Oral Presentation The Annual Scientific Meeting of the Australian Diabetes Society and the Australian Diabetes Educators Association 2013

Anaerobic Exercise at Self-Report in Adults With Type 1 Diabetes Co-segregates With Increased Exercise Duration But Not With Hypoglycaemia: A Potential Role for Resistance Exercise in Limiting Hypoglycaemia (#43)

Agata Piotrowicz 1 , Margaret McGill 2 , Jane Overland 2 , Lea Sorensen 2 , Stephen M Twigg 1
  1. Diabetes Centre, Department of Endocrinology, Royal Prince Alfred Hospital, and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  2. Diabetes Centre, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

Exercise in people with type 1 diabetes is associated with increased hypoglycaemia frequency and fear of hypoglycaemia. A potential role for regular anaerobic exercise (AnaE) to minimise hypoglycaemia has not been reported and was explored in this analysis.

Methods: n=79 adults with type 1 diabetes, 53% male, with mean±SD age 41.7±13.4 years, diabetes duration 18.3±13.2 years, HbA1c 8.3±1.4%, completed validated self-report questionnaires, pertaining to exercise type and frequency (Stanford), attitudes to exercise and fear of hypoglycaemia (HFS-II, FH-15). Only 6/79 that performed no exercise were excluded.

Results: On average, 209±193 minutes of weekly exercise was reported, with 192±164 minutes of AerE and 17.3 ± 47.8 minutes of AnaE, respectively. Only n=15 undertook AnaE, which all cases were combined with AerE, and total exercise averaged 1.9 fold more than AerE alone (n=58), with at least 83.0 minutes/week. While increased duration of total and AerE each correlated positively with fear of overall (r=0.30, P=0.01 and r=0.31, P=0.01) and nocturnal hypoglycaemia (r=0.30, P=0.01 and r=0.31, P=0.01), no such correlations were found for AnaE. Compared with undertaking similar duration AerE alone, AnaE was associated with ~3 fold fewer hypoglycaemia events (severe: 5.75vs1.90 /12 months P=0.041; mod.: 4.62vs1.55 /6months P=0.055; mild:4.02vs 1.35/month P=0.13, for AnaE vs AerE respectively).

For lack of hypoglycaemia awareness (LOHA), 52% sensed hypoglycaemia normally with BGL symptom threshold 3.3-3.8 mM, but 31% (2.7-3.2), 6% (2.7-2.2) and 10% (<2.2) mM. Data indicate that greater severity of LOHA occurs with greater duration of total or AerE, whereas increased AnaE relatively protects against more severe LOHA.

Conclusion: This self-reported data suggests that compared with aerobic exercise alone, anaerobic exercise in a mixed regimen may protect against hypoglycaemia and lack of hypoglycaemia awareness. A prospective intervention study of mixed exercise appears warranted to determine if it can help prevent exercise-induced hypoglycaemia in type 1 diabetes.