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            "abstractNote": "AIMS: Hypoglycaemia is the major limiting factor in achieving optimal glycaemic control in people with type 1 diabetes (T1DM), especially intensively treated patients with impaired glucose counter-regulation during hypoglycaemia. Naloxone, an opiate receptor blocker, has been reported to enhance the acute counter-regulatory response to hypoglycaemia when administered intravenously in humans. The current study was undertaken to investigate the oral formulation of the long-acting opiate antagonist, naltrexone, and determine if it could have a similar effect, and thus might be useful therapeutically in treatment of T1DM patients with a high risk of hypoglycaemia.\nMATERIALS AND METHODS: We performed a randomized, placebo-controlled, double-blinded, cross-over study in which 9 intensively treated subjects with T1DM underwent a 2-step euglycaemic-hypoglycaemic-hyperinsulinaemic clamp on 2 separate occasions. At 12 hours and at 1 hour before the clamp study, participants received 100 mg of naltrexone or placebo orally. Counter-regulatory hormonal responses were assessed at baseline and during each step of the hyperinsulinaemic-clamp.\nRESULTS: Glucose and insulin levels did not differ significantly between the naltrexone and placebo visits; nor did the glucose infusion rates required to keep glucose levels at target. During hypoglycaemia, naltrexone, in comparison with the placebo group, induced an increase in epinephrine levels ( P  = .05). However, no statistically significant differences in glucagon, cortisol and growth hormone responses were observed.\nCONCLUSION: In contrast to the intravenous opiate receptor blocker naloxone, overnight administration of the oral long-acting opiate receptor blocker, naltrexone, at a clinically used dose, had a limited effect on the counter-regulatory response to hypoglycaemia in intensively treated subjects with T1DM.",
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            "title": "Effects of acute caffeine supplementation on reducing exercise-associated hypoglycaemia in individuals with Type 1 diabetes mellitus",
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                    "firstName": "D. P.",
                    "lastName": "Zaharieva"
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            "abstractNote": "AIM: To determine the effects of acute caffeine ingestion on glycaemia during moderate to vigorous intensity aerobic exercise and in recovery in individuals with Type 1 diabetes.\nMETHODS: A total of 13 patients with Type 1 diabetes [eight women, five men: mean ± sd age 25.9 ± 8.8 years, BMI 71.9 ± 11.0 kg, maximal oxygen consumption 46.6 ± 12.7 ml/kg/min, body fat 19.9 ± 7.2%, duration of diabetes 14.4 ± 10.1 years and HbA1c 55 ± 8 mmol/mol (7.4 ± 0.8%)] were recruited. Participants ingested capsules that contained gelatin or pure caffeine (6.0 mg/kg body mass) and performed afternoon exercise for 45 min at 60% maximal oxygen consumption on two separate visits with only circulating basal insulin levels.\nRESULTS: The main finding was that a single caffeine dose attenuates the drop in glycaemia by 1.8 ± 2.8 mmol/l compared with placebo intake during exercise (P=0.056). Continuous glucose monitoring data, however, showed that caffeine was associated with elevated glycaemia at bedtime after exercise, compared with placebo, but lower glucose concentrations in the early morning the next day.\nCONCLUSIONS: Caffeine intake should be considered as another strategy that may modestly attenuate hypoglycaemia in individuals with Type 1 diabetes during exercise, but should be taken with precautionary measures as it may increase the risk of late-onset hypoglycaemia.",
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            "abstractNote": "BACKGROUND: The microbiota of both humans and animals plays an important role in their health and the development of disease. Therefore, the bacterial flora of the conjunctiva may also be associated with some diseases. However, there are no reports on the alteration of bacterial flora in conjunctiva of diabetic rats in the literature. Therefore, we investigated the changes in bacterial flora in bulbar conjunctiva of rats with streptozotocin (STZ)-induced type I diabetes.\nMETHODS: A high dose of STZ (60 mg/kg, i.p.) was injected into Sprague-Dawley (SD) rats to induce type I diabetes mellitus (T1DM). The diabetic rats were raised in the animal laboratory and at 8 months post-injection of STZ swab samples were taken from the bulbar conjunctiva for cultivation of aerobic bacteria. The bacterial isolates were identified by Gram staining and biochemical features. The identified bacteria from both diabetic and healthy rats were then compared.\nRESULTS: The diabetic and healthy rats had different bacterial flora present in their bulbar conjunctiva. In total, 10 and 8 bacterial species were found in the STZ and control groups, respectively, with only three species (Enterococcus faecium, Enterococcus gallinarum and Escherichia coli) shared between the two groups. Gram-positive bacteria were common in both groups and the most abundant was Enterococcus faecium. However, after the development of T1DM, the bacterial flora in the rat bulbar conjunctiva changed considerably, with a reduced complexity evident.\nCONCLUSIONS: STZ-induced diabetes caused alterations of bacterial flora in the bulbar conjunctiva in rats, with some bacterial species disappearing and others emerging. Our results indicate that the conjunctival bacterial flora in diabetic humans should be surveyed for potential diagnostic markers or countermeasures to prevent eye infections in T1DM patients.",
            "publicationTitle": "PloS One",
            "publisher": "",
            "place": "",
