Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 21;9(2):164.
doi: 10.3390/nu9020164.

Metabolic Effects of Glucose-Fructose Co-Ingestion Compared to Glucose Alone during Exercise in Type 1 Diabetes

Lia Bally  1 , Patrick Kempf  2 , Thomas Zueger  3 , Christian Speck  4 , Nicola Pasi  5 , Carlos Ciller  6   7 , Katrin Feller  8 , Hannah Loher  9 , Robin Rosset  10 , Matthias Wilhelm  11 , Chris Boesch  12 , Tania Buehler  13 , Ayse S Dokumaci  14 , Luc Tappy  15 , Christoph Stettler  16
Affiliations

Metabolic Effects of Glucose-Fructose Co-Ingestion Compared to Glucose Alone during Exercise in Type 1 Diabetes

Lia Bally et al. Nutrients. .

Abstract

This paper aims to compare the metabolic effects of glucose-fructose co-ingestion (GLUFRU) with glucose alone (GLU) in exercising individuals with type 1 diabetes mellitus. Fifteen male individuals with type 1 diabetes (HbA1c 7.0% ± 0.6% (53 ± 7 mmol/mol)) underwent a 90 min iso-energetic continuous cycling session at 50% VO2max while ingesting combined glucose-fructose (GLUFRU) or glucose alone (GLU) to maintain stable glycaemia without insulin adjustment. GLUFRU and GLU were labelled with 13C-fructose and 13C-glucose, respectively. Metabolic assessments included measurements of hormones and metabolites, substrate oxidation, and stable isotopes. Exogenous carbohydrate requirements to maintain stable glycaemia were comparable between GLUFRU and GLU (p = 0.46). Fat oxidation was significantly higher (5.2 ± 0.2 vs. 2.6 ± 1.2 mg·kg-1·min-1, p < 0.001) and carbohydrate oxidation lower (18.1 ± 0.8 vs. 24.5 ± 0.8 mg·kg-1·min-1p < 0.001) in GLUFRU compared to GLU, with decreased muscle glycogen oxidation in GLUFRU (10.2 ± 0.9 vs. 17.5 ± 1.0 mg·kg-1·min-1, p < 0.001). Lactate levels were higher (2.2 ± 0.2 vs. 1.8 ± 0.1 mmol/L, p = 0.012) in GLUFRU, with comparable counter-regulatory hormones between GLUFRU and GLU (p > 0.05 for all). Glucose and insulin levels, and total glucose appearance and disappearance were comparable between interventions. Glucose-fructose co-ingestion may have a beneficial impact on fuel metabolism in exercising individuals with type 1 diabetes without insulin adjustment, by increasing fat oxidation whilst sparing glycogen.

Keywords: carbohydrates; exercise; fructose; glucose; glycaemia; substrate oxidation; type 1 diabetes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Carbohydrate administration during first, second, and third 30 min-intervals of exercise. GLUFRU (glucose-fructose co-ingestion) = dark grey bar and GLU (glucose alone ingestion) = light grey bar. Results are expressed as mean ± SEM.
Figure 2
Figure 2
Measured blood glucose and insulin during GLUFRU (black circle) and GLU (white circle). Left to right: blood glucose, p = 0.67; insulin, p = 0.89. Results are expressed as mean ± SEM.
Figure 3
Figure 3
Measured hormones and metabolites during GLUFRU (black circle) and GLU (white circle). Clockwise from top left: lactate, p = 0.012; non-esterified fatty acids (NEFAs), p = 0.43; growth hormone, p = 0.50; adrenaline, p = 0.39; dopamine, p = 0.037; cortisol, p = 0.54; noradrenaline, p = 0.45; glucagon, p = 0.16. Results are expressed as mean ± SEM.
Figure 3
Figure 3
Measured hormones and metabolites during GLUFRU (black circle) and GLU (white circle). Clockwise from top left: lactate, p = 0.012; non-esterified fatty acids (NEFAs), p = 0.43; growth hormone, p = 0.50; adrenaline, p = 0.39; dopamine, p = 0.037; cortisol, p = 0.54; noradrenaline, p = 0.45; glucagon, p = 0.16. Results are expressed as mean ± SEM.
Figure 4
Figure 4
Carbohydrate (CHO) and fat oxidation during GLUFRU (black circle) and GLU (white circle). Results are expressed as mean ± SEM. Left to right: CHO oxidation, p < 0.001; fat oxidation, p < 0.001.
See this image and copyright information in PMC

References

    1. LaPorte R.E., Dorman J.S., Tajima N., Cruickshanks K.J., Orchard T.J., Cavender D.E., Becker D.J., Drash A.L. Pittsburgh Insulin-Dependent Diabetes Mellitus Morbidity and Mortality Study: Physical activity and diabetic complications. Pediatrics. 1986;78:1027–1033. - PubMed
    1. Zoppini G., Carlini M., Muggeo M. Self-reported exercise and quality of life in young type 1 diabetic subjects. Diabetes Nutr. Metab. 2003;16:77–80. - PubMed
    1. Brazeau A.S., Rabasa-Lhoret R., Strychar I., Mircescu H. Barriers to physical activity among patients with type 1 diabetes. Diabetes Care. 2008;31:2108–2109. doi: 10.2337/dc08-0720. - DOI - PMC - PubMed
    1. Riddell M.C., Gallen I.W., Smart C.E., Taplin C.E., Adolfsson P., Lumb A.N., Kowalski A., Rabasa-Lhoret R., McCrimmon R.J., Hume C., et al. Exercise management in type 1 diabetes: A consensus statement. Lancet Diabetes Endocrinol. 2017 doi: 10.1016/S2213-8587(17)30014-1. - DOI - PubMed
    1. McAuley S.A., Horsburgh J.C., Ward G.M., La Gerche A., Gooley J.L., Jenkins A.J., MacIsaac R.J., O’Neal D.N. Insulin pump basal adjustment for exercise in type 1 diabetes: A randomised crossover study. Diabetologia. 2016;59:1636–1644. doi: 10.1007/s00125-016-3981-9. - DOI - PubMed

MeSH terms