Evidence mapPaperPMID 33020134Full record

Trial reportBMJ open diabetes research & care2020

Metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes.

Olivia McCarthy, Jason Pitt, Rachel Churm, Gareth J Dunseath, Charlotte Jones, Lia Bally, Christos T Nakas, Rachel Deere, Max L Eckstein, Stephen C Bain and 2 more

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 4 countries.

Olivia McCarthyApplied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University College of Engineering, Swansea, UK olivia.mccarthy@swansea.ac.uk.ORCID 0000-0001-6971-611X
Jason PittApplied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University College of Engineering, Swansea, UK.
Rachel ChurmApplied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University College of Engineering, Swansea, UK.
Gareth J DunseathDiabetes Research Group, Swansea University Medical School, Swansea, UK.
Charlotte JonesDiabetes Research Group, Swansea University Medical School, Swansea, UK.
Lia BallyDepartment of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital University Hospital Bern, Bern, Switzerland.ORCID 0000-0003-1993-7672
Christos T NakasLaboratory of Biometry, University of Thessaly, Volos, Thessaly, Greece.
Rachel DeereDepartment of Health, University of Bath, Bath, Somerset, UK.
Max L EcksteinDepartment of Internal Medicine, Medical University of Graz, Graz, Austria.
Stephen C BainDiabetes Research Group, Swansea University Medical School, Swansea, UK.
Othmar MoserDepartment of Internal Medicine, Medical University of Graz, Graz, Austria.ORCID 0000-0002-1661-0685
Richard M BrackenApplied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University College of Engineering, Swansea, UK.
Swansea University · GBMedical University of Graz · ATUniversity Hospital of Bern · CHUniversity of Bath · GBUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study sought to compare the metabolomic, hormonal and physiological responses to hypoglycemia versus euglycemia during exercise in adults with type 1 diabetes (T1D). RESEARCH DESIGN AND

methodsThirteen individuals with T1D (hemoglobin; 7.0%±1.3% (52.6±13.9 mmol/mol), age; 36±15 years, duration diabetes; 15±12 years) performed a maximum of 45 min submaximal exercise (60%±6% V̇O

resultsCardiorespiratory and counterregulatory hormone responses, whole-body fuel use and perception of fatigue during exercise were similar under conditions of hypoglycemia and euglycemia (BG 3.5±0.3 vs 5.8±1.1 mmol/L, respectively p<0.001). HypoEx was associated with greater adenosine salvage pathway activity (5'-methylthioadenosine, p=0.023 and higher cysteine and methionine metabolism), increased utilization of glucogenic amino acids (glutamine, p=0.021, alanine, aspartate and glutamate metabolism and homoserine/threonine, p=0.045) and evidence of enhanced β-oxidation (lower carnitine p<0.001, higher long-chain acylcarnitines).

conclusionsExposure to acute hypoglycemia during exercise potentiates alterations in subclinical indices of metabolic stress at the level of the metabolome. However, the physiological responses induced by dynamic physical exercise may mask the symptomatic recognition of mild hypoglycemia during exercise in people with T1D, a potential clinical safety concern that reinforces the need for diligent glucose management. TRIAL REGISTRATION NUMBER: DRKS00013509.

Indexed as

Diabetes Mellitus, Type 1HypoglycemiaAdultExerciseHumansInsulinMiddle AgedRetrospective StudiesYoung AdultInsulindiabetes mellitusenergy metabolismexercisehypoglycemiatype 1

Identifiers

PMID33020134
PMCPMC7536836
OpenAlexW3091170525

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.