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Am J Physiol Endocrinol Metab 280: E908-E917, 2001;
0193-1849/01 $5.00
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Vol. 280, Issue 6, E908-E917, June 2001

Effects of antecedent prolonged exercise on subsequent counterregulatory responses to hypoglycemia

Pietro Galassetti, Stephnie Mann, Donna Tate, Ray A. Neill, Fernando Costa, David H. Wasserman, and Stephen N. Davis

Departments of Medicine and Molecular Physiology and Biophysics, Vanderbilt University School of Medicine and Nashville Veteran Affairs Medical Center, Nashville, Tennessee 37232-6303

In the present study the hypothesis tested was that prior exercise may blunt counterregulatory responses to subsequent hypoglycemia. Healthy subjects [15 females (f)/15 males (m), age 27 ± 1 yr, body mass index 22 ± 1 kg/m2, hemoglobin AIc 5.6 ± 0.5%] were studied during 2-day experiments. Day 1 involved either 90-min morning and afternoon cycle exercise at 50% maximal O2 uptake (VO2 max) (priorEXE, n = 16, 8 m/8 f) or equivalent rest periods (priorREST, n = 14, 7 m/7 f). Day 2 consisted of a 2-h hypoglycemic clamp in all subjects. Endogenous glucose production (EGP) was measured using [3-3H]glucose. Muscle sympathetic nerve activity (MSNA) was measured using microneurography. Day 2 insulin (87 ± 6 µU/ml) and plasma glucose levels (54 ± 2 mg/dl) were equivalent after priorEXE and priorREST. Significant blunting (P < 0.01) of day 2 norepinephrine (-30 ± 4%), epinephrine (-37 ± 6%), glucagon (-60 ± 4%), growth hormone (-61 ± 5%), pancreatic polypeptide (-47 ± 4%), and MSNA (-90 ± 8%) responses to hypoglycemia occurred after priorEXE vs. priorREST. EGP during day 2 hypoglycemia was also suppressed significantly (P < 0.01) after priorEXE compared with priorREST. In summary, two bouts of exercise (90 min at 50% VO2 max) significantly reduced glucagon, catecholamines, growth hormone, pancreatic polypeptide, and EGP responses to subsequent hypoglycemia. We conclude that, in normal humans, antecedent prolonged moderate exercise blunts neuroendocrine and metabolic counterregulatory responses to subsequent hypoglycemia.

glucose clamp; epinephrine; glucagon


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