Type 1 Diabetes: Preventing Exercise-induced Hypoglycemia with Nutrition

New Study Looks at Adolescents with Type 1 Diabetes

Young man looking into a refrigerator at various food optionsThere have been very few studies on nutritional strategies to help prevent exercise-induced hypoglycemia in adolescents who have type 1 diabetes. To examine this relationship more closely, Canadian researchers compared the impact of various food strategies on blood glucose (BG) levels both during and after 60 minutes of moderately intense exercise.

Their study was published online in late February 2012 in the article “Nutritional strategies to prevent hypoglycemia at exercise in diabetic adolescents.” The article will appear in an issue of the journal Medicine & Science in Sports & Exercise.

Study participants exercised 120 minutes after breakfast under 1 of the following 3 conditions:

  • standardized breakfast + pre-exercise placebo beverage (PL)
  • standardized breakfast + pre-exercise carbohydrate beverage (CHO) (8 mg of CHO per kg of body weight per minute of exercise)
  • protein supplemented breakfast (PROT) (8 mg of protein per kg of body weight per minute of exercise added to a standardized breakfast) + pre-exercise placebo beverage

Ten participants were involved in each condition. The average age of the participants was 14.0 ± 1.5 years old.

As soon as BG levels fell below 4 mmol/L or if symptomatic hypoglycemia was present during exercise, the exercise session was stopped, and CHO tablets were given to correct hypoglycemia.

Researchers found that BG levels decreased by 6.0 ± 1.9 mmol/L in PL conditions, 1.0 ± 3.1 mmol/l in CHO conditions, and 4.6 ± 1.9 mmol/L in PROT conditions (p<0.05).

It was noted that the proportion of participants who reached hypoglycemic values or hypoglycemic sensations was significantly different between the various conditions: 4/10 in the PL conditions, 1/10 in the CHO conditions, and 0/10 in the PROT conditions (p<0.05).

The research team concluded that the pre-exercise CHO beverage had the least dramatic decrease in BG levels during exercise. They also found that the PROT breakfast had an overall similar decrease in BG levels compared to PL and a larger decrease in BG levels compared to the CHO beverage. However, participants who ate the PROT breakfast had a similar rate of hypoglycemia compared with participants who took the CHO beverage.

Researchers suggest that taking a CHO supplement before unplanned exercise remains the best strategy in an adolescent population to prevent exercise-induced hypoglycemia. But they also suggest that a protein supplement strategy may be beneficial in reducing the rate of hypoglycemia both during and immediately after exercise.

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