            "date": "2015",
            "volume": "10",
            "issue": "7",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "e0133021",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "PLoS ONE",
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            "title": "Algorithm that delivers an individualized rapid-acting insulin dose after morning resistance exercise counters post-exercise hyperglycaemia in people with Type 1 diabetes",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "D.",
                    "lastName": "Turner"
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                {
                    "creatorType": "author",
                    "firstName": "S.",
                    "lastName": "Luzio"
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                    "firstName": "B. J.",
                    "lastName": "Gray"
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                    "lastName": "Bain"
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                    "lastName": "Hanley"
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                    "firstName": "A.",
                    "lastName": "Richards"
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                    "creatorType": "author",
                    "firstName": "D. C.",
                    "lastName": "Rhydderch"
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                    "firstName": "R.",
                    "lastName": "Martin"
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                {
                    "creatorType": "author",
                    "firstName": "M. D.",
                    "lastName": "Campbell"
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                    "creatorType": "author",
                    "firstName": "L. P.",
                    "lastName": "Kilduff"
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                    "creatorType": "author",
                    "firstName": "D. J.",
                    "lastName": "West"
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                    "creatorType": "author",
                    "firstName": "R. M.",
                    "lastName": "Bracken"
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            ],
            "abstractNote": "AIMS: To develop an algorithm that delivers an individualized dose of rapid-acting insulin after morning resistance exercise to counter post-exercise hyperglycaemia in individuals with Type 1 diabetes.\nMETHODS: Eight people with Type 1 diabetes, aged 34 ± 7 years with HbA1c concentrations 72 ± 12 mmol/mol (8.7 ± 1.1%), attended our laboratory on two separate mornings after fasting, having taken their usual basal insulin the previous evening. These people performed a resistance exercise session comprising six exercises for two sets of 10 repetitions at 60%1RM<comment> AUTHOR: Please give '%1RM' in full.</comment>. In a randomized and counterbalanced order, the participants were administered an individualized dose of rapid-acting insulin (2 ± 1 units, range 0-4 units) immediately after resistance exercise (insulin session) by means of an algorithm or were not administered this (no-insulin session). Venous blood glucose concentrations were measured for 125 min after resistance exercise. Data (mean ± sem values) were analysed using anova (P≤0.05).\nRESULTS: Participants had immediate post-resistance exercise hyperglycaemia (insulin session 13.0 ± 1.6 vs. no-insulin session 12.7 ± 1.5 mmol/l; P=0.834). The decline in blood glucose concentration between peak and 125 min after exercise was greater in the insulin exercise session than in the no-insulin session (3.3 ± 1.0 vs. 1.3 ± 0.4 mmol/l: P=0.015). There were no episodes of hypoglycaemia (blood glucose <3.9 mmol/l).\nCONCLUSIONS: Administration of rapid-acting insulin according to an individualized algorithm reduced the hyperglycaemia associated with morning resistance exercise without causing hypoglycaemia in the 2 h post-exercise period in people with Type 1 diabetes. This article is protected by copyright. All rights reserved.",
            "publicationTitle": "Diabetic Medicine: A Journal of the British Diabetic Association",
            "publisher": "",
            "place": "",
            "date": "Jul 29, 2015",
            "volume": "",
            "issue": "",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "Diabet. Med.",
            "DOI": "10.1111/dme.12870",
            "citationKey": "",
            "url": "",
            "accessDate": "",
            "PMID": "26220149",
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            "shortTitle": "",
            "language": "ENG",
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            "title": "BDNF, IGF-I, Glucose and Insulin during Continuous and Interval Exercise in Type 1 Diabetes",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "C.",
                    "lastName": "Tonoli"
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                {
                    "creatorType": "author",
                    "firstName": "E.",
                    "lastName": "Heyman"
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                    "firstName": "B.",
                    "lastName": "Roelands"
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                    "firstName": "L.",
                    "lastName": "Buyse"
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                    "firstName": "F.",
                    "lastName": "Piacentini"
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                    "lastName": "Berthoin"
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                    "firstName": "S.",
