PMID- 33632598
OWN - NLM
STAT- MEDLINE
DCOM- 20210405
LR  - 20221207
IS  - 1590-3729 (Electronic)
IS  - 0939-4753 (Linking)
VI  - 31
IP  - 4
DP  - 2021 Apr 9
TI  - Comparison of two carbohydrate intake strategies to improve glucose control 
      during exercise in adolescents and adults with type 1 diabetes.
PG  - 1238-1246
LID - S0939-4753(20)30520-2 [pii]
LID - 10.1016/j.numecd.2020.12.011 [doi]
AB  - BACKGROUND AND AIMS: During aerobic physical activity (PA), hypoglycemia is 
      common in people with type 1 diabetes (T1D). Few studies have compared the 
      effectiveness of different carbohydrate (CHO) intake strategies to prevent 
      PA-induced hypoglycemia. Our objective was to compare the efficacy of two CHO 
      intake strategies, same total amount but different CHO intake timing, to maintain 
      glucose levels in the target range (4.0-10.0 mmol/L) during PA in people with 
      T1D. METHODS AND RESULTS: An open-label, randomized, crossover study in 33 
      participants (21 adults; 12 adolescents). Participants practiced 60 min PA 
      sessions (ergocyle) at 60% VO(2peak) 3.5 h after lunch comparing an intake of 
      0.5 g of CHO per kg of body weight applied in a pre-PA single CHO intake (SCI) or 
      in a distributed CHO intake (DCI) before and during PA. The percentage of time 
      spent in glucose level target range during PA was not different between the two 
      strategies (SCI: 75 +/- 35%; DCI: 87 +/- 26%; P = 0.12). Hypoglycemia (<4.0 mmol/L) 
      occurred in 4 participants (12%) with SCI compared to 6 participants (18%) with 
      DCI (P = 0.42). The SCI strategy led to a higher increase (P = 0.01) and 
      variability of glucose levels (P = 0.04) compared with DCI. CONCLUSIONS: In 
      people living with T1D, for a 60 min moderate aerobic PA in the post-absorptive 
      condition, a 0.5 g/kg CHO intake helped most participants maintain acceptable 
      glycemic control with both strategies. No clinically significant difference was 
      observed between the SCI and DCI strategies. ClinicalTrials.gov Identifier: 
      NCT03214107 (July 11, 2017).
CI  - Copyright (c) 2020 The Italian Diabetes Society, the Italian Society for the Study 
      of Atherosclerosis, the Italian Society of Human Nutrition and the Department of 
      Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. 
      All rights reserved.
FAU - Goulet-Gelinas, Lucas
AU  - Goulet-Gelinas L
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada; Department of Nutrition, Faculty of Medicine, Universite de 
      Montreal, 2405 Chemin de La Cote-Sainte-Catherine, Montreal, Quebec, Canada.
FAU - Saade, Marie-Beatrice
AU  - Saade MB
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada; Research Center of Centre Hospitalier Universitaire 
      Sainte-Justine, 3175 Chemin de La Cote-Sainte-Catherine, Montreal, Quebec, 
      Canada.
FAU - Suppere, Corinne
AU  - Suppere C
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada.
FAU - Fortin, Andreanne
AU  - Fortin A
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada.
FAU - Messier, Virginie
AU  - Messier V
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada.
FAU - Taleb, Nadine
AU  - Taleb N
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada.
FAU - Tagougui, Semah
AU  - Tagougui S
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada; Department of Nutrition, Faculty of Medicine, Universite de 
      Montreal, 2405 Chemin de La Cote-Sainte-Catherine, Montreal, Quebec, Canada.
FAU - Shohoudi, Azadeh
AU  - Shohoudi A
AD  - Altasciences, 1200 Avenue Beaumont, Montreal, Quebec, Canada.
FAU - Legault, Laurent
AU  - Legault L
AD  - Department of Pediatrics, Division of Endocrinology and Metabolism, McGill 
      University Health Centre, 1001, Decarie, Montreal, Quebec, Canada.
FAU - Henderson, Melanie
AU  - Henderson M
AD  - Research Center of Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin 
      de La Cote-Sainte-Catherine, Montreal, Quebec, Canada; Department of Pediatrics, 
      Faculty of Medicine, Universite de Montreal, 3175 Chemin de La 
      Cote-Sainte-Catherine, Montreal, Quebec, Canada.
