Physiology Commons^™

Cloning, Characteristics, And Functional Analysis Of Rabbit Nadph Oxidase 5, Feng Chen, Caiyong Yin, Christiana Dimitropoulou, David J.R. Fulton

Bioelectrics Publications

Background: Nox5 was the last member of the Nox enzyme family to be identified. Functionally distinct from the other Nox isoforms, our understanding of its physiological significance has been hampered by the absence of Nox5 in mouse and rat genomes. Nox5 is present in the genomes of other species such as the rabbit that have broad utility as models of cardiovascular disease. However, the mRNA sequence, characteristics, and functional analysis of rabbit Nox5 has not been fully defined and were the goals of the current study.

Methods: Rabbit Nox5 was amplified from rabbit tissue, cloned, and sequenced. COS-7 cells were …

The Effect Of Fasted Vs Fed High-Intensity Interval Exercise On Metabolism And Diet, William Joseph Perez

Human Movement Studies & Special Education Theses & Dissertations

The purpose of this study was to investigate immediate and delayed metabolic and dietary responses to a single bout of cycling high-intensity interval exercise (HIIE) performed in the fasted and fed state. Baseline values of 11 subjects (6 female, 5 male) for resting energy expenditure (REE), respiratory exchange ratio (RER), resting VO₂, VO_2max and appetite score (VAS) were measured on the first visit. Energy balance (EB) was determined using diet tracking and activity energy expenditure (paEE). Trials followed a day at net energy balance and began in a fasted state. A 240-kcal energy bar was consumed prior …

Anti-Predator Responses Of Squid Throughout Ontogeny, Carly Anne York

Biological Sciences Theses & Dissertations

Multiple sensory modalities and a complex array of escape behaviors have evolved as components of anti-predator responses in squids. The goals of this study include: (1) examine the role of the lateral line analogue and vision in successful predator evasion; (2) measure kinematics of escape jetting; (3) document how chromatic patterning, posturing and inking in squid change in response to predators; and (4) investigate escape jet hydrodynamics of squid. Given that squids undergo considerable morphological, ecological, and behavioral changes throughout ontogeny, the goals above were all investigated across different life history stages. To test the respective roles of vision and …

The Effects Of Fitness Level And Sex On Epoc Following High Intensity Interval And Moderate Intensity Aerobic Exercise, Rachel Lauren Simmons

Human Movement Studies & Special Education Theses & Dissertations

In the past few years, much attention has been directed toward shorter-duration vigorous intensity aerobic exercise as opposed to longer-duration moderate intensity exercise. There is conflicting evidence as to whether vigorous exercise can result in a greater excess post-exercise oxygen consumption (EPOC) and thus more calories burned when compared to moderate continuous exercise performed for a longer duration. In addition, the literature contains a dearth of information isolating and investigating male and female response to these exercises, as well as fit and unfit subjects. The purpose of this study was to quantify EPOC following moderate intensity aerobic exercise (MOD) and …

The Relationship Between Landing Error Scoring System-Real Time And Dorsiflexion Range Of Motion In Recreational Athletes, Hannah M. Twiddy

Human Movement Studies & Special Education Theses & Dissertations

Participation in physical activity is important for overall health; however, lower extremity injuries are a major risk associated with physical activity. Injuries can lead to time away from physical activity and be associated with negative health consequences. The most common injuries are traumatic injuries to the knee and ankle; which may be related to poor landing mechanics and decreased range of motion. Previous research utilizing motion analysis systems have determined people with greater dorsiflexion range of motion (DROM) demonstrated smaller ground reaction forces and greater knee and hip flexion displacement while landing; indicating a softer landing strategy. The ability to …

Mitochondrial Function Assessed By 31p Mrs And Bold Mri In Non-Obese Type 2 Diabetic Rats, Yuchi Liu, Xunbai Mei, Jielei Li, Nicola Lai, Xin Yu

