Advances in Exercise and Nutrition as Therapy in Diabetes.

Anticipation of Historical Exercise Patterns by a Novel Artificial Pancreas System Reduces Hy... I Garcia-Tirado J SP 1 sp , Brown SA SP 1,2 sp , Laichuthai N SP 1,3 sp , Colmegna P SP 1 sp , Koravi CLK SP 1 sp , Ozaslan B SP 1 sp , Corbett JP SP 1 sp , Barnett CL SP 1 sp , Pajewski M SP 1 sp , Oliveri MC SP 1 sp , Myers H SP 1 sp , Breton MD SP 1 sp i I SP 1 sp Center for Diabetes Technology, University of Virginia, Charlottesville, VA; SP 2 sp Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia, Charlottesville, VA; SP 3 sp Excellence Center in Diabetes, Hormone, and Metabolism, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, and Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand i Diabetes Technol Ther 2021; 23: 277-285 This manuscript is also discussed in article on Decision Support Systems and Closed-Loop, page XX Background Maintaining tight glycemic control during and after exercise is often a major challenge for individuals with type 1 diabetes. Results Fructose ingestion 30 minutes before exercise was well tolerated, did not promote hyperglycemia before exercise, and promoted an 88% risk reduction in the incidence of exercise-associated hypoglycemia, as compared to water ingestion (one event of hypoglycemia with fructose intake vs six events in the water only protocol). Several papers were published this year on carbohydrate intake strategies to limit exercise-related hypoglycemia, including one by our team looking at a fast-acting carbohydrate dose of 0.3 g/kg body mass for 2 hours of fasted exercise ([35]) and another by Goulet-Gélinas and colleagues ([36]) who used the 0.5 g/kg body mass per hour of exercise prescription, given either in one dose or in a more distributed fashion. [Extracted from the article]