                    "lastName": "Bailey"
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                    "lastName": "Pattyn"
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                    "lastName": "Meeusen"
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            "abstractNote": "Type 1 diabetes (T1D) can have a significant impact on brain function, mostly ascribed to episodes of hypoglycemia and chronic hyperglycemia. Exercise has positive effects on acute and chronic glycemic control in T1D, and has beneficial effects on cognitive function by increasing neurotrophins such as BDNF and IGF-I in non-diabetic humans. The present study examines the effects of different types of exercise intensities on neurotrophins in T1D. 10 participants with type 1 diabetes were evaluated in 3 sessions: high-intensity exercise (10×[60 s 90%Wmax, 60 s 50 W]), continuous exercise (22 min, 70% VO2 max) and a control session. Blood glucose, serum free insulin, serum BDNF and IGF-I were assessed pre/post all the trials and after recovery. Blood glucose significantly decreased after both exercise intensities and BDNF levels increased, with a dose-response effect for exercise intensity on BDNF. IGF-I changed over time, but without a difference between the different exercise protocols. Both exercise intensities change neurotrophins in T1D, but also exhibit a dose response effect for BDNF. The intensity-dependent findings may aid in designing exercise prescriptions for maintaining or improving neurological health in T1D, but both types of exercise can be implemented.",
            "publicationTitle": "International Journal of Sports Medicine",
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            "date": "Jul 24, 2015",
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            "issue": "",
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            "title": "Bone's responses to mechanical loading are impaired in type 1 diabetes",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Ashutosh",
                    "lastName": "Parajuli"
                },
                {
                    "creatorType": "author",
                    "firstName": "Chao",
                    "lastName": "Liu"
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                {
                    "creatorType": "author",
                    "firstName": "Wen",
                    "lastName": "Li"
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                    "creatorType": "author",
                    "firstName": "Xiaoyu",
                    "lastName": "Gu"
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                    "lastName": "Lai"
                },
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                    "firstName": "Shaopeng",
                    "lastName": "Pei"
                },
                {
                    "creatorType": "author",
                    "firstName": "Christopher",
                    "lastName": "Price"
                },
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                    "firstName": "Lidan",
                    "lastName": "You"
                },
                {
                    "creatorType": "author",
                    "firstName": "X. Lucas",
                    "lastName": "Lu"
                },
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                    "creatorType": "author",
                    "firstName": "Liyun",
                    "lastName": "Wang"
                }
            ],
            "abstractNote": "Diabetes adversely impacts many organ systems including the skeleton. Clinical trials have revealed a startling elevation in fracture risk in diabetic patients. Bone fractures can be life threatening: nearly 1 in 6 hip fracture patients die within one year. Because physical exercise is proven to improve bone properties and reduce fracture risk in non-diabetic subjects, we tested its efficacy in type 1 diabetes. We hypothesized that diabetic bone's response to anabolic mechanical loading would be attenuated, partially due to impaired mechanosensing of osteocytes under hyperglycemia. Heterozygous C57BL/6-Ins2(Akita)/J (Akita) male and female diabetic mice and their age- and gender-matched wild-type (WT) C57BL/6J controls (7-month-old, N=5-7 mice/group) were subjected to unilateral axial ulnar loading with a peak strain of 3500με at 2Hz and 3min/day for 5days. The Akita female mice, which exhibited a relatively normal body weight and a mild 40% elevation of blood glucose level, responded with increased bone formation (+6.5% in Ct.B.Ar, and 4 to 36-fold increase in Ec.BFR/BS and Ps.BFR/BS), and the loading effects, in terms of changes of static and dynamic indices, did not differ between Akita and WT females (p≥0.1). However, loading-induced anabolic effects were greatly diminished in Akita males, which exhibited reduced body weight, severe hyperglycemia (+230%), diminished bone formation (ΔCt.B.Ar: 0.003 vs. 0.030mm(2), p=0.005), and suppressed periosteal bone appositions (ΔPs.BFR/BS, p=0.02). Hyperglycemia (25mM glucose) was further found to impair the flow-induced intracellular calcium signaling in MLO-Y4 osteocytes, and significantly inhibited the flow-induced downstream responses including reduction in apoptosis and sRANKL secretion and PGE2 release. These results, along with previous findings showing adverse effects of hyperglycemia on osteoblasts and mesenchymal stem cells, suggest that failure to maintain normal glucose levels may impair bone's responses to mechanical loading in diabetics.",
            "publicationTitle": "Bone",
            "publisher": "",
            "place": "",
            "date": "Jul 13, 2015",
            "volume": "81",
            "issue": "",
