Exercise effects (EE) on whole body glucose rate of disappearance (Rd) occur through insulin- independent (IIRd) and insulin-dependent (IDRd) mechanisms. Quantifying these processes in vivo would allow a better understanding of the physiology of glucose regulation. This is of particular importance in individuals with type 1 diabetes (T1D) since such a knowledge may help to improve glucose management. However, such a model is still lacking. Here, we analyzed data from 6 T1D and 6 nondiabetic (ND) subjects undergoing a labeled glucose clamp study during, before and after a 60 min exercise session at 65% VO₂max on three randomized visits: euglycemia-low insulin, euglycemia-high insulin and hyperglycemia-low insulin. We tested a set of models, all sharing a single-compartment description of glucose kinetics, but differing in how exercise is assumed to modulate glucose disposal. Model selection was based on parsimony criteria. The best model assumed an exercise-induced immediate effect on IIRd and a delayed effect on IDRd. It predicted that exercise increases IIRd, compared to rest, by 66% - 82% and 67% - 97% in T1D and ND, respectively, not significantly different between the two groups. Conversely, the exercise effect on IDRd ranged between 81% - 155% in T1D and it was significantly higher than ND, which ranged between 10% - 40%. The exaggerated effect observed in IDRd can explain the higher hypoglycemia risk related to T1D individuals. This novel exercise model could help in informing safe and effective glucose management during and after exercise in T1D individuals.

中文翻译：

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运动对健康和 1 型糖尿病患者胰岛素依赖型和胰岛素非依赖型葡萄糖利用的影响。建模研究。

运动效应 (EE) 对全身葡萄糖消失率 (Rd) 的影响通过胰岛素非依赖性 (IIRd) 和胰岛素依赖性 (IDRd) 机制发生。在体内量化这些过程将有助于更好地了解葡萄糖调节的生理学。这对于 1 型糖尿病 (T1D) 患者尤其重要，因为此类知识可能有助于改善血糖管理。然而，这样的模型仍然缺乏。在这里，我们分析了 6 名 T1D 和 6 名非糖尿病 (ND) 受试者的数据，这些受试者在 65% VO ₂的 60 分钟锻炼期间、之前和之后进行了标记葡萄糖钳夹研究最多 3 次随机访问：正常血糖 - 低胰岛素、正常血糖 - 高胰岛素和高血糖 - 低胰岛素。我们测试了一组模型，所有模型都共享一个葡萄糖动力学的单室描述，但在假设运动如何调节葡萄糖处理方面有所不同。模型选择基于简约标准。最好的模型假设运动引起的对 IIRd 的直接影响和对 IDRd 的延迟影响。它预测，与休息相比，运动使 T1D 和 ND 的 IIRd 分别增加 66% - 82% 和 67% - 97%，两组之间没有显着差异。相反，运动对 IDRd 的影响在 T1D 中介于 81% - 155% 之间，并且显着高于 ND，后者介于 10% - 40% 之间。在 IDRd 中观察到的夸大效应可以解释与 T1D 个体相关的较高低血糖风险。