Electrical & Computer Engineering Faculty Publications

The study aims to characterize age-associated changes in skeletal muscle bioenergetics by evaluating the response to ischemia-reperfusion in the skeletal muscle of the Goto-Kakizaki (GK) rats, a rat model of non-obese type 2 diabetes (T2D). ³¹P magnetic resonance spectroscopy (MRS) and blood oxygen level-dependent (BOLD) MRI was performed on the hindlimb of young (12 weeks) and adult (20 weeks) GK and Wistar (control) rats. ³¹P-MRS and BOLD-MRI data were acquired continuously during an ischemia and reperfusion protocol to quantify changes in phosphate metabolites and muscle oxygenation. The time constant of phosphocreatine recovery, an index of mitochondrial oxidative capacity, …

Physical Activity/Exercise And Diabetes: A Position Statement Of The American Diabetes Association, Sheri R. Colberg, Ronald J. Sigal, Jane E. Yardley, Michael C. Riddell, David W. Dunstan, Paddy C. Dempsey

Human Movement Studies & Special Education Faculty Publications

The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes and prediabetes. Recommendations and precautions vary depending on individual characteristics and health status. In this Position Statement, we provide a clinically oriented review and evidence-based recommendations regarding physical activity and exercise in people with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, and prediabetes.

Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and …

Rnd3 As A Novel Target To Ameliorate Microvascular Leakage, Jerome W. Breslin, Dayle A. Daines, Travis M. Doggett, Kristine H. Kurtz, Flavia M. Souza-Smith, Xun E. Zhang, Mack H. Wu, Sarah Y. Yuan

Biological Sciences Faculty Publications

Background -Microvascular leakage of plasma proteins is a hallmark of inflammation that leads to tissue dysfunction. There are no current therapeutic strategies to reduce microvascular permeability. The purpose of this study was to identify the role of Rnd3, an atypical Rho family GTPase, in the control of endothelial barrier integrity. The potential therapeutic benefit of Rnd3 protein delivery to ameliorate microvascular leakage was also investigated.

Methods and Results-Using immunofluorescence microscopy, Rnd3 was observed primarily in cytoplasmic areas around the nuclei of human umbilical vein endothelial cells. Permeability to fluorescein isothiocyanate-albumin and transendothelial electrical resistance of human umbilical vein …

Hsp90 Inhibition Suppresses Nf-Κb Transcriptional Activation Via Sirt-2 In Human Lung Microvascular Endothelial Cells, Gagan S. Thangjam, Charalampos Birmpas, Nektarios Barabutis, Betsy W. Gregory, Mary Ann Clemens, Joseph R. Newton, David Fulton, John D. Catravas

Bioelectrics Publications

The ability of anti-heat shock protein 90 (Hsp90) drugs to attenuate NF-κB-mediated transcription is the major basis for their anti-inflammatory properties. While the molecular mechanisms underlying this effect are not clear, they appear to be distinct in human endothelial cells. We now show for the first time that type 2 sirtuin (Sirt-2) histone deacetylase binds human NF-κB target gene promoter and prevents the recruitment of NF-κB proteins and subsequent assembly of RNA polymerase II complex in human lung microvascular endothelial cells. Hsp90 inhibitors stabilize the Sirt-2/promoter interaction and impose a “transcriptional block,” which is reversed by either inhibition or downregulation …

A Flexible Pet-Based Wearable Sensor For Arterial Pulse Waveform Measurement, Dan Wang, Dean Krusienski, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

In light of the need of health monitoring, the paper presents a flexible polyethylene terephthalate (PET)-based wearable sensor for arterial pulse waveform measurement. The sensor encompasses a polydimethylsiloxane (PDMS) microstructure embedded with an electrolyte-enabled 5×1 transducer array, which spans 6mm and has a spatial resolution of 1.5mm. A pulse signal exerts a deflection on the microstructure and is recorded as a resistance change by a transducer at the site of the pulse. An untrained individual can easily align the sensor on a targeted artery with a negligible margin and then acquire the arterial pulse waveform continuously and non-invasively. This sensor …

Gender Differences In Vo2 And Hr Kinetics At The Onset Of Moderate And Heavy Exercise Intensity In Adolescents, Nicola Lai, Alessandro Martis, Alfredo Belfiori, Fatima Tolentino-Silva, Melita M. Nasca, James Strainic, Marco E. Cabrera

