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PREDICCION DE LA CANTIDAD DE CARBOHIDRATOS UTILIZADOS DURANTE EL EJERCICIO

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El presente estudio ilustra que el concepto del "pulso de glucosa", es decir la tasa de oxidación de la glucosa expresada por unidad de frecuencia cardíaca, podría ser de utilidad en la práctica clínica para predecir la cantidad de carbohidratos utilizados durante el ejercicio con el objetivo de prevenir la hipoglucemia en pacientes con diabetes tipo 1.
francescato9.jpg Autor:
Maria pia Francescato
Columnista Experto de SIIC

Institución:
Department of Biomedical Sciences and Technologies, University of Udine

Artículos publicados por Maria pia Francescato
Coautores
Mario Geat* Luigi Cattin* 
MD, Department of Clinical, Morphological and Technological Sciences, University of Trieste, Trieste, Italia*
Recepción del artículo
15 de Agosto, 2006 		Aprobación
17 de Agosto, 2006
Primera edición
15 de Enero, 2007 		Segunda edición, ampliada y corregida
7 de Junio, 2021

PREDICCION DE LA CANTIDAD DE CARBOHIDRATOS UTILIZADOS DURANTE EL EJERCICIO

Resumen
Durante el ejercicio, los pacientes diabéticos sufren con frecuencia desequilibrios metabólicos debido a la ausencia de secreción de insulina. El objetivo primario de este estudio fue identificar un método simple para predecir la cantidad de glucosa oxidada durante el ejercicio. Quince pacientes con diabetes tipo 1 y 15 controles sanos apareados (18 a 45 años; masa corporal 70.5 ± 9.5 kg) se ejercitaron en un cicloergómetro a 4 intensidades durante 10 minutos en cada caso. Durante los últimos 5 minutos de cada prueba se registró el consumo de oxígeno, la producción de dióxido de carbono y la frecuencia cardíaca (FC). Estos datos permitieron calcular la tasa de oxidación de la glucosa (GLUox) y la relación entre GLUox y la FC fue definida como "pulso de glucosa". A los pacientes se les administraron cantidades estimadas de carbohidratos antes del ejercicio o durante su realización. Durante el ejercicio, la GLUox aumentó con el incremento de la FC sin diferencias significativas entre los grupos, mientras que el entrenamiento referido por los pacientes mostró un efecto significativo (p < 0.005). Las relaciones entre GLUox y el porcentaje de frecuencia cardíaca máxima (%FCmáx) puede describirse mediante las siguientes ecuaciones: GLUox = 0.504 · %FCmáx - 22.11 (n = 36; R = 0.888) [pacientes entrenados]; GLUox = 0.679 · %FCmáx - 22.05 (n = 29; R = 0.909) [pacientes sedentarios]. El presente estudio demuestra que el "pulso de glucosa" podría ser de utilidad en la práctica clínica para predecir la cantidad de carbohidratos utilizados durante el ejercicio.

Palabras clave
hipoglucemia, diabetes tipo 1, ejercicio, tasa de oxidación de la glucosa, aptitud física


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PREVENTION OF EXERCISE-INDUCED HYPOGLYCEMIA IN TYPE 1 DIABETIC PATIENTS

Abstract
Type 1 diabetic patients undergo frequent metabolic imbalances during exercise due to the lack of insulin release. The primary aim of this study was to identify a simple method for predicting the amount of oxidized glucose during exercise. Fifteen type 1 diabetic patients and 15 healthy matched controls (18-45 years; body mass: 70.5 ± 9.5 kg) exercised on a cycloergometer at 4 intensities for 10 minutes each. Oxygen consumption, carbon dioxide production and heart rate (HR) were acquired during the last 5 minutes of each test, enabling us to calculate the glucose oxidation rate (GLUox) and ratio between GLUox and HR defined as "glucose pulse". Patients were given estimated amounts of carbohydrates prior to and/or during exercise. During exercise, GLUox increased with increasing HR without significant difference between groups, whereas self-reported training showed a significant effect (p < 0.005). The relationships between GLUox and percentage of maximal heart rate (%HRmax) can be described by the following equations: GLUox = 0.504 · %HRmax - 22.11 (n = 36; R = 0.888) and GLUox = 0.679 · %HRmax - 22.05 (n = 29; R = 0.909) for trained and sedentary patients, respectively. The present study shows that the "glucose pulse" could be useful in clinical practice to predict the amount of carbohydrates utilized during exercise.

Key words
hypoglycemia, type 1 diabetes, exercise, glucose oxidation rate, fitness level


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Especialidades
Principal: Diabetología, Nutrición
Relacionadas: Atención Primaria, Endocrinología y Metabolismo, Medicina Deportiva, Medicina Familiar, Medicina Interna, Pediatría



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Enviar correspondencia a:
Maria Pia Francescato, Deparment of Biomedical Sciences and Technologies, University of Udine, 33100, P.le Kolbe 4, Udine, Italia
Patrocinio y reconocimiento:
Agradecimientos: A los dres. E. Tosoratti y S. Lazzer por su ayuda durante las sesiones experimentales y al Prof. P. E. di Prampero por sus útiles comentarios.
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