The objective was to investigate the impact of the combination of exercise
and alcohol on the metabolic response in nonfasting and fasting type 2 diab
etic subjects. In part 1, 12 untrained middle-aged type 2 diabetic subjects
participated on 3 test days. On each day, they ingested a light meal (1,82
4 kJ) containing 48 energy percent (E%) carbohydrate, 38 E% fat, and 14 E%
protein. The meal was followed by either (A) rest or (B) 30 minutes of exer
cise (40% of maximum O-2 consumption [VO(2)max]) or (C) taken with alcohol
(0.4 g/kg body weight) followed by 30 minutes of exercise (40% of VO(2)max)
. In part 2, 11 untrained middle-aged type 2 diabetic subjects participated
on 4 test days without a meal. The Subjects were either (A) resting, (B) d
rinking alcohol (0.4 g/kg body weight), (C) exercising 30 minutes (40% of V
O(2)max), or (D) drinking alcohol (0.4 g/kg body weight) and exercising 30
minutes (40% of VO(2)max). On each test day, regular blood samples were dra
wn for 4 hours for analysis of glucose, insulin, lactate, triglycerides, no
nesterified fatty acid (NEFA), and ethanol. Comparing exercise and rest fol
lowing a light meal (part 1, no change (7%) occurred in the plasma glucose
response area (642 +/- 119 v 724 +/- 109 mmol.L-1 240 min, NS). However, it
was significantly reduced (by 27%) in response to exercise and alcohol (50
9 +/- 98 v 724 +/- 109 mmol.L-1 x 240 min; P = .03). Similar serum insulin
response areas were obtained. After exercise and alcohol, plasma lactate in
creased compared with the resting state (2.2 +/- 0.2 v 1.6 +/- 0.1 mmol.L-1
, P = .004) and with exercise alone (2.2 +/- 0.2 v 1.8 +/- 0.2 mmol +/- L-1
, P = .04). Serum NEFAs were significantly reduced by exercise and alcohol
compared with the resting state (0.50 +/- 0.04 v 0.65 +/- 0.06 mmol.L-1, P
= .008) and with exercise alone (0.50 +/- 0.04 v 0.61 +/- 0.05 mmol.L-1, P
= .02). Similar serum triglycerides were found. During the fasting state (p
art 2), similar plasma glucose response areas were obtained in the four sit
uations. The insulin response area to exercise and alcohol increased signif
icantly compared with the resting state (3,325 +/- 744 v 882 +/- 295 pmol.L
-1 x 240 min, P = .02) and with exercise alone (3,325 +/- 744 v 1,328 +/- 4
22 pmol L-l x 240 min, P = .007). No difference was found compared with alc
ohol alone. Plasma lactate was higher after alcohol intake versus the resti
ng state (1.9 +/- 0.1 v 1.3 +/- 0.1 mmol.L-1, P = .003), as well as after e
xercise and alcohol (1.9 +/- 0.1 v 1.3 +/- 0.1 mmol.L-1, P = .01). After ex
ercise and alcohol serum NEFAs were significantly reduced compared with the
resting state (0.43 +/- 0.02 v 0.64 +/- 0.02 mmol.L-1, P < .007), alcohol
alone (0.43 +/- 0.02 v 0.51 +/- 0.02 mmol.L-1, P < .001), and exercise alon
e (0.43 +/- 0.02 v 0.64 +/- 0.02 mmol.L-1, P < .001). Serum triglycerides w
ere similar in the four situations. We conclude that moderate exercise with
or without moderate alcohol intake does not cause acute hypoglycemia eithe
r after a light meal or in the fasting state in untrained overweight type 2
diabetic subjects. Copyright (C) 1999 by W.B. Saunders Company.