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Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study

Olivia McCarthy, Max L Eckstein, Sam N Scott, Federico Y Fontana, Mark P Christiansen, Christoph Stettler, Miles Fisher, Bruce Bode, Michael C Riddell, Charlotte Hayes, Peter L Lagrou, Phil Southerland, Othmar Moser, Richard Bracken Orcid Logo

BMJ Open Diabetes Research & Care, Volume: 8, Issue: 1

Swansea University Authors: Olivia McCarthy, Richard Bracken Orcid Logo

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DOI (Published version): 10.1136/bmjdrc-2020-001245

Abstract

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 cyc...

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Published in: BMJ Open Diabetes Research & Care
ISSN: 2052-4897 2052-4897
Published: 2020
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-01-14T13:50:11.7883951</datestamp><bib-version>v2</bib-version><id>55189</id><entry>2020-09-16</entry><title>Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study</title><swanseaauthors><author><sid>4fea3e19b39712dea1d051d317614572</sid><firstname>Olivia</firstname><surname>McCarthy</surname><name>Olivia McCarthy</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f5da81cd18adfdedb2ccb845bddc12f7</sid><ORCID>0000-0002-6986-6449</ORCID><firstname>Richard</firstname><surname>Bracken</surname><name>Richard Bracken</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2020-09-16</date><deptcode>STSC</deptcode><abstract>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&#xB1;4 years; duration of T1D: 11&#xB1;5 years; body mass index: 22&#xB1;2&#x2009;kg/m2; glycated hemoglobin: 7%&#xB1;1% (50&#xB1;6&#x2009;mmol/mol); maximum rate of oxygen consumption: 73&#xB1;4&#x2009;mL/kg/min) performed road cycle sessions (50%&#x2013;90% of the anaerobic threshold, duration 1&#x2013;6&#x2009;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 &#x2264;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&lt;0.001) and a twofold risk of low glucose during cycling (p&lt;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.</abstract><type>Journal Article</type><journal>BMJ Open Diabetes Research &amp; Care</journal><volume>8</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher/><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2052-4897</issnPrint><issnElectronic>2052-4897</issnElectronic><keywords/><publishedDay>16</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2020</publishedYear><publishedDate>2020-04-16</publishedDate><doi>10.1136/bmjdrc-2020-001245</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-01-14T13:50:11.7883951</lastEdited><Created>2020-09-16T15:51:06.2900437</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Olivia</firstname><surname>McCarthy</surname><order>1</order></author><author><firstname>Max L</firstname><surname>Eckstein</surname><order>2</order></author><author><firstname>Sam N</firstname><surname>Scott</surname><order>3</order></author><author><firstname>Federico Y</firstname><surname>Fontana</surname><order>4</order></author><author><firstname>Mark P</firstname><surname>Christiansen</surname><order>5</order></author><author><firstname>Christoph</firstname><surname>Stettler</surname><order>6</order></author><author><firstname>Miles</firstname><surname>Fisher</surname><order>7</order></author><author><firstname>Bruce</firstname><surname>Bode</surname><order>8</order></author><author><firstname>Michael C</firstname><surname>Riddell</surname><order>9</order></author><author><firstname>Charlotte</firstname><surname>Hayes</surname><order>10</order></author><author><firstname>Peter L</firstname><surname>Lagrou</surname><order>11</order></author><author><firstname>Phil</firstname><surname>Southerland</surname><order>12</order></author><author><firstname>Othmar</firstname><surname>Moser</surname><order>13</order></author><author><firstname>Richard</firstname><surname>Bracken</surname><orcid>0000-0002-6986-6449</orcid><order>14</order></author></authors><documents><document><filename>55189__18179__072a42d11bf74874b4a79a43dcf6d850.pdf</filename><originalFilename>55189.pdf</originalFilename><uploaded>2020-09-16T15:52:46.4536707</uploaded><type>Output</type><contentLength>2980631</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; Author(s) (or their employer(s)) 2020. 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spelling 2021-01-14T13:50:11.7883951 v2 55189 2020-09-16 Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study 4fea3e19b39712dea1d051d317614572 Olivia McCarthy Olivia McCarthy true false f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2020-09-16 STSC 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. Journal Article BMJ Open Diabetes Research & Care 8 1 2052-4897 2052-4897 16 4 2020 2020-04-16 10.1136/bmjdrc-2020-001245 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-01-14T13:50:11.7883951 2020-09-16T15:51:06.2900437 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Olivia McCarthy 1 Max L Eckstein 2 Sam N Scott 3 Federico Y Fontana 4 Mark P Christiansen 5 Christoph Stettler 6 Miles Fisher 7 Bruce Bode 8 Michael C Riddell 9 Charlotte Hayes 10 Peter L Lagrou 11 Phil Southerland 12 Othmar Moser 13 Richard Bracken 0000-0002-6986-6449 14 55189__18179__072a42d11bf74874b4a79a43dcf6d850.pdf 55189.pdf 2020-09-16T15:52:46.4536707 Output 2980631 application/pdf Version of Record true © Author(s) (or their employer(s)) 2020. All article content, except where otherwise noted, is licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license true eng http://creativecommons.org/licenses/by-nc/4.0/
title Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
spellingShingle Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
Olivia McCarthy
Richard Bracken
title_short Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
title_full Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
title_fullStr Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
title_full_unstemmed Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
title_sort Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study
author_id_str_mv 4fea3e19b39712dea1d051d317614572
f5da81cd18adfdedb2ccb845bddc12f7
author_id_fullname_str_mv 4fea3e19b39712dea1d051d317614572_***_Olivia McCarthy
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken
author Olivia McCarthy
Richard Bracken
author2 Olivia McCarthy
Max L Eckstein
Sam N Scott
Federico Y Fontana
Mark P Christiansen
Christoph Stettler
Miles Fisher
Bruce Bode
Michael C Riddell
Charlotte Hayes
Peter L Lagrou
Phil Southerland
Othmar Moser
Richard Bracken
format Journal article
container_title BMJ Open Diabetes Research & Care
container_volume 8
container_issue 1
publishDate 2020
institution Swansea University
issn 2052-4897
2052-4897
doi_str_mv 10.1136/bmjdrc-2020-001245
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
active_str 0
description 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.
published_date 2020-04-16T04:09:13Z
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