Abstract
Objectives
Exercise-induced hyperglycemia is recognized in type 1 diabetes (T1D) clinical guidelines,
but its association with high-intensity intermittent exercise (HIIE) in acute studies
is inconsistent. In this meta-analysis, we examined the available evidence of blood
glucose responses to HIIE in adults with T1D. The secondary, aim was to examine predictors
of blood glucose responses to HIIE. We hypothesized that there would be no consistent
effect on blood glucose from HIIE, unless examined in the context of participant prandial
status.
Methods
We conducted a literature search using key words related to T1D and HIIE. Studies
were required to include at least 6 participants with T1D with a mean age >18 years,
involve an HIIE intervention, and contain pre- and postexercise measures of blood
glucose. Analyses of extracted data were performed using a general inverse variance
statistical method with a random effects model and a weighted multiple regression.
Results
Nineteen interventions from 15 reports were included in the analysis. A mean overall
blood glucose decrease of −1.3 mmol/L (95% confidence interval [CI], −2.3 to −0.2
mmol/L) was found during exercise, albeit with high heterogeneity (I2=84%). When performed after an overnight fast, exercise increased blood glucose by +1.7
mmol/L (95% CI, 0.4 to 3.0 mmol/L), whereas postprandial exercise decreased blood
glucose by −2.1 mmol/L (95% CI, −2.8 to −1.4 mmol/L), with a statistically significant
difference between groups (p<0.0001). No associations with fitness (p=0.4), sex (p=0.4),
age (p=0.9), exercise duration (p=0.9), or interval duration (p=0.2) were found.
Conclusion
The effect of HIIE on blood glucose is inconsistent, but partially explained by prandial
status.
Résumé
Objectifs
Dans les lignes directrices de pratique clinique en matière de diabète de type 1 (DT1),
on reconnaît l’hyperglycémie induite par l’exercice, mais son association avec l’exercice
intermittent à haute intensité (EIHI) dans les études ponctuelles est incohérente.
Dans la présente méta-analyse, nous avons examiné les données probantes disponibles
sur les réponses de la glycémie à l’EIHI des adultes atteints du DT1. L’objectif secondaire
était d’examiner les prédicteurs des réponses de la glycémie à l’EIHI. Nous avons
posé l’hypothèse qu’il n’y aurait aucun effet cohérent de l’EIHI sur la glycémie,
sauf s’il était étudié dans le contexte de participants en état prandial.
Méthodes
Nous avons réalisé une recherche bibliographique à partir des mots clés en lien avec
le DT1 et l’EIHI. Les études devaient compter au moins 6 participants atteints du
DT1 dont l’âge moyen était de > 18 ans, porter sur une intervention d’EIHI, et comporter
des mesures de la glycémie avant et après l’exercice. Nous avons analysé les données
extraites à l’aide de la méthode statistique de la variance inverse générale avec
un modèle à effets aléatoires et une régression multiple pondérée.
Résultats
Nous avons inclus à l’analyse 19 interventions issues de 15 rapports. Nous avons observé
une diminution moyenne globale de la glycémie de −1,3 mmol/L (intervalle de confiance
[IC] à 95 %, de −2,3 à −0,2 mmol/L) durant l’exercice, mais une hétérogénéité élevée
(I2 = 84 %). Lorsque l’exercice était pratiqué à jeun le matin, la glycémie augmentait
de +1,7 mmol/L (IC à 95 %, de 0,4 à 3,0 mmol/L), alors que lorsque l’exercice était
pratiqué après un repas, la glycémie diminuait de −2,1 mmol/L (IC à 95 %, de −2,8
à −1,4 mmol/L), avec une différence statistiquement significative entre les groupes
(p < 0,0001). Nous n’avons observé aucune association avec la forme (p = 0,4), le
sexe (p = 0,4), l’âge (p = 0,9), la durée de l’exercice (p = 0,9) ou la durée des
intervalles (p = 0,2).
Conclusion
L’effet de l’EIHI sur la glycémie est incohérent, mais partiellement expliqué par
l’état prandial.
Keywords
Mots clés
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Article info
Publication history
Published online: November 24, 2022
Accepted:
November 22,
2022
Received in revised form:
November 21,
2022
Received:
October 12,
2022
Identification
Copyright
© 2022 Canadian Diabetes Association.
