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June 9, 2009DiabetesOpen Access

Effects of Differing Antecedent Increases of Plasma Cortisol on Counterregulatory Responses During Subsequent Exercise in Type 1 Diabetes

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Why the study?

Does antecedent increase in plasma cortisol blunt counterregulatory responses during subsequent exercise in patients with type 1 diabetes?

Population

22 type 1 diabetic subjects (11 men and 11 women, age 27 +/- 2 years, BMI 24 +/- 1 kg/m2, A1C 7.9 +/- 0.2%)

Comparison

Antecedent hypoglycemia, euglycemia with… vs Antecedent euglycemia during 2-h…

Design

RCT, randomized 2-day protocols

Follow-up

2 days per protocol

Authors

SBShichun BaoShenzhen UniversityVBVanessa Jones BriscoeVanderbilt UniversityDTDonna B. TateUniversity of Baltimore

Discussion

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Implication

Antecedent cortisol blunts counterregulatory responses to exercise in T1D; confirms mechanism of hypoglycemia-associated autonomic failure.

Structured PICO

Does antecedent increase in plasma cortisol blunt counterregulatory responses during subsequent exercise in patients with type 1 diabetes?

P
Population
22 type 1 diabetic subjects (11 men and 11 women, age 27 +/- 2 years, BMI 24 +/- 1 kg/m2, A1C 7.9 +/- 0.2%)
I
Intervention
Antecedent hypoglycemia (2.9 mmol/l), euglycemia with physiologic low-dose intravenous cortisol, or euglycemia with high-dose intravenous cortisol during 2-h hyperinsulinemic clamps on Day 1
C
Comparator
Antecedent euglycemia (5.1 mmol/l) during 2-h hyperinsulinemic clamps on Day 1
O
Outcome
Neuroendocrine, autonomic nervous system, and metabolic counterregulatory responses (glucagon, growth hormone, epinephrine, norepinephrine, pancreatic polypeptide, endogenous glucose production, and lipolysis) during 90-min euglycemic cycling exercise on Day 2surrogate

Antecedent physiologic increases in cortisol blunt neuroendocrine and metabolic counterregulatory responses during subsequent exercise in type 1 diabetes, suggesting a mechanism for exercise-related counterregulatory failure.

Cite This Study

Bao et al. (2009) studied this question.

synapsesocial.com/papers/6a910cc31cb9ea1c853e7a8dhttps://doi.org/10.2337/db09-0382
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Glucose clamp technique: a method for quantifying insulin secretion and resistance.1979 · 7,488 citations
  2. 2Prevention of an increase in plasma cortisol during hypoglycemia preserves subsequent counterregulatory responses.1997 · 98 citations
  3. 3Elevated endogenous cortisol reduces autonomic neuroendocrine and symptom responses to subsequent hypoglycemia2002 · 68 citations
  4. 4Effects of glucocorticoids on energy metabolism and food intake in humans1996 · 416 citations
  5. 5The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus1993 · 24,816 citations