Abstract
Purpose
To compare the effect of high-intensity aerobic (AER), resistance (RES), and combined (COMB: RES + AER) exercise, on interstitial glucose (IG) variability and skeletal muscle signalling pathways in type 1 diabetes (T1D).
Methods
T1D participants (6 M/6F) wore a flash glucose monitoring system in four randomized sessions: one control (CONT), and one AER, RES and COMB (40 min each). Mean amplitude of glycemic excursions (MAGE), standard deviation (SD) and coefficient variation (CV) of IG were used to compare the 24 h post-exercise IG variability. Blood and muscle samples were collected to compare exercise-induced systemic and muscle signalling responses related to metabolic, growth and inflammatory adaptations.
Results
Both RES and COMB decreased the 24 h MAGE compared to CONT; additionally, COMB decreased the 24 h SD and CV. In the 6–12 h post-exercise, all exercise modalities reduced the IG CV while SD decreased only after COMB. Both AER and COMB stimulated the PGC-1α mRNA expression and promoted the splicing of IGF-1Ea variant, while Akt and p38MAPK phosphorylation increased only after RES and COMB. Additionally, COMB enhanced eEF2 activation and RES increased myogenin and MRF4 mRNA expression. Blood lactate and glycerol levels and muscle IL-6, TNF-α, and MCP-1 mRNAs increased after all exercise sessions, while serum CK and LDH level did not change.
Conclusion
COMB is more effective in reducing IG fluctuations compared to single-mode AER or RES exercise. Moreover, COMB simultaneously activates muscle signalling pathways involved in substrate metabolism and anabolic adaptations, which can help to improve glycaemic control and maintain muscle health in T1D.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Abbreviations
- AER:
-
Aerobic
- Akt:
-
AKT serine/threonine kinase 1
- AMPK:
-
Protein kinase AMP-activated catalytic subunit alpha 1
- ANOVA:
-
Analysis of variance
- ATP:
-
Adenosine triphosphate
- B2M:
-
Beta-2-microglobulin
- BMI:
-
Body mass index
- CK:
-
Creatine kinase
- COMB:
-
Combined
- CONT:
-
Control
- CV:
-
Coefficient of variation
- DEXA:
-
Dual-energy X-ray absorptiometry
- eEF2:
-
Eukaryotic translation elongation factor 2
- ERK1/2:
-
Extracellular signal-regulated protein kinases 1 and 2
- FGM:
-
Flash interstitial glucose monitoring
- GAPDH:
-
Glyceraldehyde-3-phosphate dehydrogenase
- GLUT4:
-
Solute carrier family 2, facilitated glucose transporter member 4
- GPAQ:
-
Global Physical Activity Questionnaire
- HbA1c:
-
Glycated hemoglobin
- HR:
-
Heart rate
- HRR:
-
Heart rate reserve
- IG:
-
Interstitial glucose
- IGF-1:
-
Insulin-like growth factor 1
- IGF1R:
-
Insulin-like growth factor 1 Receptor
- IL-6:
-
Interleukin-6
- LDH:
-
Lactate dehydrogenase
- MAGE:
-
Mean amplitude of glycemic excursions
- MCP-1:
-
Monocyte chemoattractant protein 1/C–C motif chemokine 2
- MRF4:
-
Myogenic regulatory factor 4/Myogenic factor 6
- mRNA:
-
Messenger ribonucleic acid
- mTOR:
-
Mechanistic target of rapamycin kinase
- Myf5:
-
Myogenic factor 5
- MyoD:
-
Myogenic differentiation 1
- p38MAPK:
-
P38 map kinase
- PGC-1α:
-
Peroxisome proliferative activated receptor, gamma, coactivator 1 alpha
- PI3K:
-
Phosphatidylinositol-4,5-bisphosphate 3-kinase
- 1RM:
-
One-repetition maximum
- RES:
-
Resistance
- RT-PCR:
-
Real-time polymerase chain reaction
- SD:
-
Standard deviation
- T1D:
-
Type 1 diabetes
- TNF-α:
-
Tumor necrosis factor-alpha
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Acknowledgements
Mr. Minnock was supported in this research by the Irish Research Council, where he is the recipient of the IRC EBS fellowship award (EBPPG/2016/278). All sensors and FGM systems were generously provided by Innovation Zed Ltd, Dublin, Ireland. We also thank Dr. Patricia Martins Bock (Hospital de Clínicas de Porto Alegre) for the advice on the glucose variability analysis.
Funding
This research was supported by the Irish Research Council where Dean Minnock is the recipient of the IRC EBS fellowship award (EBPPG/2016/278).
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DM and GDV conceived and designed the study. DM, GA and GDV analysed the data and drafted the manuscript. DM, CWLR, MK and GDV designed, prescribed and supervised the exercise sessions and contributed to the drafting of the manuscript. DM, SC, RS, GV and GDV collected, processed and stored the biological samples. GA, SC, RS, GV and EB performed the RT-PCR experiments and western blotting. CWLR, MK, VS, EB, and GDV provided overall direction to the project and revised the manuscript. All authors contributed to manuscript revision, read and approved the submitted version.
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Innovation Zed Ltd, are a medical technology company based in Dublin, Ireland developing technologies for self-injection devices and declares no conflict of interest or self-gain from this study. This study has no other potential conflicts of interest relevant to this study.
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This study was approved by the Human Research Ethics Committee of University College Dublin (Application ID-LS-16-67-Minnock-DeVito).
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Minnock, D., Annibalini, G., Le Roux, C.W. et al. Effects of acute aerobic, resistance and combined exercises on 24-h glucose variability and skeletal muscle signalling responses in type 1 diabetics. Eur J Appl Physiol 120, 2677–2691 (2020). https://doi.org/10.1007/s00421-020-04491-6
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DOI: https://doi.org/10.1007/s00421-020-04491-6