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Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems

Olivia M. McCarthy Orcid Logo, Merete Bechmann Christensen, Sandra Tawfik, Kasper Birch Kristensen Orcid Logo, Bolette Hartmann Orcid Logo, Jens Juul Holst Orcid Logo, Signe Schmidt Orcid Logo, Kirsten Nørgaard Orcid Logo, Richard Bracken Orcid Logo

Nutrients, Volume: 16, Issue: 23, Start page: 4098

Swansea University Author: Richard Bracken Orcid Logo

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DOI (Published version): 10.3390/nu16234098

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Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight p...

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Published in: Nutrients
ISSN: 2072-6643
Published: MDPI 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68485
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2024-12-09T11:39:06.0418641</datestamp><bib-version>v2</bib-version><id>68485</id><entry>2024-12-09</entry><title>Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems</title><swanseaauthors><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>2024-12-09</date><deptcode>EAAS</deptcode><abstract>Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight participants with T1D being treated with automated insulin pumps (five females, age: 47 &#xB1; 16 years, BMI: 27.5 &#xB1; 3.8 kg&#xB7;m2, diabetes duration: 23 &#xB1; 11 years, HbA1c: 8.3 &#xB1; 0.9 [67.5 &#xB1; 9.5]% [mmol/mol]) attended the laboratory on two separate occasions and consumed an isocaloric amount of isomaltulose as either (1) a single serving (0.75g CHO&#xB7;kg&#x2212;1 BM) with a 25% reduction in bolus insulin 90 min before 45 min of cycling (PEC) or (2) three separate isocaloric servings (0.25g CHO&#xB7;kg&#x2212;1 BM each) without bolus insulin during exercise (DEC). Plasma glucose (PG), gut incretins (GLP-1 and GIP), pancreatic glucagon, exogenous insulin, and whole-body fuel oxidation rates were determined. Data were treated via a two-way repeated measures ANOVA, with p &#x2264; 0.05 accepted as significant. Results: PG concentrations throughout exercise were higher and less variable with DEC compared to PEC. The exercise-induced change in PG was directionally divergent between trials (PEC: &#x2206; &#x2212; 3.2 &#xB1; 1.2 mmol/L vs. DEC: &#x2206; + 1.7 &#xB1; 1.5 mmol/L, p &lt; 0.001), changing at a rate of &#x2212;0.07 &#xB1; 0.03 mmol/L/min with PEC and +0.04 &#xB1; 0.03 mmol/L/min with DEC (p &lt; 0.001 between conditions). Throughout the exercise period, GLP-1, GIP, glucagon, and total insulin concentrations were lower with DEC (all p &#x2264; 0.02). The oxidation rates of carbohydrates were lower (p = 0.009) and of lipids were greater (p = 0.014) with DEC compared to PEC. Conclusions: The consumption of smaller servings of isomaltulose during, rather than as a single isocaloric serving before, submaximal sustained exercise provided (i) a better glycemic protective effect, (ii) a lesser push on pancreatic and gut-mediated glucoregulatory hormones, and (iii) a lower reliance on whole-body carbohydrate oxidation. Such information serves to remind us of the potential importance of nutrition for modulating the metabolic fate of an acute bout of exercise and may help inform best practice guidelines for exercise management in the T1D-sphere.</abstract><type>Journal Article</type><journal>Nutrients</journal><volume>16</volume><journalNumber>23</journalNumber><paginationStart>4098</paginationStart><paginationEnd/><publisher>MDPI</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2072-6643</issnElectronic><keywords>Exercise; type 1 diabetes; automated insulin delivery systems; glucose; incretin hormones; nutrition</keywords><publishedDay>28</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-11-28</publishedDate><doi>10.3390/nu16234098</doi><url/><notes/><college>COLLEGE NANME</college><department>Engineering and Applied Sciences School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>EAAS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>The original randomized controlled trial, from which the participants in the present exercise sub-study were recruited, was an investigator-initiated study funded by Medtronic Diabetes, USA. K.N. holds shares in Novo Nordisk, has been a paid consultant for Novo Nordisk and Medtronic, has received a speaker honorarium and honorarium for the Advisory Board to her institution from Medtronic, Novo Nordisk, Convatec, and Abbott, and her institution has received research funding from Zealand Pharma, Novo Nordisk, Medtronic, and Dexcom. The authors would like to thank the participants for their willingness to contribute and commit to the study protocol. We would also like to thank the Diabetesforeningen (Denmark) for their financial contributions to the project, as well as BENEO GmbH (Mannhein, Germany) for supplying the carbohydrate source used in this research (Palatinose&#x2122;).