The Effect of Starting Blood Glucose Levels on Serum Electrolyte Concentrations during and after Exercise in Type 1 Diabetes

Zeinab Momeni; Normand G Boulé; Carla M Prado; Heather A Hinz; Jane E Yardley

doi:10.3390/ijerph20032109

The Effect of Starting Blood Glucose Levels on Serum Electrolyte Concentrations during and after Exercise in Type 1 Diabetes

Int J Environ Res Public Health. 2023 Jan 24;20(3):2109. doi: 10.3390/ijerph20032109.

Authors

Zeinab Momeni^{1

2

3}, Normand G Boulé^{2

4}, Carla M Prado^{3

5

6}, Heather A Hinz^{2

4}, Jane E Yardley^{1

2

3

4}

Affiliations

¹ Augustana Faculty, University of Alberta, 4901-46th Avenue, Camrose, AB T4V 2R3, Canada.
² Physical Activity and Diabetes Laboratory, Alberta Diabetes Institute, 112 Street, Edmonton, AB T6G 2T9, Canada.
³ Women's and Children's Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada.
⁴ Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 3-100 University Hall, Van Vliet Complex, Edmonton, AB T6G 2H9, Canada.
⁵ Human Nutrition Research Unit, Alberta Diabetes Institute, 112 Street, Edmonton, AB T6G 2T9, Canada.
⁶ Faculty of Agricultural, Life and Environmental Science, University of Alberta, Edmonton, AB T6G 2P5, Canada.

Abstract

Fear of hypoglycemia is a major exercise barrier for people with type 1 diabetes (PWT1D). Consequently, although guidelines recommend starting exercise with blood glucose (BG) concentration at 7-10 mmol/L, PWT1D often start higher, potentially affecting hydration and serum electrolyte concentrations. To test this, we examined serum and urine electrolyte concentrations during aerobic exercise (cycling 45 min at 60%VO₂peak) in 12 PWT1D (10F/2M, mean ± SEM: age 29 ± 2.3 years, VO₂peak 37.9 ± 2.2 mL·kg^-1·min^-1) with starting BG levels: 8-10 (MOD), and 12-14 (HI) mmol/L. Age, sex, and fitness-matched controls without diabetes (CON) completed one exercise session with BG in the normal physiological range. Serum glucose was significantly higher during exercise and recovery in HI versus MOD (p = 0.0002 and p < 0.0001, respectively) and in MOD versus CON (p < 0.0001). During exercise and recovery, MOD and HI were not significantly different in serum insulin (p = 0.59 and p = 0.63), sodium (p = 0.058 and p = 0.08), potassium (p = 0.17 and p = 0.16), calcium (p = 0.75 and 0.19), and magnesium p = 0.24 and p = 0.09). Our findings suggest that exercise of moderate intensity and duration with higher BG levels may not pose an immediate risk to hydration or serum electrolyte concentrations for PWT1D.

Keywords: blood glucose; electrolytes; exercise; hydration; type 1 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Blood Glucose
Diabetes Mellitus, Type 1*
Electrolytes
Exercise / physiology
Humans
Hypoglycemia*
Insulin

Substances

Blood Glucose
Insulin
Electrolytes

Grants and funding

J.E.Y. is supported by the Heart and Stroke Foundation Alberta New Investigator Award. This project was funded by a pilot project grant from the Alberta Diabetes Institute. In-kind support was provided by LifeScan Canada and Abbott Nutrition Canada. Zeinab Momeni is supported by the Alberta Women’s Health Foundation through the Women and Children’s Health Research Institute.