ECSS Paris 2023: CP-MH26
INTRODUCTION: For adults with type 1 diabetes (T1D), evidence that high-intensity interval aerobic exercise (HIIE) prevents hypoglycaemia vs. moderate-intensity continuous exercise (CONT) remains inconsistent. Glycaemic responses may vary with exercise timing during the day or relative to the last bolused meal. In the few matched-work studies available in literature, two third (1;2;3;6) of those using an exercise performed >3h after the last bolused meal reported a protective effect of HIIE on glycemic decrease during exercise, while none of the three studies using an exercise performed <2h after the last bolus demonstrated protection (8; 9; 10). No studies used in the same design postprandial (PP) and postabsorptive (PA) exercises. Given interindividual variability, within-subject testing is needed. In addition, carbohydrate intake during exercise recovery and its confounding impact on glycaemia were almost never reported in the previous studies, while satiety may differ depending on exercise modality and intensity. This randomized crossover study compares HIIE vs. CONT in early PP and PA, while controlling diet and insulin during exercise and early/late recovery. METHODS: Twenty-one physical active adults with T1D using continuous glucose monitoring (CGM) completed 4 conditions: HIIE-PP, CONT-PP, HIIE-PA, CONT-PA. Cycle-ergometer sessions were work- and duration-matched: warm-up and active recovery at 20% maximal aerobic power (MAP); HIIE comprised 10×1 min at 100% MAP with 1 min passive recovery; CONT consisted of 20 min at 50% MAP. Exercise started 1.5 h and 5 h after lunch in PP and in PA, respectively. Outcomes were analysed using linear mixed-effects models or mixed-effects binary logistic regressions. RESULTS: Despite matched work and duration, HIIE elicited higher oxygen consumption (P=0.02), heart rate (P<0.001), lactate (P=0.014) and RPE (P<0.001) than CONT, while perceived enjoyment was comparable. Muscle blood volume variation (near-infrared spectroscopy) increased less during HIIE than CONT (P=0.04). Capillary glycemia declined faster when pre-exercise glycemia was higher (P<0.001). The decline was attenuated in PA vs. PP (e=+0.313 mg·dL⁻¹·min⁻¹, P=0.003) and in HIIE vs. CONT (e=+0.074 mg·dL⁻¹·min⁻¹, P=0.038), with a stronger HIIE protection in PA than PP (three-way interaction P=0.001; HIIE vs. CONT slope difference: +1.85 mg·dL⁻¹/25 min in PP vs. +26.92 mg·dL⁻¹/25 min in PA). During the 24h-recovery period, time spent <54 mg·dL⁻¹ was lower following HIIE vs. CONT (P=0.011), despite lower dietary glycemic load (P=0.046). CONCLUSION: Overall, HIIE may provide greater training efficiency (i.e., higher energy expenditure for comparable perceived enjoyment) and, when performed postabsorptively rather than postprandially, may offer stronger protection against hypoglycaemia than CONT. (1) Jayawardene, 2017; (2) Molveau, 2025; (3) Moser, 2015; (6) Parent, 2024; (7) Da Prato, 2024 ; (8) Sarnblad, 2021; (9) Sills, 1983; (10) Tonoli, 2015.
Read CV Angéline MelinECSS Paris 2023: CP-MH26
INTRODUCTION: In kidney transplant recipients (KTRs), conventional anthropometry, based on BMI, often masks clinical reality, failing to detect functional decline and metabolic frailty. A rapid and non-invasive screening tool is essential to stratify risk and guide prescription. Our hypothesis was that hand grip strength (HGS) goes beyond a measure of mechanical strength, serving as a systemic indicator of cellular integrity, skeletal muscle reserve, and metabolic status. This study aimed to validate HGS as a primary clinical marker to predict negative structural and metabolic changes in KTRs. METHODS: A cross-sectional study evaluated 155 kidney transplant recipients (52.3% men, 47.7% women; mean age 54 ± 12 years). Functional screening was performed using handgrip dynamometry, stratified by sex. Metabolic and structural health was assessed using octapolar bioimpedance (Sanny) to quantify phase angle (PA), skeletal muscle mass (SMM), and body fat percentage, along with waist-to-height ratio (WHR) for central adiposity. Spearman and Mann-Whitney U correlation tests determined the predictive value of handgrip strength on health outcomes. RESULTS: Dynapenia was alarmingly prevalent, affecting 91.9% of women and 76.5% of men, despite a homogeneous obesity rate (approximately 76% body fat) between the sexes. Crucially, handgrip strength proved to be a robust predictor of systemic health. Cellular Integrity: Handgrip strength (HGS) showed a strong positive correlation with phase angle in both men (r=0.54, p<0.001) and women (r=0.39, p=0.001), indicating that lower strength effectively predicts cell membrane fragility and poorer nutritional status. Screening for Sarcopenia and Frailty: HGS showed a strong correlation with appendicular skeletal muscle mass (ESM) (Women: r=0.58; Men: r=0.44; p<0.001), validating its use to detect occult muscle depletion. Metabolic Risk: In men, HGS showed an inverse association with visceral adiposity; Men with dynapenia had a significantly worse waist-to-height ratio (WHR) (0.96 vs. 0.93 in men without dynapenia; p=0.036), associating low strength with a high-risk cardiometabolic profile. CONCLUSION: Handgrip strength is a powerful and independent biomarker in kidney transplant recipients that transcends neuromuscular function. It successfully predicts negative changes in cellular integrity (phase angle), structural muscle reserve (sarcopenia), and central metabolic risk (visceral fat). Healthcare professionals should prioritize dynamometry as a mandatory vital screening sign to identify metabolic and functional risk early.
Read CV CARLOS AMORIMECSS Paris 2023: CP-MH26