</funders><projectreference/><lastEdited>2024-12-09T11:39:06.0418641</lastEdited><Created>2024-12-09T11:29:20.8714761</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>Olivia M.</firstname><surname>McCarthy</surname><orcid>0000-0001-6971-611X</orcid><order>1</order></author><author><firstname>Merete Bechmann</firstname><surname>Christensen</surname><order>2</order></author><author><firstname>Sandra</firstname><surname>Tawfik</surname><order>3</order></author><author><firstname>Kasper Birch</firstname><surname>Kristensen</surname><orcid>0000-0001-8614-6729</orcid><order>4</order></author><author><firstname>Bolette</firstname><surname>Hartmann</surname><orcid>0000-0001-8509-2036</orcid><order>5</order></author><author><firstname>Jens Juul</firstname><surname>Holst</surname><orcid>0000-0001-6853-3805</orcid><order>6</order></author><author><firstname>Signe</firstname><surname>Schmidt</surname><orcid>0000-0002-6968-6675</orcid><order>7</order></author><author><firstname>Kirsten</firstname><surname>N&#xF8;rgaard</surname><orcid>0000-0003-1620-8271</orcid><order>8</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>9</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2024-12-09T11:39:06.0418641 v2 68485 2024-12-09 Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2024-12-09 EAAS Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight participants with T1D being treated with automated insulin pumps (five females, age: 47 ± 16 years, BMI: 27.5 ± 3.8 kg·m2, diabetes duration: 23 ± 11 years, HbA1c: 8.3 ± 0.9 [67.5 ± 9.5]% [mmol/mol]) attended the laboratory on two separate occasions and consumed an isocaloric amount of isomaltulose as either (1) a single serving (0.75g CHO·kg−1 BM) with a 25% reduction in bolus insulin 90 min before 45 min of cycling (PEC) or (2) three separate isocaloric servings (0.25g CHO·kg−1 BM each) without bolus insulin during exercise (DEC). Plasma glucose (PG), gut incretins (GLP-1 and GIP), pancreatic glucagon, exogenous insulin, and whole-body fuel oxidation rates were determined. Data were treated via a two-way repeated measures ANOVA, with p ≤ 0.05 accepted as significant. Results: PG concentrations throughout exercise were higher and less variable with DEC compared to PEC. The exercise-induced change in PG was directionally divergent between trials (PEC: ∆ − 3.2 ± 1.2 mmol/L vs. DEC: ∆ + 1.7 ± 1.5 mmol/L, p < 0.001), changing at a rate of −0.07 ± 0.03 mmol/L/min with PEC and +0.04 ± 0.03 mmol/L/min with DEC (p < 0.001 between conditions). Throughout the exercise period, GLP-1, GIP, glucagon, and total insulin concentrations were lower with DEC (all p ≤ 0.02). The oxidation rates of carbohydrates were lower (p = 0.009) and of lipids were greater (p = 0.014) with DEC compared to PEC. Conclusions: The consumption of smaller servings of isomaltulose during, rather than as a single isocaloric serving before, submaximal sustained exercise provided (i) a better glycemic protective effect, (ii) a lesser push on pancreatic and gut-mediated glucoregulatory hormones, and (iii) a lower reliance on whole-body carbohydrate oxidation. Such information serves to remind us of the potential importance of nutrition for modulating the metabolic fate of an acute bout of exercise and may help inform best practice guidelines for exercise management in the T1D-sphere. Journal Article Nutrients 16 23 4098 MDPI 2072-6643 Exercise; type 1 diabetes; automated insulin delivery systems; glucose; incretin hormones; nutrition 28 11 2024 2024-11-28 10.3390/nu16234098 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee The original randomized controlled trial, from which the participants in the present exercise sub-study were recruited, was an investigator-initiated study funded by Medtronic Diabetes, USA. K.N. holds shares in Novo Nordisk, has been a paid consultant for Novo Nordisk and Medtronic, has received a speaker honorarium and honorarium for the Advisory Board to her institution from Medtronic, Novo Nordisk, Convatec, and Abbott, and her institution has received research funding from Zealand Pharma, Novo Nordisk, Medtronic, and Dexcom. The authors would like to thank the participants for their willingness to contribute and commit to the study protocol. We would also like to thank the Diabetesforeningen (Denmark) for their financial contributions to the project, as well as BENEO GmbH (Mannhein, Germany) for supplying the carbohydrate source used in this research (Palatinose™). 