RT Journal Article
SR Electronic
T1 Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e001245
DO 10.1136/bmjdrc-2020-001245
VO 8
IS 1
A1 Olivia McCarthy
A1 Max L Eckstein
A1 Sam N Scott
A1 Federico Y Fontana
A1 Mark P Christiansen
A1 Christoph Stettler
A1 Miles Fisher
A1 Bruce Bode
A1 Michael C Riddell
A1 Charlotte Hayes
A1 Peter L Lagrou
A1 Phil Southerland
A1 Othmar Moser
A1 Richard M Bracken
YR 2020
UL http://drc.bmj.com/content/8/1/e001245.abstract
AB Introduction This prospective observational study sought to establish the glycemic, physiological and dietary demands of strenuous exercise training as part of a 9-day performance camp in a professional cycling team with type 1 diabetes (T1D).Research design and methods Sixteen male professional cyclists with T1D on multiple daily injections (age: 27±4 years; duration of T1D: 11±5 years; body mass index: 22±2 kg/m2; glycated hemoglobin: 7%±1% (50±6 mmol/mol); maximum rate of oxygen consumption: 73±4 mL/kg/min) performed road cycle sessions (50%–90% of the anaerobic threshold, duration 1–6 hours) over 9 consecutive days. Glycemic (Dexcom G6), nutrition and physiological data were collected throughout. Glycemic data were stratified into predefined glycemic ranges and mapped alongside exercise physiology and nutritional parameters, as well as split into daytime and night-time phases for comparative analysis. Data were assessed by means of analysis of variance and paired t-tests. A p value of ≤0.05 (two-tailed) was statistically significant.Results Higher levels of antecedent hypoglycemia in the nocturnal hours were associated with greater time spent in next-day hypoglycemia overall (p=0.003) and during exercise (p=0.019). Occurrence of nocturnal hypoglycemia was associated with over three times the risk of next-day hypoglycemia (p<0.001) and a twofold risk of low glucose during cycling (p<0.001). Moreover, there was trend for a greater amount of time spent in mild hypoglycemia during the night compared with daytime hours (p=0.080).Conclusion The higher prevalence of nocturnal hypoglycemia was associated with an increased risk of next-day hypoglycemia, which extended to cycle training sessions. These data highlight the potential need for additional prebed carbohydrates and/or insulin dose reduction strategies around exercise training in professional cyclists with T1D.Trial registration number DRKS00019923.