FAU - Rabasa-Lhoret, Remi
AU  - Rabasa-Lhoret R
AD  - Montreal Clinical Research Institute (IRCM), 110 Avenue des Pins Ouest, Montreal, 
      Quebec, Canada; Department of Nutrition, Faculty of Medicine, Universite de 
      Montreal, 2405 Chemin de La Cote-Sainte-Catherine, Montreal, Quebec, Canada; 
      Montreal Diabetes Research Center & Endocrinology Division, 900 Rue Saint-Denis, 
      Montreal, Quebec, Canada. Electronic address: remi.rabasa-lhoret@ircm.qc.ca.
LA  - eng
SI  - ClinicalTrials.gov/NCT03214107
GR  - CIHR/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20201217
PL  - Netherlands
TA  - Nutr Metab Cardiovasc Dis
JT  - Nutrition, metabolism, and cardiovascular diseases : NMCD
JID - 9111474
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Biomarkers/blood
MH  - Blood Glucose/*metabolism
MH  - Cross-Over Studies
MH  - Diabetes Mellitus, Type 1/blood/diagnosis/*diet therapy
MH  - Dietary Carbohydrates/*administration & dosage/metabolism
MH  - *Exercise
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - *Glycemic Control
MH  - Humans
MH  - Hypoglycemia/blood/etiology/*prevention & control
MH  - Male
MH  - Middle Aged
MH  - Quebec
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Carbohydrate intake
OT  - Glycemic control & hypoglycemia
OT  - Physical activity
OT  - Type 1 diabetes
COIS- Declaration of competing interest R.R.-L.: Research grants: Diabetes Canada, 
      Astra-Zeneca, E Lilly, Cystic Fibrosis Canada, CIHR, Janssen, JDRF, Merck, NIH, 
      Novo-Nordisk, Prometic Societe Francophone du Diabete, Sanofi-Aventis, Vertex 
      Pharmaceutical. Consulting/advisory panel: Abbott, Amgen, Astra-Zeneca, 
      Boehringer I, Dexcom, E Lilly, HSL therapeutics, Insulet, Janssen, Medtronic, 
      Merck, Neomed, Novo-Nordisk, Roche, Sanofi-Aventis. Honoraria for conferences: 
      Abbott, Astra-Zeneca, Boehringer I, CPD Network, Dexcom, E Lilly, Janssen, 
      Medtronic, Merck, Novo-Nordisk, Sanofi-Aventis, Vertex Pharmaceutical. Consumable 
      gift (in Kind): Animas, E Lilly, Medtronic. Unrestricted grants fors clinical and 
      educational activities: Abbott, E Lilly, Medtronic, Merck, Novo Nordisk, 
      Sanofi-Aventis. Patent: T2D risk biomarkers, catheter life. Purchase fees: E 
      Lilly (artificial pancreas). M.H.: holds a Diabetes Junior Investigator Award 
      from the Canadian Society of Endocrinology and Metabolism/AstraZeneca and a Fonds 
      de Recherche du Quebec - Sante Junior 2 salary award. L.L.: Lilly and Dexcom 
      advisory committee, research funds (paid to the institution): Merck, and 
      Astra-Zeneca. Intellectual property in the field of closed loop (not marketed). 
      V.M.: Purchase fees: E Lilly (artificial pancreas). L.G.-G: grants from IRSC, 
      grants from FRQS, during the conduct of the study. M.-B.S: Grants from JDRF/ISPAD 
      Research Fellowship, during the conduct of the study. C.S., A.F., N.T., S.T. & 
      A.S. have no relevant conflict of interest to disclose.
EDAT- 2021/02/27 06:00
MHDA- 2021/04/07 06:00
CRDT- 2021/02/26 05:44
PHST- 2020/07/08 00:00 [received]
PHST- 2020/12/08 00:00 [revised]
PHST- 2020/12/10 00:00 [accepted]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2021/04/07 06:00 [medline]
PHST- 2021/02/26 05:44 [entrez]
AID - S0939-4753(20)30520-2 [pii]
AID - 10.1016/j.numecd.2020.12.011 [doi]
PST - ppublish
SO  - Nutr Metab Cardiovasc Dis. 2021 Apr 9;31(4):1238-1246. doi: 
      10.1016/j.numecd.2020.12.011. Epub 2020 Dec 17.