Metabolic effects of physical exercise in insulin-dependent diabetics controlled by continuous subcutaneous insulin infusion or conventional injection therapy

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Abstract
The metabolic and hormonal response to moderately severe exercise 2 h after breakfast was assessed in 8 insulin-dependent diabetics during conventional insulin injection therapy and after 3 wk of continuous s.c. insulin infusion. Blood glucose fell from 12.1 to 4.4 mmol/l on injection therapy; this was accompanied by a significant rise (P < 0.05) in free insulin to 57 mU/l. On infusion therapy plasma glucose fell and stabilized at 3.6 mmol/l from pre-exercise levels of 7.1 mmol/l, while free insulin level was unchanged at the end of the exercise period (31 mU/l). The fall in blood glucose on injection therapy was accompanied by an exaggerated growth hormone response to exercise that was normalized by 3 wk of infusion therapy. Basal and post-prandial levels of intermediary metabolites, catecholamines and glucagon were comparable on the 2 insulin regimens. Response during exercise were generally similar and no different from those of normal subjects with the exception of plasma NEFA [non-esterified fatty acids] levels which became abnormally suppressed. Good metabolic control of diabetes is accompanied by nearly normal hormonal and metabolic response to moderately severe exercise.

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