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, Per Gustav Hagelqvist Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Correspondence should be addressed to Prof. Tina Vilsbøll, Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; phone: +45 4094 0825; e-mail: tina.vilsboell.01@regionh.dk; or MD PhD Per G. Hagelqvist, Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; phone: +45 31390346; e-mail: per.gustav.hagelqvist.01@regionh.dk Search for other works by this author on: Oxford Academic Andreas Andersen Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Search for other works by this author on: Oxford Academic Kaisar Maytham Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Search for other works by this author on: Oxford Academic Christine Rode Andreasen Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Search for other works by this author on: Oxford Academic Susanne Engberg Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Search for other works by this author on: Oxford Academic Ulrik Pedersen-Bjergaard Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Department of Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, University of Copenhagen , Hillerød , Denmark Search for other works by this author on: Oxford Academic Julie Lyng Forman Section of Biostatistics, Department of PublicHealth, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Search for other works by this author on: Oxford Academic Pär Johansson Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Clinical Academic Groups, Center for Endotheliomics, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark Search for other works by this author on: Oxford Academic Jens Lykkesfeldt Section of Experimental Animal Models, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Denmark Search for other works by this author on: Oxford Academic Filip Krag Knop Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-9017-9010 Tina Vilsbøll Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen , Herlev , Denmark Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen , Hellerup , Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen , Denmark Correspondence should be addressed to Prof. Tina Vilsbøll, Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; phone: +45 4094 0825; e-mail: tina.vilsboell.01@regionh.dk; or MD PhD Per G. Hagelqvist, Clinical Research, Steno Diabetes Center Copenhagen, University of Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark; phone: +45 31390346; e-mail: per.gustav.hagelqvist.01@regionh.dk Search for other works by this author on: Oxford Academic
The Journal of Clinical Endocrinology & Metabolism, dgae278, https://doi.org/10.1210/clinem/dgae278
Published:
20 April 2024
Article history
Received:
28 September 2023
Revision received:
15 April 2024
Editorial decision:
16 April 2024
Accepted:
16 April 2024
Published:
20 April 2024
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Per Gustav Hagelqvist, Andreas Andersen, Kaisar Maytham, Christine Rode Andreasen, Susanne Engberg, Ulrik Pedersen-Bjergaard, Julie Lyng Forman, Pär Johansson, Jens Lykkesfeldt, Filip Krag Knop, Tina Vilsbøll, Hemostatic Effects of Exercise-Related Hypoglycemia in Male Persons With Type 1 Diabetes, The Journal of Clinical Endocrinology & Metabolism, 2024;, dgae278, https://doi.org/10.1210/clinem/dgae278
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Abstract
Context
People with type 1 diabetes (T1D) are at increased risk of thrombosis, however, the underlying mechanisms remain unclear. Hypoglycemia induced at rest can induce coagulation activation, but little is known about the hemostatic effects of exercise-related hypoglycemia in people with T1D.
Objective
We compared hemostatic profiles of individuals with T1D with healthy controls and explored hemostatic effects of hypoglycemia, induced with or without exercise, in participants with T1D.
Methods
Thrombelastography (TEG) was used for a baseline hemostatic comparison between fifteen men with T1D and matched healthy controls. In addition, the participants with T1D underwent two euglycemic-hypoglycemic clamp days in a randomized, crossover fashion. Hypoglycemia was induced with the participants at rest (Hypo-rest) or during exercise (Hypo-exercise). TEG provides data on the rate of coagulation activation (R-time), the rate of clot formation (K-time, α-Angle), the maximum clot amplitude (MA), the functional fibrinogen contribution to the clot strength (MA-FF) and the fibrinolysis (LY-30).
Results
The T1D group exhibited shorter R-time and K-time and a greater α-Angle compared to the controls. During the clamp experiments, Hypo-exercise induced an increased clot strength (MA) with a mean difference from baseline of 2.77 mm [95% confidence interval 2.04; 3.51] accompanied with a decreased fibrinolysis (LY-30) of -0.45 percentage points [-0.60; -0.29]. Hypo-rest resulted in increased functional fibrinogen (MA-FF) of 0.74 mm [0.13; 1.36] along with an increased fibrinolysis (LY-30) of 0.54 percentage points [0.11; 0.98].
Conclusion
Individuals with T1D exhibit a hypercoagulable hemostatic profile compared to healthy controls and exercise-related hypoglycemia may increase the susceptibility to thrombosis via both procoagulant and antifibrinolytic effects.
Cardiovascular Disease, Coagulation, Fibrinolysis, Hypoglycemia, Type 1 diabetes
Accepted manuscripts
Accepted manuscripts are PDF versions of the author’s final manuscript, as accepted for publication by the journal but prior to copyediting or typesetting. They can be cited using the author(s), article title, journal title, year of online publication, and DOI. They will be replaced by the final typeset articles, which may therefore contain changes. The DOI will remain the same throughout.
This content is only available as a PDF.
© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
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