Simulated games activity versus continuous running exercise: a novel comparison of the glycaemic and metabolic responses in T1DM patients

AIM: To compare the glycaemic and metabolic responses to simulated intermittent games activity and continuous running exercise in T1DM. METHODS: Nine patients (7 male, 2 female; 354 years; HbA1c 8.10.2% / 652 mmol.mol-1) treated on a basal-bolus regimen completed two main trials, a continuous treadmill run (CON) or an intermittent running protocol (INT). Patients arrived to the laboratory fasted at ~08:00 h, replicating their usual pre-exercise meal and administering a 50% reduced dose of rapid-acting insulin before exercising. Blood glucose (BG), K+, Na++, pH, triglycerides, serum cortisol and NEFA were measured at baseline and for 60 minutes post-exercise. Interstitial glucose was measured for a further 23 hours under free-living conditions. RESULTS: Following exercise, BG declined under both conditions but was less under INT (INT -1.1±1.4 vs. CON -5.3±0.4 mmol.l-1, p=0.037) meaning more patients experienced hypoglycaemia (BG≤3.5mmol.l-1; CON n=3 vs. INT n=2) but less hyperglycaemia (BG≥10.9 mmol.l-1; CON n=0 vs. INT n=6) under CON. Blood lactate was significantly greater, and pH lower, with a temporal delay in K+ under INT (p<0.05). No conditional differences were observed in other measures during this time, or in interstitial glucose concentrations during the remaining 23 hours after exercise. CONCLUSIONS: Simulated games activity carries a lower risk of early, but not late-onset hypoglycaemia than continuous running exercise in T1DM