Electrical & Computer Engineering Faculty Publications

The majority of the studies on VO₂ kinetics in pediatric populations investigated gender differences in prepubertal children during submaximal intensity exercise, but studies are lacking in adolescents. The purpose of this study was to test the hypothesis that gender differences exist in the VO₂ and heart rate (HR) kinetic responses to moderate (M) and heavy (H) intensity exercise in adolescents. Twenty-one healthy African-American adolescents (9 males, 15.8 ± 1.1 year; 12 females, 15.7 ± 1 year) performed constant work load exercise on a cycle ergometer at M and H. The VO₂ kinetics of the male group was …

Nanosecond Pulsed Platelet-Rich Plasma (Nsprp) Improves Mechanical And Electrial Cardiac Function Following Myocardial Reperfusion Injury, Barbara Y. Hargrave, Frency Varghese, Nektarios Barabutis, John Catravas, Christian Zemlin

School of Medical Diagnostics & Translational Sciences Publications

Ischemia and reperfusion (I/R) of the heart is associated with biochemical and ionic changes that result in cardiac contractile and electrical dysfunction. In rabbits, platelet-rich plasma activated using nanosecond pulsed electric fields (nsPRP) has been shown to improve left ventricular pumping. Here, we demonstrate that nsPRP causes a similar improvement in mouse left ventricular function. We also show that nsPRP injection recovers electrical activity even before reperfusion begins. To uncover the mechanism of nsPRP action, we studied whether the enhanced left ventricular function in nsPRP rabbit and mouse hearts was associated with increased expression of heat-shock proteins and altered mitochondrial …

P53: "The Wall Watcher", Nektarios Barabutis, John D. Catravas

Bioelectrics Publications

No abstract provided.

Kinematics And Hydrodynamics Of Cephalopod Turning Performance In Routine Swimming And Predatory Attacks, Rachel A. Jastrebsky

Biological Sciences Theses & Dissertations

Steady rectilinear swimming has received considerable attention in aquatic animal locomotion studies. Unsteady swimming movements, however, represent a large portion of many aquatic animals’ locomotive repertoire and have not been examined extensively. This study incorporates kinematic analyses of routine turning performance of brief squid Lolliguncula brevis and dwarf cuttlefish Sepia bandensis (Chapter 2), 3D velocimetry techniques to examine hydrodynamic turning performance of L. brevis (Chapter 3) and kinematic analyses of turning performance of L. brevis during predatory attacks on shrimp and fish prey (Chapter 4).

Both L. brevis and S. bandensis demonstrated high maneuverability, having the lowest measures of length-specific …

Bracing Of The Trunk And Neck Has A Differential Effect On Head Control During Gait, S. Morrison, D. M. Russell, K. Kelleran, M. L. Walker

Rehabilitation Sciences Faculty Publications

During gait, the trunk and neck are believed to play an important role in dissipating the transmission of forces from the ground to the head. This attenuation process is important to ensure head control is maintained. The aim of the present study was to assess the impact of externally restricting the motion of the trunk and/or neck segments on acceleration patterns of the upper body and head and related trunk muscle activity. Twelve healthy adults performed three walking trials on a flat, straight 65-m walkway, under four different bracing conditions: 1) control-no brace; 2) neck-braced; 3) trunk-braced; and 4) neck-trunk …

Introduction To Fifth Special Issue On Electroporation-Based Technologies And Treatments, Damijan Miklavčič, Lluis M. Mir, P. Thomas Vernier

Bioelectrics Publications

This special issue of the Journal of Membrane Biology contains reports on recent developments in the field of electroporation by participants in the International Workshop and Postgraduate Course on Electroporation-Based Technologies and Treatments held in November 2014 in Ljubljana. This was the eighth session of what is now an annual event, first organized in 2003.

Picosecond To Terahertz Perturbation Of Interfacial Water And Electropermeabilization Of Biological Membranes, P. Thomas Vernier, Zachary A. Levine, Ming-Chak Ho, Shu Xiao, Iurii Semenov, Andrei G. Pakhomov

Bioelectrics Publications

Non-thermal probing and stimulation with subnanosecond electric pulses and terahertz electromagnetic radiation may lead to new, minimally invasive diagnostic and therapeutic procedures and to methods for remote monitoring and analysis of biological systems, including plants, animals, and humans. To effectively engineer these still-emerging tools, we need an understanding of the biophysical mechanisms underlying the responses that have been reported to these novel stimuli. We show here that subnanosecond (≤500 ps) electric pulses induce action potentials in neurons and cause calcium transients in neuroblastoma-glioma hybrid cells, and we report complementary molecular dynamics simulations of phospholipid bilayers in electric fields in which …

