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  1. Professor Martin P Schwellnus
  1. University of Cape Town, South Africa

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    The effect of exercise on the absorption of inhaled human insulin in healthy volunteers

    ▸ Petersen AH, Kohler G, Korsatko S, et al. Br?J?Clin Pharmacol 2007;65:165–71.


    Inhaled human insulin is a new alternative to administration by subcutaneous injection. However, the absorption of inhaled insulin may be affected by exercise — this information is important for the diabetic athlete

    Research question/s:

    Does moderate exercise increase the absorption of inhaled insulin?


    Subjects: 12 non-smoking healthy subjects (22.7–36.4 years)

    Experimental procedure: All the subjects were screened and then underwent three interventions after inhaling 3.5 mg human insulin via a nebuliser in a random order as follows: no exercise (Con), 30 min exercise (50% VO2max) immediately after inhalation (ExImm), or 30 min exercise starting 30 min after inhalation (Ex30). The study was carried out as a 10 h euglycaemic glucose clamp (5.0 mmol/litre)

    Main measures of outcome: Absorption of insulin in first 2 h (% increase from Con), insulin concentration

    Main finding/s:


    Insulin administration by inhalation (nebuliser) either immediately before, or 30 min before, moderate intensity (50% VO2max) exercise for 30 min results in increased insulin absorption over the first 2 h — athletes using inhaled insulin should be made aware of this change

    Evidence based rating:


    Clinical interest rating:


    Type of study:

    Randomised, controlled, cross-over clinical trial

    Methodological considerations:

    Well conducted study


    athletes, diabetes, insulin, inhalation, absorption, exercise

    Hitting the wall in the marathon: phenomenological characteristics and associations with expectancy, gender, and running history

    ▸ Buman MP, Brewer BW, Cornelius AE, et al. Psych Sport Exerc 2008;9:177–90.


    Marathon runners frequently report the phenomenon of “hitting the wall” in the last quarter of a race when they experience general fatigue and inability to maintain running speed — factors associated with this phenomenon are not known

    Research question/s:

    What is the self-reported frequency of “hitting the wall” in marathon runners, what are the characteristics of this phenomenon, and what factors are related to this phenomenon (expectancy, gender, and running history)?


    Subjects: 315 marathon runners (male = 218, female = 97) from three Eastern …

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