Paradoxical Rise in Hypoglycemia Symptoms With Development of Hyperglycemia During High-Intensity Interval Training in Type 1 Diabetes.

Abstract

To assess the reliability of self-perception of glycemia during high-intensity interval training (HIIT) in subjects with type 1 diabetes. This randomized crossover study included subjects who completed four fasted HIIT sessions. Subjects answered the Edinburgh Hypoglycemia Scale, estimated their blood glucose (BG), and had plasma glucose (PG) collected throughout exercise and recovery. As PG increased throughout exercise, hypoglycemia scores increased across each category: autonomic (3.1-4.4, <i>P</i> < 0.05), neuroglycopenic (1.5-2.4, <i>P</i> < 0.05), and nonspecific (1.3-1.9, <i>P</i> < 0.05). Subjects' estimated BG showed a negative bias that widened as exercise progressed and peaked at -1.6 ± 3.3 mmol/L (<i>P</i> < 0.001) postinsulin correction. During HIIT, despite progressing hyperglycemia, subjects experience increased hypoglycemia symptoms and tend to underestimate their BG level.