Histone Deacetylase Inhibitors Prevent Pulmonary Endothelial Hyperpermeability And Acute Lung Injury By Regulating Heat Shock Protein 90 Function, Atul D. Joshi, Nektarios Barabutis, Charalampos Birmpas, Christiana Dimitropoulou, Gagan Thangjam, Mary Cherian-Shaw, John Dennison, John D. Catravas

Bioelectrics Publications

Transendothelial hyperpermeability caused by numerous agonists is dependent on heat shock protein 90 (Hsp90) and leads to endothelial barrier dysfunction (EBD). Inhibition of Hsp90 protects and restores transendothelial permeability. Hyperacetylation of Hsp90, as by inhibitors of histone deacetylase (HDAC), suppresses its chaperone function and mimics the effects of Hsp90 inhibitors. In this study we assessed the role of HDAC in mediating lipopolysaccharide (LPS)-induced transendothelial hyperpermeability and acute lung injury (ALI). We demonstrate that HDAC inhibition protects against LPS-mediated EBD. Inhibition of multiple HDAC by the general inhibitors panobinostat or trichostatin provided protection against LPS-induced transendothelial hyperpermeability, acetylated and suppressed Hsp90 …

A Novel Cardiac Muscle-Derived Biomaterial Reduces Dyskinesia And Postinfarct Left Ventricular Remodeling In A Mouse Model Of Myocardial Infarction, Daniel M. O'Connor, Nivedita K. Naresh, Bryan A. Piras, Yaqin Xu, Robert S. Smith, Roy C. Ogle

School of Medical Diagnostics & Translational Sciences Publications

Extracellular matrix (ECM) degradation after myocardial infarction (MI) leaves the myocardium structurally weakened and, as a result, susceptible to early infarct zone dyskinesia and left ventricular (LV) remodeling. While various cellular and biomaterial preparations have been transplanted into the infarct zone in hopes of improving post-MI LV remodeling, an allogeneic cardiac muscle-derived ECM extract has yet to be developed and tested in the setting of reperfused MI. We sought to determine the effects of injecting a novel cardiac muscle-derived ECM into the infarct zone on early dyskinesia and LV remodeling in a mouse model of MI. Cardiac muscle ECM was …

Mutations In The Plasmodium Falciparum Chloroquine Resistance Transporter, Pfcrt, Enlarge The Parasite's Food Vacuole And Alter Drug Sensitivities, Serena Pulcini, Henry M. Staines, Andrew H. Lee, Sarah H. Shafik, Guillaume Bouyer, Catherine M. Moore, Daniel A. Daley, Matthew J. Hoke, Lindsey M. Altenhofen, Heather J. Painter, Jainbing Mu, David J.P. Ferguson, Manuel Llinás, Rowena E. Martin, David A. Fidock, Roland A. Cooper, Sanjeev Krishna

Biological Sciences Faculty Publications

Mutations in the Plasmodium falciparum chloroquine resistance transporter, PfCRT, are the major determinant of chloroquine resistance in this lethal human malaria parasite. Here, we describe P. falciparum lines subjected to selection by amantadine or blasticidin that carry PfCRT mutations (C101F or L272F), causing the development of enlarged food vacuoles. These parasites also have increased sensitivity to chloroquine and some other quinoline antimalarials, but exhibit no or minimal change in sensitivity to artemisinins, when compared with parental strains. A transgenic parasite line expressing the L272F variant of PfCRT confirmed this increased chloroquine sensitivity and enlarged food vacuole phenotype. Furthermore, the introduction …

Transcriptome Of The Female Synganglion Of The Black-Legged Tick Ixodes Scapularis (Acari: Ixodidae) With Comparison Between Illumina And 454 Systems, Noble Egekwu, Daniel E. Sonenshine, Brooke W. Bissinger, R. Michael Roe

