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 c ommercially 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(car bohydrate and electrolytes), or sport drink B (carbohydrate, fat, and prote in) before, during, and after 1 h of bicycle exercise at 60% VO2max in the late afternoon. Drinks were isocaloric (470 +/- 150 kcal) and the number of calories consumed was based on individual energy expenditure. No adjustmen t in insulinization was allowed in anticipation of exercise. Results: Durin g water trials all subjects became hypoglycemic. Most drinks lead to a mode rate hyperglycemia(range of mean values = 200-280 mg.dL(-1)) during the per iod between the end of exercise and dinner, but this was not the case for w hole 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 mean s = 200-310 mg.dL(-1)) from after exercise to about 4 h postexercise was ob served with sports drink B. A decline in glycemia in the evening was greate st during the skim milk trial and required subjects to ingest more carbohyd rate as a late evening snack. The least decline during this period occurred during the whole milk trial. Subjects experienced pre-bed and early mornin g (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 use d by persons with type 1 diabetes in an effort to avoid LOPEH.