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Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes / BENJAMIN WELLMAN

Swansea University Author: BENJAMIN WELLMAN

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Abstract

To characterise blood glucose responses in cardiopulmonary exercise testing (CPET) in individuals with type 1 diabetes and to assess the impact of hyperglycaemia vs euglycemia on physiological and metabolic responses during CPET in T1DM. This study was a retrospective, secondary analysis of pooled C...

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Published: Swansea, Wales, UK 2022
Institution: Swansea University
Degree level: Master of Research
Degree name: MSc by Research
Supervisor: Bracken, R. M.
URI: https://cronfa.swan.ac.uk/Record/cronfa63571
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>63571</id><entry>2023-06-02</entry><title>Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes</title><swanseaauthors><author><sid>73a0399abeb7542591e6edeec725ba36</sid><firstname>BENJAMIN</firstname><surname>WELLMAN</surname><name>BENJAMIN WELLMAN</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-06-02</date><abstract>To characterise blood glucose responses in cardiopulmonary exercise testing (CPET) in individuals with type 1 diabetes and to assess the impact of hyperglycaemia vs euglycemia on physiological and metabolic responses during CPET in T1DM. This study was a retrospective, secondary analysis of pooled CPET data from three randomised controlled trials using identical 1-minute incremental test stages. Participants followed standardised glycaemic management criteria prior to exercise. During CPX testing, cardiopulmonary variables were measured continuously whilst blood glucose (BG) and lactate values were obtained minutely via capillary earlobe sampling. Anaerobic threshold (AT) was determined using the modified V-slope index by the ventilatory equivalents for CO2 and O2 (VE/VCO2, VE/VCO2), expressed as a function of VO2. Data were reported as mean±SD and analysed by a students paired t-test with p≤0.05. Data from 36 individuals with T1DM HbA1c 7.3±1.1%, age 32±13 years, diabetes duration 17±10 years, maximum heart rate 180±13 bpm and V̇ O2max of 3.2±0.9 L.min-1 were included. BG values remained equivalent to sitting concentrations (8.91±2.47 mmol.L-1) at each stage of the CPET protocol. The change in BG above the anaerobic threshold was differently significantly from the change in BG below the AT (Sit–AT; +0.2±0.7 vs. AT-Peak; -0.5±0.8 mmol.L-1, [i.e. Δ 0.7], p&lt;0.001). The rate of change (ROC) between values showed that the change in the ROC from Sit-AT to AT-Peak was significantly different between groups (Sit-AT; Δ0.004±0.06 vs. AT-Peak; Δ-0.049±0.10 mmol.L-1 , p=0.01). Between Hyperglycaemia (Hyper) vs. Euglycemia (Eu), BG remained comparable within each respective starting BG levels. The magnitude of change in BG from Sit-AT was significantly differentbetween groups (Hyper Δ-0.09±0.35 vs. Eu Δ+0.32±0.76 p=0.030). Hyper from Sit-AT had a significantly different magnitude in the ROC to AT-Peak (-0.04±-0.06 mmol.L-1/min, p=0.032) but not in the Eu group. We found that under correct CPET protocol, glycaemia is minimally disturbed and does not result in hypoglycaemia or changes in performance outcomes. However, starting exercise with high blood glucose levels (hyperglycaemia) impacts some cardio-metabolic outcomes during maximal and recovery phases around CPET.</abstract><type>E-Thesis</type><journal/><volume/><journalNumber/><paginationStart/><paginationEnd/><publisher/><placeOfPublication>Swansea, Wales, UK</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic/><keywords>Type 1 Diabetes, Glucose, Glycemia, Cardiopulmonary Exercise Test, CPEX</keywords><publishedDay>23</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-09-23</publishedDate><doi/><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><supervisor>Bracken, R. M.</supervisor><degreelevel>Master of Research</degreelevel><degreename>MSc by Research</degreename><degreesponsorsfunders>Swansea University</degreesponsorsfunders><apcterm/><funders>Swansea University</funders><projectreference/><lastEdited>2023-10-27T15:57:19.6607132</lastEdited><Created>2023-06-02T11:42:40.0809182</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>BENJAMIN</firstname><surname>WELLMAN</surname><order>1</order></author></authors><documents><document><filename>63571__27683__9f0f9b5ebb5f4ee1b3f3113f524a8996.pdf</filename><originalFilename>2023_Wellman_B.final.63571.pdf</originalFilename><uploaded>2023-06-02T11:54:31.9479058</uploaded><type>Output</type><contentLength>1581302</contentLength><contentType>application/pdf</contentType><version>E-Thesis – open access</version><cronfaStatus>true</cronfaStatus><documentNotes>Copyright: The Author, Benjamin Wellman, 2023.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling v2 63571 2023-06-02 Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes 73a0399abeb7542591e6edeec725ba36 BENJAMIN WELLMAN BENJAMIN WELLMAN true false 2023-06-02 To characterise blood glucose responses in cardiopulmonary exercise testing (CPET) in individuals with type 1 diabetes and to assess the impact of hyperglycaemia vs euglycemia on physiological and metabolic responses during CPET in T1DM. This study was a retrospective, secondary analysis of pooled CPET data from three randomised controlled trials using identical 1-minute incremental test stages. Participants followed standardised glycaemic management criteria prior to exercise. During CPX testing, cardiopulmonary variables were measured continuously whilst blood glucose (BG) and lactate values were obtained minutely via capillary earlobe sampling. Anaerobic threshold (AT) was determined using the modified V-slope index by the ventilatory equivalents for CO2 and O2 (VE/VCO2, VE/VCO2), expressed as a function of VO2. Data were reported as mean±SD and analysed by a students paired t-test with p≤0.05. Data from 36 individuals with T1DM HbA1c 7.3±1.1%, age 32±13 years, diabetes duration 17±10 years, maximum heart rate 180±13 bpm and V̇ O2max of 3.2±0.9 L.min-1 were included. BG values remained equivalent to sitting concentrations (8.91±2.47 mmol.L-1) at each stage of the CPET protocol. The change in BG above the anaerobic threshold was differently significantly from the change in BG below the AT (Sit–AT; +0.2±0.7 vs. AT-Peak; -0.5±0.8 mmol.L-1, [i.e. Δ 0.7], p<0.001). The rate of change (ROC) between values showed that the change in the ROC from Sit-AT to AT-Peak was significantly different between groups (Sit-AT; Δ0.004±0.06 vs. AT-Peak; Δ-0.049±0.10 mmol.L-1 , p=0.01). Between Hyperglycaemia (Hyper) vs. Euglycemia (Eu), BG remained comparable within each respective starting BG levels. The magnitude of change in BG from Sit-AT was significantly differentbetween groups (Hyper Δ-0.09±0.35 vs. Eu Δ+0.32±0.76 p=0.030). Hyper from Sit-AT had a significantly different magnitude in the ROC to AT-Peak (-0.04±-0.06 mmol.L-1/min, p=0.032) but not in the Eu group. We found that under correct CPET protocol, glycaemia is minimally disturbed and does not result in hypoglycaemia or changes in performance outcomes. However, starting exercise with high blood glucose levels (hyperglycaemia) impacts some cardio-metabolic outcomes during maximal and recovery phases around CPET. E-Thesis Swansea, Wales, UK Type 1 Diabetes, Glucose, Glycemia, Cardiopulmonary Exercise Test, CPEX 23 9 2022 2022-09-23 COLLEGE NANME COLLEGE CODE Swansea University Bracken, R. M. Master of Research MSc by Research Swansea University Swansea University 2023-10-27T15:57:19.6607132 2023-06-02T11:42:40.0809182 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences BENJAMIN WELLMAN 1 63571__27683__9f0f9b5ebb5f4ee1b3f3113f524a8996.pdf 2023_Wellman_B.final.63571.pdf 2023-06-02T11:54:31.9479058 Output 1581302 application/pdf E-Thesis – open access true Copyright: The Author, Benjamin Wellman, 2023. true eng
title Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
spellingShingle Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
BENJAMIN WELLMAN
title_short Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
title_full Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
title_fullStr Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
title_full_unstemmed Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
title_sort Blood glucose response during cardiopulmonary exercise testing in individuals with type 1 diabetes
author_id_str_mv 73a0399abeb7542591e6edeec725ba36
author_id_fullname_str_mv 73a0399abeb7542591e6edeec725ba36_***_BENJAMIN WELLMAN
author BENJAMIN WELLMAN
author2 BENJAMIN WELLMAN
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publishDate 2022
institution Swansea University
college_str Faculty of Science and Engineering
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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 Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
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description To characterise blood glucose responses in cardiopulmonary exercise testing (CPET) in individuals with type 1 diabetes and to assess the impact of hyperglycaemia vs euglycemia on physiological and metabolic responses during CPET in T1DM. This study was a retrospective, secondary analysis of pooled CPET data from three randomised controlled trials using identical 1-minute incremental test stages. Participants followed standardised glycaemic management criteria prior to exercise. During CPX testing, cardiopulmonary variables were measured continuously whilst blood glucose (BG) and lactate values were obtained minutely via capillary earlobe sampling. Anaerobic threshold (AT) was determined using the modified V-slope index by the ventilatory equivalents for CO2 and O2 (VE/VCO2, VE/VCO2), expressed as a function of VO2. Data were reported as mean±SD and analysed by a students paired t-test with p≤0.05. Data from 36 individuals with T1DM HbA1c 7.3±1.1%, age 32±13 years, diabetes duration 17±10 years, maximum heart rate 180±13 bpm and V̇ O2max of 3.2±0.9 L.min-1 were included. BG values remained equivalent to sitting concentrations (8.91±2.47 mmol.L-1) at each stage of the CPET protocol. The change in BG above the anaerobic threshold was differently significantly from the change in BG below the AT (Sit–AT; +0.2±0.7 vs. AT-Peak; -0.5±0.8 mmol.L-1, [i.e. Δ 0.7], p<0.001). The rate of change (ROC) between values showed that the change in the ROC from Sit-AT to AT-Peak was significantly different between groups (Sit-AT; Δ0.004±0.06 vs. AT-Peak; Δ-0.049±0.10 mmol.L-1 , p=0.01). Between Hyperglycaemia (Hyper) vs. Euglycemia (Eu), BG remained comparable within each respective starting BG levels. The magnitude of change in BG from Sit-AT was significantly differentbetween groups (Hyper Δ-0.09±0.35 vs. Eu Δ+0.32±0.76 p=0.030). Hyper from Sit-AT had a significantly different magnitude in the ROC to AT-Peak (-0.04±-0.06 mmol.L-1/min, p=0.032) but not in the Eu group. We found that under correct CPET protocol, glycaemia is minimally disturbed and does not result in hypoglycaemia or changes in performance outcomes. However, starting exercise with high blood glucose levels (hyperglycaemia) impacts some cardio-metabolic outcomes during maximal and recovery phases around CPET.
published_date 2022-09-23T15:57:17Z
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score 11.017731

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