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            "partNumber": "",
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            "pages": "152-160",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
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            "url": "",
            "accessDate": "",
            "PMID": "26183251",
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                    "lastName": "Mutlu"
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            "abstractNote": "BACKGROUND: Children with type 1 diabetes mellitus (T1DM) have low physical activity levels and are at high risk for psychosocial morbidities, including depression, heightened anxiety and low health-related quality of life (HRQoL).\nOBJECTIVE: The aim of this study was to assess the associations of physical activity level with depression, anxiety, and HRQoL in children with T1DM.\nSUBJECTS AND METHODS: A cross-sectional study design, including children with T1DM aged between 8 and 12 years and healthy controls, was used. Physical activity (PA) level was assessed with the Physical Activity Questionnaire for Older Children (PAQ-C). Anxiety was screened by The Screen for Anxiety Related Emotional Disorders (SCARED) questionnaire. Depressive symptoms were evaluated using the Children's Depression Inventory (CDI). Quality of life was assessed with the The Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0).\nRESULTS: Forty-seven T1DM and 55 healthy children were included with mean ages of 9.87±1.63 and 9.56±1.60 years, respectively. The T1DM group had significantly higher depression and anxiety score (p<0.05) and lower HRQoL-child self-report score (p<0.05, for all) compared with the control group. Significant associations were found between PAQ-C and PedsQL 4.0 (p<0.05), between SCARED and PedsQL 4.0 (p<0.05), and between HbA1c and PedsQL 4.0 (p<0.05) in children with T1DM.\nCONCLUSIONS: The result of our study suggested that only HRQoL was related to physical activity, anxiety and HbA1c in children with T1DM.",
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            "title": "Needle detachment in a slim and physically active child with insulin pump treatment",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Christine",
                    "lastName": "Moser"
                },
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                    "creatorType": "author",
                    "firstName": "Kathrin",
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                    "firstName": "Sabine E.",
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            "abstractNote": "Insulin pump therapy (CSII) is well established in pediatric patients with type 1 diabetes. In childhood diabetes, insulin pump treatment shows considerable advantages such as fewer injections, increased flexibility, fewer hypoglycemic events and lower HbA1c levels. Side effects such as catheter obstruction, technical pump failure, and dermatological complications have been observed, but are rarely reported. The reported patient is a physically very active and slim 10-year-old boy with reduced subcutaneous fatty tissue. After strong muscular activity an accidental rupture of the infusion set and needle detachment occurred in October 2013. X-ray and ultrasound imaging localized the needle in the musculus rectus femoris dexter. The needle was kept in situ and oral antibiotic treatment to prevent inflammatory reaction was prescribed. Repeated ultrasound measurements documented that the needles position had remained unchanged. Steel needle catheters (Sure-T infusion set, 6 mm) positioned in a thin layer of subcutaneous fat tissue of the thigh, combined with intense sports activity can result in a needle rupture and penetration into the muscle. Careful monitoring provides an alternative to surgery and lowers the risk of muscular necrosis. Because of differences in the distribution of subcutaneous fat tissue, an individualized catheter selection is necessary in pump treatment for children and adolescents, requiring a variety of different catheter sets.",
            "publicationTitle": "Pediatric Diabetes",
            "publisher": "",
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            "date": "Jul 23, 2015",
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            "issue": "",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "",
            "series": "",
            "seriesTitle": "",
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            "PMID": "26201949",
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        "data": {
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            "version": 740,
            "itemType": "journalArticle",
            "title": "Explaining the increased mortality in type 1 diabetes",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Chiara",
                    "lastName": "Mameli"
                },
                {
                    "creatorType": "author",
                    "firstName": "Sara",
                    "lastName": "Mazzantini"
                },
                {
                    "creatorType": "author",
                    "firstName": "Moufida",
                    "lastName": "Ben Nasr"
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                {
                    "creatorType": "author",
                    "firstName": "Paolo",
                    "lastName": "Fiorina"
                },
                {
                    "creatorType": "author",
                    "firstName": "Andrea E.",
                    "lastName": "Scaramuzza"
                },
                {
                    "creatorType": "author",
                    "firstName": "Gian Vincenzo",
                    "lastName": "Zuccotti"