Biological Sciences Faculty Publications

Illumina and 454 pyrosequencing were used to characterize genes from the synganglion of female Ixodes scapularis. GO term searching success for biological processes was similar for samples sequenced by both methods. However, for molecular processes, it was more successful for the Illumina samples than for 454 samples. Functional assignments of transcripts predicting neuropeptides, neuropeptide receptors, neurotransmitter receptors and other genes of interest was done, supported by strong e-values (<-6), and high consensus sequence alignments. Transcripts predicting 15 putative neuropeptide prepropeptides ((allatostatin, allatotropin, bursicon α, corticotropin releasing factor (CRF), CRF-binding protein, eclosion hormone, FMRFamide, glycoprotein A, insulin-like peptide, ion transport peptide, myoinhibitory peptide, inotocin ( = neurophysin-oxytocin), Neuropeptide F, sulfakinin and SIFamide)) and transcripts predicting receptors for 14 neuropeptides (allatostatin, calcitonin, cardioacceleratory peptide, corazonin, CRF, eclosion hormone, gonadotropin-releasing hormone/AKH-like, insulin-like peptide, neuropeptide F, proctolin, pyrokinin, SIFamide, sulfakinin and tachykinin) are reported. Similar to Dermacentor variabilis, we found transcripts matching pro-protein convertase, essential for converting neuropeptide hormones to their mature form. Additionally, transcripts predicting 6 neurotransmitter/neuromodulator receptors (acetylcholine, GABA, dopamine, glutamate, octopamine and …

The Effects Of Squat Depth On Lower Extremity Joint Kinetics, Acl Loading, Pcl Loading, Tibiofemoral Compressive Forces And Activations Of Eight Lower Extremity Muscles, Zachary A. Sievert

Human Movement Studies & Special Education Theses & Dissertations

Performing resistance training exercises are important in many facets oflife. Resistance training can be used from elite athletes preparing for the Olympics to the average person exercising for overall health. The squat is a common training exercise that can be utilized to improve lower extremity strength and performance. There has been much debate on the effects of squatting depth on lower extremity joint kinetics and kinematics. Therefore the purpose of this thesis is to examine the effects of depth and load on the muscle activation of eight lower extremity muscles and three-dimensional (30) joint moments about the right knee, hip …

Intensity Of Exercise And Endothelial Function In Healthy Adults, Jacquelyn R. Moxey

Human Movement Studies & Special Education Theses & Dissertations

PURPOSE: To examine the effects of acute bouts of isocaloric exercise at different intensities on endothelial function. The flow-mediated dilation (FMD) responses after the different acute exercise bouts were compared to a control (no exercise) condition. METHODS: Nine healthy subjects completed the study (6 males, 3 females, X ± SD = 24 ± 5 yr, 1.75 ± 0.11 m, 79.2 ± 12.4 kg, 47.9 ± 6.9 mL•kg^-1•min^-1). Vascular responses were compared under three different conditions- HIT: a bout of high-intensity interval treadmill exercise consisting of ten 1-minute intervals at ~100% VO_2max; MOD: moderate-intensity exercise …

Leptin Regulates Cd16 Expression On Human Monocytes In A Sex-Specific Manner, Joseph G. Cannon, Gyanendra Sharma, Gloria Sloan, Christiana Dimitropoulou, R. Randall Baker, Andrew Mazzoli, Barbara Kraj, Anthony Mulloy, Miriam Cortez-Cooper

School of Medical Diagnostics & Translational Sciences Publications

Fat mass is linked mechanistically to the cardiovascular system through leptin, a 16 kDa protein produced primarily by adipocytes. In addition to increasing blood pressure via hypothalamic-sympathetic pathways, leptin stimulates monocyte migration, cytokine secretion, and other functions that contribute to atherosclerotic plaque development. These functions are also characteristics of CD16-positive monocytes that have been implicated in the clinical progression of atherosclerosis. This investigation sought to determine if leptin promoted the development of such CD16-positive monocytes. Cells from 45 healthy men and women with age ranging from 20 to 59 years were analyzed. Circulating numbers of CD14++16++ monocytes, which are primary …

Basic Features Of A Cell Electroporation Model: Illustrative Behavior For Two Very Different Pulses, Reuben S. Son, Kyle C. Smith, Thiruvallur R. Gowrishankar, P. Thomas Vernier, James C. Weaver

