory hormonal responses to hypoglycemia during acute physical exercise in people with type 1 diabetes (T1D). A secondary aim was to explore relationships between biomarkers of pancreatic &#x3B2;-cell function and indices of glycemia following acute exercise including the nocturnal period.Methods This study involved an exploratory, secondary analysis of data from individuals with T1D who partook in a four-peroid, randomized, cross-over trial involving a bout of evening exercise followed by an overnight stay in a clinical laboratory facility. Participants were split into two groups: (i) a stimulated C-peptide level of &#x2265;30 pmol&#x22C5;L&#x2212;1 (low-level secretors [LLS], n = 6) or (ii) &lt;30 pmol&#x22C5;L&#x2212;1 (microsecretors [MS], n = 10). Pancreatic hormones (C-peptide, proinsulin, and glucagon), catecholamines (epinephrine [EPI] and norepinephrine [NE]), and metabolic biomarkers (blood glucose, blood lactate, and &#x3B2;-hydroxybutyrate) were measured at rest, during exercise with and without a hypoglycemic (blood glucose &#x2264;3.9 mmol&#x22C5;L&#x2212;1) episode, and throughout a 13-h postexercise period. Interstitial glucose monitoring was used to assess indices of glycemic variability.Results During in-exercise hypoglycemia, LLS presented with greater sympathoadrenal (EPI and NE P &#x2264; 0.05) and ketone (P &lt; 0.01) concentrations. Glucagon remained similar (P = 0.09). Over exercise, LLS experienced larger drops in C-peptide and proinsulin (both P &lt; 0.01) as well as greater increases in EPI (P &lt; 0.01) and &#x3B2;-hydroxybutyrate (P = 0.03). LLS spent less time in the interstitial-derived hypoglycemic range acutely postexercise and had lower glucose variability throughout the nocturnal period.Conclusion Higher residual &#x3B2;-cell function was associated with greater sympathoadrenal and ketonic responses to exercise-induced hypoglycemia as well as improved glycemia leading into and throughout the nocturnal hours. Even a minimal amount of residual &#x3B2;-cell function confers a beneficial effect on glycemic outcomes during and after exercise in people with T1D.</abstract><type>Journal Article</type><journal>Medicine &amp; Science in Sports &amp; Exercise</journal><volume>53</volume><journalNumber>7</journalNumber><paginationStart>1326</paginationStart><paginationEnd>1333</paginationEnd><publisher>Ovid Technologies (Wolters Kluwer Health)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0195-9131</issnPrint><issnElectronic>1530-0315</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-07-01</publishedDate><doi>10.1249/mss.0000000000002613</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-11-05T17:24:07.0195541</lastEdited><Created>2021-06-28T12:19:50.1359262</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Olivia</firstname><surname>McCarthy</surname><order>1</order></author><author><firstname>Jason</firstname><surname>Pitt</surname><order>2</order></author><author><firstname>MAX L.</firstname><surname>ECKSTEIN</surname><order>3</order></author><author><firstname>OTHMAR</firstname><surname>MOSER</surname><order>4</order></author><author><firstname>Steve</firstname><surname>Bain</surname><orcid>0000-0001-8519-4964</orcid><order>5</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>6</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2021-11-05T17:24:07.0195541 v2 57228 2021-06-28 Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes 4fea3e19b39712dea1d051d317614572 Olivia McCarthy Olivia McCarthy true false 0103027605e3ccd2909f4170d9d2c96f Jason Pitt Jason Pitt true false 5399f4c6e6a70f3608a084ddb938511a 0000-0001-8519-4964 Steve Bain Steve Bain true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2021-06-28 STSC Purpose This study aimed to investigate the influence of residual β-cell function on counterregulatory hormonal responses to hypoglycemia during acute physical exercise in people with type 1 diabetes (T1D). A secondary aim was to explore relationships between biomarkers of pancreatic β-cell function and indices of glycemia following acute exercise including the nocturnal period.Methods This study involved an exploratory, secondary analysis of data from individuals with T1D who partook in a four-peroid, randomized, cross-over trial involving a bout of evening exercise followed by an overnight stay in a clinical laboratory facility. Participants were split into two groups: (i) a stimulated C-peptide level of ≥30 pmol⋅L−1 (low-level secretors [LLS], n = 6) or (ii) <30 pmol⋅L−1 (microsecretors [MS], n = 10). Pancreatic hormones (C-peptide, proinsulin, and glucagon), catecholamines (epinephrine [EPI] and norepinephrine [NE]), and metabolic biomarkers (blood glucose, blood lactate, and β-hydroxybutyrate) were measured at rest, during exercise with and without a hypoglycemic (blood glucose ≤3.9 mmol⋅L−1) episode, and throughout a 13-h postexercise period. Interstitial glucose monitoring was used to assess indices of glycemic variability.Results During in-exercise