Abstract：
OBJECTIVE: Exercise-induced hyperglycemia is recognized in type 1 diabetes (T1D) clinical guidelines, but its association with high-intensity intermittent exercise (HIIE) in acute studies is inconsistent. In this meta-analysis, we examined the available evidence of blood glucose responses to HIIE in adults with T1D. The secondary, aim was to examine predictors of blood glucose responses to HIIE. We hypothesized that there would be no consistent effect on blood glucose from HIIE, unless examined in the context of participant prandial status.
METHODS: We conducted a literature search using key words related to T1D and HIIE. Studies were required to include at least 6 participants with T1D with a mean age >18 years, involve an HIIE intervention, and contain pre- and postexercise measures of blood glucose. Analyses of extracted data were performed using a general inverse variance statistical method with a random effects model and a weighted multiple regression.
RESULTS: Nineteen interventions from 15 reports were included in the analysis. A mean overall blood glucose decrease of -1.3 mmol/L (95% confidence interval [CI], -2.3 to -0.2 mmol/L) was found during exercise, albeit with high heterogeneity (I2=84%). When performed after an overnight fast, exercise increased blood glucose by +1.7 mmol/L (95% CI, 0.4 to 3.0 mmol/L), whereas postprandial exercise decreased blood glucose by -2.1 mmol/L (95% CI, -2.8 to -1.4 mmol/L), with a statistically significant difference between groups (p<0.0001). No associations with fitness (p=0.4), sex (p=0.4), age (p=0.9), exercise duration (p=0.9), or interval duration (p=0.2) were found.
CONCLUSIONS: The effect of HIIE on blood glucose is inconsistent, but partially explained by prandial status.
METHODS: We conducted a literature search using key words related to T1D and HIIE. Studies were required to include at least 6 participants with T1D with a mean age >18 years, involve an HIIE intervention, and contain pre- and postexercise measures of blood glucose. Analyses of extracted data were performed using a general inverse variance statistical method with a random effects model and a weighted multiple regression.
RESULTS: Nineteen interventions from 15 reports were included in the analysis. A mean overall blood glucose decrease of -1.3 mmol/L (95% confidence interval [CI], -2.3 to -0.2 mmol/L) was found during exercise, albeit with high heterogeneity (I2=84%). When performed after an overnight fast, exercise increased blood glucose by +1.7 mmol/L (95% CI, 0.4 to 3.0 mmol/L), whereas postprandial exercise decreased blood glucose by -2.1 mmol/L (95% CI, -2.8 to -1.4 mmol/L), with a statistically significant difference between groups (p<0.0001). No associations with fitness (p=0.4), sex (p=0.4), age (p=0.9), exercise duration (p=0.9), or interval duration (p=0.2) were found.
CONCLUSIONS: The effect of HIIE on blood glucose is inconsistent, but partially explained by prandial status.
摘要：
目的：运动诱发的高血糖在1型糖尿病（T1D）临床指南中得到认可，但其与急性研究中高强度间歇性运动(HIIE)的相关性不一致.在这项荟萃分析中，我们检查了成人T1D患者对HIIE的血糖反应的可用证据。次要目的是检查对HIIE的血糖反应的预测因子。我们假设HIIE对血糖没有一致的影响，除非在参与者的餐时状态下进行检查。
方法：我们使用与T1D和HIIE相关的关键词进行了文献检索。研究要求包括至少6名平均年龄>18岁的T1D参与者，涉及HIIE干预，并包含运动前和运动后的血糖测量。使用具有随机效应模型和加权多元回归的一般逆方差统计方法对提取的数据进行分析。
结果：分析包括15份报告中的19项干预措施。平均总血糖下降-1.3mmol/L(95%置信区间[CI]，-2.3至-0.2mmol/L）在运动过程中发现，尽管具有高度异质性（I2=84%）。当在一夜禁食后进行时，运动使血糖增加+1.7mmol/L（95%CI，0.4-3.0mmol/L），而餐后运动使血糖下降-2.1mmol/L（95％CI，-2.8至-1.4mmol/L），组间差异有统计学意义(p<0.0001)。与健身无关（p=0.4），性别（p=0.4），年龄（p=0.9），运动持续时间(p=0.9)或间隔时间(p=0.2)。
结论：HIIE对血糖的影响不一致，但部分解释为膳食状态。
方法：我们使用与T1D和HIIE相关的关键词进行了文献检索。研究要求包括至少6名平均年龄>18岁的T1D参与者，涉及HIIE干预，并包含运动前和运动后的血糖测量。使用具有随机效应模型和加权多元回归的一般逆方差统计方法对提取的数据进行分析。
结果：分析包括15份报告中的19项干预措施。平均总血糖下降-1.3mmol/L(95%置信区间[CI]，-2.3至-0.2mmol/L）在运动过程中发现，尽管具有高度异质性（I2=84%）。当在一夜禁食后进行时，运动使血糖增加+1.7mmol/L（95%CI，0.4-3.0mmol/L），而餐后运动使血糖下降-2.1mmol/L（95％CI，-2.8至-1.4mmol/L），组间差异有统计学意义(p<0.0001)。与健身无关（p=0.4），性别（p=0.4），年龄（p=0.9），运动持续时间(p=0.9)或间隔时间(p=0.2)。
结论：HIIE对血糖的影响不一致，但部分解释为膳食状态。