Bioelectrics Publications

Science increasingly involves complex modeling. Here we describe a model for cell electroporation in which membrane properties are dynamically modified by poration. Spatial scales range from cell membrane thickness (5 nm) to a typical mammalian cell radius (10 μm), and can be used with idealized and experimental pulse waveforms. The model consists of traditional passive components and additional active components representing nonequilibrium processes. Model responses include measurable quantities: transmembrane voltage, membrane electrical conductance, and solute transport rates and amounts for the representative "long" and "short" pulses. The long pulse-1.5 kV/cm, 100 μs-evolves two pore subpopulations with a valley at ~5 …

Introduction To Fourth Special Issue On Electroporation-Based Technologies And Treatments, Damijan Miklavčič, Lluis M. Mir, P. Thomas Vernier

Bioelectrics Publications

This fourth special electroporation-based technologies and treatments issue of the Journal of Membrane Biology contains reports on recent developments in the field of electroporation by participants in the 7th International Workshop and Postgraduate Course on electroporation based technologies and treatments (EBTT 2013) held in Ljubljana, November 17–23, 2013. The 65 participants included faculty members, invited lecturers, special guests, and young scientists, and students from 16 countries. In addition to lectures on the fundamentals, this year’s sessions included talks on microbial inactivation by pulsed electric fields, modeling of intracellular electroporation, electroporation in food processing, and electrotransfer-facilitated DNA vaccination.

Blood Glucose Responses To Type, Intensity, Duration, And Timing Of Exercise, Sheri R. Colberg, Manuel J. Hernandez, Fatima Shahzad

Human Movement Studies & Special Education Faculty Publications

[First Paragraph] The Big Blue Test (BBT) is an annual initiative by the Diabetes Hands Foundation to raise awareness of the importance of physical activity in managing diabetes. Individuals with diabetes voluntarily exercise and record self-monitored blood glucose levels. During the 2012 BBT, 5,157 diabetic participants (~90% insulin users) anonymously entered exercise type, intensity, duration, time elapsed since last meal, and blood glucose readings before and after one or more bouts of exercise separately through www.BigBlueTest.org or an Iphone app.

Development And Validation Of A Predictive Model Of Acute Glucose Response To Exercise In Individuals With Type 2 Diabetes, Bryan S. Gibson, Sheri R. Colberg, Paul Poirier, Denise Maria Martins Vancea, Jason Jones, Robin Marcus

Human Movement Studies & Special Education Faculty Publications

Background: Our purpose was to develop and test a predictive model of the acute glucose response to exercise in individuals with type 2 diabetes.

Design and methods: Data from three previous exercise studies (56 subjects, 488 exercise sessions) were combined and used as a development dataset. A mixed-effects Least Absolute Shrinkage Selection Operator (LASSO) was used to select predictors among 12 potential predictors. Tests of the relative importance of each predictor were conducted using the Lindemann Merenda and Gold (LMG) algorithm. Model structure was tested using likelihood ratio tests. Model accuracy in the development dataset was assessed by leave-one-out cross-validation. …

Functional Effects Of Kcnq K(+) Channels In Airway Smooth Muscle, Alexey I. Evseev, Iurii Semenov, Crystal R. Archer, Jorge L. Medina, Peter H. Dube, Mark S. Shapiro, Robert Brenner

Bioelectrics Publications

KCNQ (Kv7) channels underlie a voltage-gated K+ current best known for control of neuronal excitability, and its inhibition by Gq/11-coupled, muscarinic signaling. Studies have indicated expression of KCNQ channels in airway smooth muscle (ASM), a tissue that is predominantly regulated by muscarinic receptor signaling. Therefore, we investigated the function of KCNQ channels in rodent ASM and their interplay with Gq/11-coupled M3 muscarinic receptors. Perforated-patch clamp of dissociated ASM cells detected a K+ current inhibited by the KCNQ antagonist, XE991, and augmented by the specific agonist, flupirtine. KCNQ channels begin to activate at voltages near resting potentials for ASM cells, and …

The Big Blue Test: Effects Of 14 Minutes Of Physical Activity On Blood Glucose Levels, Sheri R. Colberg, Manuel J. Hernandez

Human Movement Studies & Special Education Faculty Publications

[First paragraph] For most with diabetes, physical activity has a blood glucose lowering effect (1). Hypoglycemia (i.e., blood glucose < 65 mg/dL) resulting from exercise is a concern, particularly for insulin users (2).