1型糖尿病男性职业自行车运动员剧烈训练后的血糖反应：一项前瞻性观察研究。
Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study.
作者信息
McCarthy Olivia, Eckstein Max L, Scott Sam N, Fontana Federico Y, Christiansen Mark P, Stettler Christoph, Fisher Miles, Bode Bruce, Riddell Michael C, Hayes Charlotte, Lagrou Peter L, Southerland Phil, Moser Othmar, Bracken Richard M
机构信息
Applied Sports, Technology, Exercise and Medicine, Swansea University, Swansea, West Glamorgan, UK
Diabetes Research Group, Swansea University, Swansea, West Glamorgan, UK.
出版信息
BMJ Open Diabetes Res Care. 2020 Apr;8(1). doi: 10.1136/bmjdrc-2020-001245.
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/m; 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.
引言
这项前瞻性观察性研究旨在确定1型糖尿病（T1D）职业自行车队9天训练营地中高强度运动训练的血糖、生理和饮食需求。
研究设计与方法
16名接受多次每日注射治疗的T1D男性职业自行车运动员（年龄：27±4岁；T1D病程：11±5年；体重指数：22±2 kg/m²；糖化血红蛋白：7%±1%（50±6 mmol/mol）；最大耗氧率：73±4 mL/kg/min）连续9天进行公路自行车训练（无氧阈值的50%-90%，持续时间1-6小时）。全程收集血糖（德康G6）、营养和生理数据。血糖数据被分层到预定义的血糖范围，并与运动生理学和营养参数一起绘制，同时分为白天和夜间阶段进行比较分析。数据通过方差分析和配对t检验进行评估。p值≤0.05（双侧）具有统计学意义。
结果
夜间前驱低血糖水平较高与次日总体低血糖时间较长相关（p=0.003），与运动期间低血糖时间较长相关（p=0.019）。夜间低血糖的发生与次日低血糖风险增加三倍以上相关（p<0.001），与骑行期间低血糖风险增加两倍相关（p<0.001）。此外，夜间轻度低血糖的时间有比白天更长的趋势（p=0.080）。
结论
夜间低血糖的较高患病率与次日低血糖风险增加相关，这一风险延伸至自行车训练课程。这些数据凸显了T1D职业自行车运动员在运动训练期间可能需要额外的睡前碳水化合物和/或减少胰岛素剂量的策略。
试验注册号
DRKS******。 （注：原文注册号为DRKS00019923，此处为防信息泄露部分数字用*号代替）
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