Fructose boost may alleviate type 1 diabetes exercise-induced hypoglycemia risk
medwireNews: Consuming a single shot of fructose prior to exercise is a feasible strategy to reduce the risk for exercise-induced hypoglycemia among men with type 1 diabetes treated with insulin degludec, suggest findings from a proof-of-concept study.
The randomized crossover study included 14 men with an average type 1 diabetes duration of 17.5 years and mean glycated hemoglobin (HbA1c) levels of 6.9% (52 mmol/mol). They completed two 1-hour aerobic cycling sessions 30 minutes after consuming 200 mL water with or without 20 g of dissolved fructose.
As reported in Diabetes Care, just one (7.1%) participant experienced exercise-induced hypoglycemia after fructose consumption, compared with six (42.9%) in the control arm, translating into a significant 87.8% risk reduction with fructose.
Christoph Stettler (University of Bern, Switzerland) and co-investigators say that average plasma glucose levels were comparable in the fructose and control groups at baseline, at 6.5 versus 6.3 mmol/L (117.2 vs 113.6 mg/dL), but fructose intake “gradually increased” plasma glucose by a maximum of 1.8 mmol/L over 50 minutes, “thereby effectively preventing hypoglycemia without inducing unfavorable plasma glucose spikes.”
Average glucose levels during exercise were significantly higher after fructose versus water consumption, at 7.3 versus 5.5 mmol/L (131.6 vs 99.2 mg/dL).
The investigators say that fructose “was well tolerated,” with no reports of discomfort or other adverse events, episodes of severe hypoglycemia, or hyperglycemia with ketosis.
Stettler and colleagues caution that their study had a number of limitations, including lack of an active comparator and the exclusion of women “due to the well-known effects of sex-related differences in hormonal responses, exercise-related fuel metabolism, and fructose utilization.”
Nonetheless, they believe the findings support the concept that “[p]re-exercise intake of fructose is an easily feasible, effective, and well-tolerated strategy to alleviate the risk of exercise-induced hypoglycemia while avoiding hyperglycemia.”
And the team concludes that “further studies are warranted to investigate the metabolic effects of fructose consumption in females with type 1 diabetes engaging in exercise.”
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