Metabolic and hormonal adaptation and dysfunction in ... · EA4488 ‘Physical activity, Muscle,...

Exploratory Workshop Exploratory Workshop The Future of Research in Sport Participation in the Lifespan (EThe Future of Research in Sport Participation in the Lifespan (EW10W10--170)170)Rome, Italy Rome, Italy -- September 14September 14--17, 201117, 2011ConvenedConvened byby: Laura Capranica, Jan Cabri and : Laura Capranica, Jan Cabri and RomainRomain MeeusenMeeusen

Metabolic and hormonal adaptationand dysfunction in active patients with

Type 1 Diabetes (T1D) : fromchildhood to adulthood

Dr. Elsa Heyman

EA4488 ‘Physical activity, Muscle, Health’, University of Lille, France

Standing Committees:European Medical Research Councils (EMSC), Humanities: (SCH), Social Sciences (SCSS)

European Science Foundation ▪ 1 quai Lezay Marnésia ▪ BP90015 ▪ FR-67080 Strasbourg CedexTel: +33 (0)3 88 76 71 36 or 46 ▪ Fax: +33 (0)3 88 37 05 32 ▪ Email: [email protected] ▪

http://www.esf.org/workshops

(Sport Physiology)

Exploratory Workshop Exploratory Workshop The Future of Research in Sport Participation in the Lifespan (EThe Future of Research in Sport Participation in the Lifespan (EW10W10--170)170)


Educational Opportunities for Young Researchers

Faculty of Sport Science & Physical EducationUniversity of Lille 2

The PhD program:Master 1st year STAPS with Research specialty (1 year – 100 ECTS

credits among which 40 are dedicated to research) (BAC +4y)

Master 2nd year STAPS with Research specialty (1 year – 120 ECTS

credits among which 60 are dedicated to research) (BAC +5y)

PhD in Physical Activity - Biology & Health Doctoral School of Lille

(3years with 100h of formation) (BAC +8y)




Main research in the area of sport :EA4488 ‘Physical activity, Muscle, Health’

Director: Pr. Serge Berthoin


Physiological limiting factors of exercise performance Health benefices of physical activity

(diabetes, metabolic syndrome, cystic fibrosis, children & elderly)

Adaptations & Dysfunctions of the neuromuscular function

In humans and animals





Future plans / developments

Department of Human Physiology & Sports Medicine, Vrije UniversiteitBrussel, Pr Romain Meeusen: Visiting Professor on Exercise and Brain(Lille, 2010)

Inter-University Cooperation

Department of Human Kinsesiology, University of Montreal, Pr François Péronnet: Symposium on Substrate utilisation during exercise (Lille, 2011)

Exploratory Workshop Exploratory Workshop The future of Research in Sport Participation in the Lifespan (EThe future of Research in Sport Participation in the Lifespan (EW10W10--170)170)


Main Topic of the Presentation

•In children, adolescents & adults with Type 1 diabetes (T1D)

•Barriers to physical activity

•Management of exercise-induced hypoglycaemia

•Mechanisms underlying impairment of aerobic fitness

Prepubertal girls(n=12)

Post-pubertal girls(n=52)



Background Open questions

P<0.05 vs. Healthy : *P <0.05 vs. Prepubertal : †

0

1

2

3

*

Club-organised physical activity (h.wk-1)

†

Heyman et Berthon, review, Salud(i)Ciencia, 2008

• Problems of sport adherence in someT1D patients

• Exercise training beneficial effects in T1D patients- on quality-of-life, physical fitness, body composition, lipid profile, insulin sensitivity- in children, adolescents & adults

Heyman et al. Pediatr Exerc Sci, 2007; Riddell & Iscoe. Pediatr Diab 2006; Rigla et al. Metab 2000

Valerio et al. Nutr Metab Cardiovasc Dis, 2007

Hea

lthy

Hea

lthy

T1D

T1D



Barriers to physical activity ?

The risk of hypoglycaemia A low fitness level

Brazeau et al. Diabetes Care, 2008In T1D adults In T1D children & adolescents?


2 exercises of similar total amount of work no difference in glycaemic change during exercise




In T1D adults

Management with the modality/intensity of exercise ?

Guelfi et al. Diabetes Care, 2005Iscoe & Riddell. Diabet Med, 2011

2 studies in T1D adults

Continuous moderate-intensity : 45min at 50% VO2peakIntermittent high-intensity : 45min at 50% VO2peak + 9*15sec at 100%VO2peak

Use of a greater proportion of high intensity bouts?In T1D children & adolescents?


Brazeau et al. Diabetes Care, 2008

In healthy children:Bailey et al. Med Sci Sports Exerc, 1995






• Effect of HbA1c on O2 availibility and utilisation by muscle ?- Ongoing study in University of Lille (EA4488) (funded by Roche lab. and a PHRC)- T1D adults with HbA1c >8% or <7% and healthy subjects

Biological factors?

Low maximal oxygen uptake


? Michaliszyn et al. Pediatr Diab, 2009

Mitochondrial respiration(vastus lateralis biopsies)

Arterial blood gases Muscle, cerebral HHb(NIRS)





Biological factors?




• Metabolic/hormonal dysfunction :

Bottini et al. Diabetologia, 1995 Heyman et al. Diabetes Metab, 2007

CatecholaminesNA < and A < in T1D adultsNA < but A > in T1D adolescent girls

Overactivity in Type 2 diabetesInvolvement in metabolic and psychologic adaptations to exercise ?





Biological factors?




• Metabolic/hormonal dysfunction :CatecholaminesEndocannabinoid System

?Di Marzo. Diabetologia, 2008

Heyman et al. Psychoneuroendocrinology, in revisionIn Type 1 diabetes



Actual Forms of Interplay

The risk of hypoglycaemia

Continuous moderate exercise vs. Intermittent very high intensity exercisewith similar total amount of work

University of Lille (E. Heyman)In T1D children

Vrije Universiteit Brussel (R. Meeusen)In well-trained T1D adults

Exercise-induced glycaemic variations Harmful to cognitive function ?But chronic exercise beneficial effects on cognition?

Vrije Universiteit Brussel (C. Tonoli, L. Buyse, R. Meeusen)University of Lille (E. Heyman, S. Berthoin)

Codirection PhD(C. Tonoli)



Actual Forms of Interplay

A low fitness level

• Metabolic/hormonal dysfunction : Endocannabinoid System

AEA, 2-AG AEA, 2-AGCB1 proteins, CB1,CB2 mRNAFAAH, DAG…

Institute of Biomolecular Chemistry, Napoli (V. DiMarzo)



Enhancing Synergies

• Barriers to physical activity in T1D ?- Children/adolescents/adults- Male/female- Differences between countries, cultures in Europe ?- Psychology / Sociology / Physiology

• Role of the endocannabinoid system in exercise-inducedmetabolic adaptations and fatigue ?

- Administration of CB1 agonists/antagonists (crossing or not the BBB) in humans Ethics Committee in other European countries ?

40% VO2max – 30min

40% VO2max – 30min+ 16 Sprints of 4 sec (ev. 2min)

catecholaminesNo ≠ glucagon, insulin

glucose hepatic production

Guelfi et al. Diabetes Care 2005



Metabolic and hormonal adaptation and dysfunction in ... · EA4488 ‘Physical activity, Muscle,...

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