hypoglycemia, LLS presented with greater sympathoadrenal (EPI and NE P ≤ 0.05) and ketone (P < 0.01) concentrations. Glucagon remained similar (P = 0.09). Over exercise, LLS experienced larger drops in C-peptide and proinsulin (both P < 0.01) as well as greater increases in EPI (P < 0.01) and β-hydroxybutyrate (P = 0.03). LLS spent less time in the interstitial-derived hypoglycemic range acutely postexercise and had lower glucose variability throughout the nocturnal period.Conclusion Higher residual β-cell function was associated with greater sympathoadrenal and ketonic responses to exercise-induced hypoglycemia as well as improved glycemia leading into and throughout the nocturnal hours. Even a minimal amount of residual β-cell function confers a beneficial effect on glycemic outcomes during and after exercise in people with T1D. Journal Article Medicine & Science in Sports & Exercise 53 7 1326 1333 Ovid Technologies (Wolters Kluwer Health) 0195-9131 1530-0315 1 7 2021 2021-07-01 10.1249/mss.0000000000002613 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-11-05T17:24:07.0195541 2021-06-28T12:19:50.1359262 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Olivia McCarthy 1 Jason Pitt 2 MAX L. ECKSTEIN 3 OTHMAR MOSER 4 Steve Bain 0000-0001-8519-4964 5 Richard Bracken 0000-0002-6986-6449 6
title Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
spellingShingle Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
Olivia McCarthy
Jason Pitt
Steve Bain
Richard Bracken
title_short Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
title_full Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
title_fullStr Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
title_full_unstemmed Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
title_sort Pancreatic β-Cell Function Is Associated with Augmented Counterregulation to In-Exercise Hypoglycemia in Type 1 Diabetes
author_id_str_mv 4fea3e19b39712dea1d051d317614572
0103027605e3ccd2909f4170d9d2c96f
5399f4c6e6a70f3608a084ddb938511a
f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv 4fea3e19b39712dea1d051d317614572_***_Olivia McCarthy
0103027605e3ccd2909f4170d9d2c96f_***_Jason Pitt
5399f4c6e6a70f3608a084ddb938511a_***_Steve Bain
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Olivia McCarthy
Jason Pitt
Steve Bain
Richard Bracken
author2 Olivia McCarthy
Jason Pitt
MAX L. ECKSTEIN
OTHMAR MOSER
Steve Bain
Richard Bracken
format Journal article
container_title Medicine & Science in Sports & Exercise
container_volume 53
container_issue 7
container_start_page 1326
publishDate 2021
institution Swansea University
issn 0195-9131
1530-0315
doi_str_mv 10.1249/mss.0000000000002613
publisher Ovid Technologies (Wolters Kluwer Health)
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 0
active_str 0
description Purpose This study aimed to investigate the influence of residual β-cell function on counterregulatory hormonal responses to hypoglycemia during acute physical exercise in people with type 1 diabetes (T1D). A secondary aim was to explore relationships between biomarkers of pancreatic β-cell function and indices of glycemia following acute exercise including the nocturnal period.Methods This study involved an exploratory, secondary analysis of data from individuals with T1D who partook in a four-peroid, randomized, cross-over trial involving a bout of evening exercise followed by an overnight stay in a clinical laboratory facility. Participants were split into two groups: (i) a stimulated C-peptide level of ≥30 pmol⋅L−1 (low-level secretors [LLS], n = 6) or (ii) <30 pmol⋅L−1 (microsecretors [MS], n = 10). Pancreatic hormones (C-peptide, proinsulin, and glucagon), catecholamines (epinephrine [EPI] and norepinephrine [NE]), and metabolic biomarkers (blood glucose, blood lactate, and β-hydroxybutyrate) were measured at rest, during exercise with and without a hypoglycemic (blood glucose ≤3.9 mmol⋅L−1) episode, and throughout a 13-h postexercise period. Interstitial glucose monitoring was used to assess indices of glycemic variability.Results During in-exercise hypoglycemia, LLS presented with greater sympathoadrenal (EPI and NE P ≤ 0.05) and ketone (P < 0.01) concentrations. Glucagon remained similar (P = 0.09). Over exercise, LLS experienced larger drops in C-peptide and proinsulin (both P < 0.01) as well as greater increases in EPI (P < 0.01) and β-hydroxybutyrate (P = 0.03). LLS spent less time in the interstitial-derived hypoglycemic range acutely postexercise and had lower glucose variability throughout the nocturnal period.Conclusion Higher residual β-cell function was associated with greater sympathoadrenal and ketonic responses to exercise-induced hypoglycemia as well as improved glycemia leading into and throughout the nocturnal hours. Even a minimal amount of residual β-cell function confers a beneficial effect on glycemic outcomes during and after exercise in people with T1D.
published_date 2021-07-01T04:12:48Z
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