Fluid snacks to help persons with type 1 diabetes avoid late onset postexercise hypoglycemia

Purpose: The present study assessed whether whole milk, skim milk, or two commercially available sports drinks are effective in preventing late onset postexercise hypoglycemia (LOPEH) in persons with type 1 diabetes mellitus. Methods: Subjects ingested water, whole milk, skim milk, sport drink A(carbohydrate and electrolytes), or sport drink B (carbohydrate, fat, and protein) before, during, and after 1 h of bicycle exercise at 60% V̇O(2max) in the late afternoon. Drinks were isocaloric (470 ± 150 kcal) and the number of calories consumed was based on individual energy expenditure. No adjustment in insulinization was allowed in anticipation of exercise. Results: During water trials all subjects became hypoglycemic. Most drinks lead to a moderate hyperglycemia(range of mean values = 200-280 mg·dL^-1) during the period between the end of exercise and dinner, but this was not the case for whole milk(range 80-120 mg·dL^-1). Glycemia peaked about 1.5 h after dinner and declined over the next 90 min. Persistent hyperglycemia (range of means = 200-310 mg·dL^-1) from after exercise to about 4 h postexercise was observed with sports drink B. A decline in glycemia in the evening was greatest during the skim milk trial and required subjects to ingest more carbohydrate as a late evening snack. The least decline during this period occurred during the whole milk trial. Subjects experienced pre-bed and early morning (0300 h) hypoglycemia in 7 of the 28 trials. Conclusions: These data show that whole milk and sports drinks that are designed for both quick (sport drink A) and long lasting (sport drink B) nutrient replenishment can be used by persons with type 1 diabetes in an effort to avoid LOPEH.