691-P: Exercise Effect on Endogenous Glucose Production in Type 1 Diabetes: A Modeling Analysis

Quantifying the exercise effect (EE) on glucose turnover is fundamental for type 1 diabetes (T1D) management. We recently proposed a model describing EE on insulin-dependent and -independent glucose utilization in subjects with and without T1D (ND). However, to date, a model of EE on endogenous glucose production (EGP) is still lacking. To do so, we analysed existing data on 6 T1D (age 29±3 yrs, BMI 28.3±2.0 kg/m2, VO2 max 28.7±2.9 ml/kg/min, mean±SE) and 6 ND (age=28.2±4.2 yr, BMI=23.6 ±1.0 kg/m2, VO2 max 36.6±2.9 ml/kg/min) subjects studied with a glucose clamp, during, before and after a 60 min aerobic exercise session at 65% VO2max on three visits: euglycemia-low insulin (V1); euglycemia-high insulin (V2) and hyperglycemia-low insulin (V3) in random order. EGP was measured with the isotope dilution technique using [6,6-2H2]glucose. A battery of models was tested against data to assess if EE on EGP is mediated by insulin, glucose or both. The best model (Fig 1) provided a good description of the data in both groups. Results show that EE on EGP is delayed and insulin mediated. Further studies are needed to validate the model in real life conditions thus making it usable for optimization of insulin therapy. Disclosure D. Romeres: None. M. Schiavon: None. R. Visentin: None. A. Basu: Consultant; Spouse/Partner; GENFIT. Research Support; Spouse/Partner; AstraZeneca. C. Cobelli: None. R. Basu: Consultant; Self; GENFIT. Research Support; Self; AstraZeneca. C. Dalla Man: Research Support; Self; Sanofi-Aventis Deutschland GmbH. Funding Italian Ministry of Education (232/2016); National Institute of Diabetes and Digestive and Kidney Diseases (DK029953 to R.B.), (DK085516 to A.B.)