Adiponectin, an adipokine secreted by the adipocyte, is inversely related to adiposity and directly related to insulin sensitivity. In T1DM, however, data thus far are contradictory. We investigated the relationship between adiponectin and exercise in type 1 diabetes.
49 children (14.5 ± 2.0yrs, range 8–17) with T1DM on an insulin pump were studied during two 75min exercise sessions with and without continuation of the basal rate within 4w. Adiponectin and epinephrine concentrations were measured before and during exercise.
Mean pre-exercise adiponectin concentration was 11.2 ± 4.7 mg/L (range 2.7–23.0) with a mean absolute difference of 1.7 mg/L between the 2 days. Adiponectin concentrations did not change meaningfully during exercise (mean change: −0.1 ± 1.2; P=0.17). Adiponectin correlated inversely with BMI percentile (p=0.02) but not with age, gender, duration of diabetes, HbA1c or pre-exercise glucose. However, those with higher baseline adiponectin were less likely to become hypoglycemic during exercise, 36% becoming hypoglycemic when baseline adiponectin was <10 mg/L, 42% when 10-<15, 15% when ≥15 (p=0.02). Baseline epinephrine concentrations were not associated with adiponectin, and in those whose nadir glucose was ≤100mg/dL, there was no correlation between epinephrine response and adiponectin (p=0.16).
Adiponectin concentrations are stable from day to day, are not affected by acute exercise or metabolic control, and vary inversely with adiposity. Higher adiponectin appears to be associated with a decrease in hypoglycemia risk during exercise. Further studies are needed to examine whether adiponectin protects against exercise-induced hypoglycemia by directly enhancing the oxidation of alternate fuels.
Keywords: Adiponectin, Type 1 Diabetes, Hypoglycemia, Exercise, Insulin Pump