                }
            ],
            "abstractNote": "Despite large improvements in the management of glucose levels and in the treatment of cardiovascular risk factors, the mortality rate in individuals with type 1 diabetes (T1D) is still high. Recently, Lind et al found that T1D individuals with glycated hemoglobin levels of 6.9% or lower had a risk of death from any cause or from cardiovascular causes that is twice as high as the risk for matched controls. T1D is a chronic disease with an early onset (e.g., pediatric age) and thus in order to establish a clear correlation between death rate and the glycometabolic control, the whole history of glycemic control should be considered; particularly in the early years of diabetes. The switch from a normo- to hyperglycemic milieu in an individual with T1D in the pediatric age, represents a stressful event that may impact outcomes and death rate many years later. In this paper we will discuss the aforementioned issues, and offer our view on these findings, paying a particular attention to the several alterations occurring in the earliest phases of T1D and to the many factors that may be associated with the chronic history of T1D. This may help us to better understand the recently published death rate data and to develop future innovative and effective preventive strategies.",
            "publicationTitle": "World Journal of Diabetes",
            "publisher": "",
            "place": "",
            "date": "Jul 10, 2015",
            "volume": "6",
            "issue": "7",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "889-895",
            "series": "",
            "seriesTitle": "",
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            "PMID": "26185597",
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            "title": "Improved end-stage high intensity performance but similar glycaemic responses after waxy barley starch ingestion compared to dextrose in type 1 diabetes",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "B. J.",
                    "lastName": "Gray"
                },
                {
                    "creatorType": "author",
                    "firstName": "R.",
                    "lastName": "Page"
                },
                {
                    "creatorType": "author",
                    "firstName": "D.",
                    "lastName": "Turner"
                },
                {
                    "creatorType": "author",
                    "firstName": "D.",
                    "lastName": "West"
                },
                {
                    "creatorType": "author",
                    "firstName": "M. D.",
                    "lastName": "Campbell"
                },
                {
                    "creatorType": "author",
                    "firstName": "L. P.",
                    "lastName": "Kilduff"
                },
                {
                    "creatorType": "author",
                    "firstName": "J. W.",
                    "lastName": "Stephens"
                },
                {
                    "creatorType": "author",
                    "firstName": "S. C.",
                    "lastName": "Bain"
                },
                {
                    "creatorType": "author",
                    "firstName": "R. M.",
                    "lastName": "Bracken"
                }
            ],
            "abstractNote": "INTRODUCTION: Pre-exercise carbohydrate (CHO) ingestion is an effective strategy for reducing the occurrence of hypoglycaemia during or after exercise in individuals with type 1 diabetes (T1DM). The metabolic effects of ingestion of different CHOs for glycaemic or performance gains have been under-researched. This study compared metabolic responses and fuel use during sub-maximal and high-intensity performance running following preexercise ingestion of waxy barley starch (WBS) or dextrose (DEX) in T1DM.\nMETHODS: Seven participants attended the laboratory on two separate occasions following preliminary testing. On each visit participants consumed either 0.6 g.kg-1 body mass of DEX or WBS 2-h before a 26-min discontinuous incremental treadmill protocol (4-min running: 1.5-min rest) finishing at 80±4% O2peak followed by a 10-min performance run on a nonmotorised treadmill. Capillary blood samples were taken at rest, during and following exercise and analysed for glucose (BG) and acid-base variables. Data (mean±SEM) were analysed using repeated measures ANOVA (P<0.05).\nRESULTS: BG reached similar peak values one hour after CHO ingestion and immediate presub- maximal exercise BG were comparable. Resting CHO oxidation was elevated and lipid oxidation lower under WBS (P<0.05). There were no metabolic or cardio-respiratory differences during the sub-maximal exercise (P>0.05). In the final quartile of the performance run, a greater distance was completed under WBS (WBS 323±21 vs. DEX 301±20 m, P=0.02).\nCONCLUSIONS: Consumption of WBS demonstrated similar hyperglycaemic responses to dextrose ingestion but a greater rate of CHO use at rest. Interestingly, T1DM individuals displayed an improved performance at the latter stages of a high-intensity run test.",
            "publicationTitle": "The Journal of Sports Medicine and Physical Fitness",
            "publisher": "",
            "place": "",
            "date": "Jul 29, 2015",
            "volume": "",
            "issue": "",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "J Sports Med Phys Fitness",
            "DOI": "",
            "citationKey": "",
            "url": "",
            "accessDate": "",
            "PMID": "26223005",
            "PMCID": "",
            "ISSN": "0022-4707",
            "archive": "",
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