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Effect of sex on counterregulatory responses to exercise after antecedent hypoglycemia in type 1 diabetes.
Am J Physiol Endocrinol Metab. 2004 Jul; 287(1):E16-24.AJ

Abstract

A marked sexual dimorphism exists in healthy individuals in the pattern of blunted neuroendocrine and metabolic responses following antecedent stress. It is unknown whether significant sex-related counterregulatory differences occur during prolonged moderate exercise after antecedent hypoglycemia in type 1 diabetes mellitus (T1DM). Fourteen patients with T1DM (7 women and 7 men) were studied during 90 min of euglycemic exercise at 50% maximal O(2) consumption after two 2-h episodes of previous-day euglycemia (5.0 mmol/l) or hypoglycemia of 2.9 mmol/l. Men and women were matched for age, glycemic control, duration of diabetes, and exercise fitness and had no history or evidence of autonomic neuropathy. Exercise was performed during constant "basal" intravenous infusion of regular insulin (1 U/h) and a 20% dextrose infusion, as needed to maintain euglycemia. Plasma glucose and insulin levels were equivalent in men and women during all exercise and glucose clamp studies. Antecedent hypoglycemia produced a relatively greater (P < 0.05) reduction of glucagon, epinephrine, norepinephrine, growth hormone, and metabolic (glucose kinetics) responses in men compared with women during next-day exercise. After antecedent hypoglycemia, endogenous glucose production (EGP) was significantly reduced in men only, paralleling a reduction in the glucagon-to-insulin ratio and catecholamine responses. In conclusion, a marked sexual dimorphism exists in a wide spectrum of blunted counterregulatory responses to exercise in T1DM after prior hypoglycemia. Key neuroendocrine (glucagon, catecholamines) and metabolic (EGP) homeostatic responses were better preserved during exercise in T1DM women after antecedent hypoglycemia. Preserved counterregulatory responses during exercise in T1DM women may confer greater protection against hypoglycemia than in men with T1DM.

Authors+Show Affiliations

715 PRB, Division of Diabetes, Endocrinology & Metabolism, Vanderbilt Univ. School of Medicine, Nashville, TN 37232-6303, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14998785

Citation

Galassetti, Pietro, et al. "Effect of Sex On Counterregulatory Responses to Exercise After Antecedent Hypoglycemia in Type 1 Diabetes." American Journal of Physiology. Endocrinology and Metabolism, vol. 287, no. 1, 2004, pp. E16-24.
Galassetti P, Tate D, Neill RA, et al. Effect of sex on counterregulatory responses to exercise after antecedent hypoglycemia in type 1 diabetes. Am J Physiol Endocrinol Metab. 2004;287(1):E16-24.
Galassetti, P., Tate, D., Neill, R. A., Morrey, S., Wasserman, D. H., & Davis, S. N. (2004). Effect of sex on counterregulatory responses to exercise after antecedent hypoglycemia in type 1 diabetes. American Journal of Physiology. Endocrinology and Metabolism, 287(1), E16-24.
Galassetti P, et al. Effect of Sex On Counterregulatory Responses to Exercise After Antecedent Hypoglycemia in Type 1 Diabetes. Am J Physiol Endocrinol Metab. 2004;287(1):E16-24. PubMed PMID: 14998785.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of sex on counterregulatory responses to exercise after antecedent hypoglycemia in type 1 diabetes. AU - Galassetti,Pietro, AU - Tate,Donna, AU - Neill,Ray A, AU - Morrey,Sachiko, AU - Wasserman,David H, AU - Davis,Stephen N, Y1 - 2004/03/02/ PY - 2004/3/5/pubmed PY - 2004/7/23/medline PY - 2004/3/5/entrez SP - E16 EP - 24 JF - American journal of physiology. Endocrinology and metabolism JO - Am J Physiol Endocrinol Metab VL - 287 IS - 1 N2 - A marked sexual dimorphism exists in healthy individuals in the pattern of blunted neuroendocrine and metabolic responses following antecedent stress. It is unknown whether significant sex-related counterregulatory differences occur during prolonged moderate exercise after antecedent hypoglycemia in type 1 diabetes mellitus (T1DM). Fourteen patients with T1DM (7 women and 7 men) were studied during 90 min of euglycemic exercise at 50% maximal O(2) consumption after two 2-h episodes of previous-day euglycemia (5.0 mmol/l) or hypoglycemia of 2.9 mmol/l. Men and women were matched for age, glycemic control, duration of diabetes, and exercise fitness and had no history or evidence of autonomic neuropathy. Exercise was performed during constant "basal" intravenous infusion of regular insulin (1 U/h) and a 20% dextrose infusion, as needed to maintain euglycemia. Plasma glucose and insulin levels were equivalent in men and women during all exercise and glucose clamp studies. Antecedent hypoglycemia produced a relatively greater (P < 0.05) reduction of glucagon, epinephrine, norepinephrine, growth hormone, and metabolic (glucose kinetics) responses in men compared with women during next-day exercise. After antecedent hypoglycemia, endogenous glucose production (EGP) was significantly reduced in men only, paralleling a reduction in the glucagon-to-insulin ratio and catecholamine responses. In conclusion, a marked sexual dimorphism exists in a wide spectrum of blunted counterregulatory responses to exercise in T1DM after prior hypoglycemia. Key neuroendocrine (glucagon, catecholamines) and metabolic (EGP) homeostatic responses were better preserved during exercise in T1DM women after antecedent hypoglycemia. Preserved counterregulatory responses during exercise in T1DM women may confer greater protection against hypoglycemia than in men with T1DM. SN - 0193-1849 UR - https://www.unboundmedicine.com/medline/citation/14998785/Effect_of_sex_on_counterregulatory_responses_to_exercise_after_antecedent_hypoglycemia_in_type_1_diabetes_ DB - PRIME DP - Unbound Medicine ER -