2024-12-09T11:39:06.0418641 2024-12-09T11:29:20.8714761 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Olivia M. McCarthy 0000-0001-6971-611X 1 Merete Bechmann Christensen 2 Sandra Tawfik 3 Kasper Birch Kristensen 0000-0001-8614-6729 4 Bolette Hartmann 0000-0001-8509-2036 5 Jens Juul Holst 0000-0001-6853-3805 6 Signe Schmidt 0000-0002-6968-6675 7 Kirsten Nørgaard 0000-0003-1620-8271 8 Richard Bracken 0000-0002-6986-6449 9
title Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
spellingShingle Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
Richard Bracken
title_short Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
title_full Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
title_fullStr Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
title_full_unstemmed Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
title_sort Metabolic and Hormonal Responses to Isomaltulose Ingestion Before or During Sustained Submaximal Exercise in Adults with Type 1 Diabetes Using Automated Insulin Delivery Systems
author_id_str_mv f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Richard Bracken
author2 Olivia M. McCarthy
Merete Bechmann Christensen
Sandra Tawfik
Kasper Birch Kristensen
Bolette Hartmann
Jens Juul Holst
Signe Schmidt
Kirsten Nørgaard
Richard Bracken
format Journal article
container_title Nutrients
container_volume 16
container_issue 23
container_start_page 4098
publishDate 2024
institution Swansea University
issn 2072-6643
doi_str_mv 10.3390/nu16234098
publisher MDPI
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 Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 0
active_str 0
description Objectives: This article compares metabolic, pancreatic, and gut-derived hormone responses to isomaltulose ingestion, before versus during submaximal sustained exercise, in adults with type 1 diabetes (T1D) using automated insulin delivery systems. Methods: In a randomized, cross-over trial, eight participants with T1D being treated with automated insulin pumps (five females, age: 47 ± 16 years, BMI: 27.5 ± 3.8 kg·m2, diabetes duration: 23 ± 11 years, HbA1c: 8.3 ± 0.9 [67.5 ± 9.5]% [mmol/mol]) attended the laboratory on two separate occasions and consumed an isocaloric amount of isomaltulose as either (1) a single serving (0.75g CHO·kg−1 BM) with a 25% reduction in bolus insulin 90 min before 45 min of cycling (PEC) or (2) three separate isocaloric servings (0.25g CHO·kg−1 BM each) without bolus insulin during exercise (DEC). Plasma glucose (PG), gut incretins (GLP-1 and GIP), pancreatic glucagon, exogenous insulin, and whole-body fuel oxidation rates were determined. Data were treated via a two-way repeated measures ANOVA, with p ≤ 0.05 accepted as significant. Results: PG concentrations throughout exercise were higher and less variable with DEC compared to PEC. The exercise-induced change in PG was directionally divergent between trials (PEC: ∆ − 3.2 ± 1.2 mmol/L vs. DEC: ∆ + 1.7 ± 1.5 mmol/L, p < 0.001), changing at a rate of −0.07 ± 0.03 mmol/L/min with PEC and +0.04 ± 0.03 mmol/L/min with DEC (p < 0.001 between conditions). Throughout the exercise period, GLP-1, GIP, glucagon, and total insulin concentrations were lower with DEC (all p ≤ 0.02). The oxidation rates of carbohydrates were lower (p = 0.009) and of lipids were greater (p = 0.014) with DEC compared to PEC. Conclusions: The consumption of smaller servings of isomaltulose during, rather than as a single isocaloric serving before, submaximal sustained exercise provided (i) a better glycemic protective effect, (ii) a lesser push on pancreatic and gut-mediated glucoregulatory hormones, and (iii) a lower reliance on whole-body carbohydrate oxidation. Such information serves to remind us of the potential importance of nutrition for modulating the metabolic fate of an acute bout of exercise and may help inform best practice guidelines for exercise management in the T1D-sphere.
published_date 2024-11-28T02:54:56Z
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