Cardiovascular Diabetology Research Group, Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea, UK.
Diabetes Obes Metab. 2020 Oct;22(10):1714-1721. doi: 10.1111/dom.14083. Epub 2020 Jun 8.
To assess insulin therapy, macronutrient intake and glycaemia in professional cyclists with type 1 diabetes (T1D) over a 5-day Union Cycliste Internationale road-cycle race.
In this prospective observational study, seven professional cyclists with T1D (age 28 ± 4 years, body mass index 20.9 ± 0.9 kg/m , glycated haemoglobin concentration 56 ± 7 mmol/mol [7.3% ± 0.6%]) were monitored during a five-stage professional road cycling race. Real-time continuous glucose monitoring (rtCGM) data, smart insulin pen dose data and macronutrient intake were assessed by means of repeated-measure one-way ANOVA and post hoc testing. Associations between exercise physiological markers and rtCGM data, insulin doses and macronutrient intake were assessed via linear regression modelling (P ≤ 0.05).
Bolus insulin dose was significantly reduced over the 5-day period (P = 0.03), while carbohydrate intake (P = 0.24) and basal insulin doses remained unchanged (P = 0.64). A higher mean previous-day race intensity was associated with a lower mean sensor glucose level (P = 0.03), less time above range level 2 (>13.9 mmol/L [250 mg/dL]; P = 0.05) and lower doses of bolus insulin (P = 0.04) on the subsequent day. No significant associations were found for any other glycaemic range and glycaemic variability (P > 0.05).
This is the first study to demonstrate the influence of previous-day race intensity on subsequent bolus insulin dose requirements in professional cyclists with T1D. These data may help inform therapeutic strategies to ensure safe exercise performance.
评估 1 型糖尿病（T1D）职业自行车运动员在国际自行车联盟 5 天公路自行车赛期间的胰岛素治疗、宏量营养素摄入和血糖水平。
在这项前瞻性观察研究中，对 7 名 T1D（年龄 28 ± 4 岁，体重指数 20.9 ± 0.9 kg/m ，糖化血红蛋白浓度 56 ± 7 mmol/mol [7.3% ± 0.6%]）职业自行车运动员在为期 5 天的职业公路自行车比赛期间进行监测。通过重复测量单向方差分析和事后检验评估实时连续血糖监测（rtCGM）数据、智能胰岛素笔剂量数据和宏量营养素摄入。通过线性回归模型评估运动生理标志物与 rtCGM 数据、胰岛素剂量和宏量营养素摄入之间的关系（P ≤ 0.05）。
在 5 天期间，胰岛素推注剂量显著降低（P = 0.03），而碳水化合物摄入（P = 0.24）和基础胰岛素剂量保持不变（P = 0.64）。前一天比赛强度较高与平均传感器血糖水平较低（P = 0.03）、高于范围水平 2 的时间（>13.9 mmol/L [250 mg/dL]；P = 0.05）和较低的胰岛素推注剂量（P = 0.04）相关。对于任何其他血糖范围和血糖变异性，都没有发现显著的相关性（P > 0.05）。
这是第一项研究表明前一天比赛强度对 T1D 职业自行车运动员随后胰岛素推注剂量需求的影响。这些数据可能有助于制定治疗策略，以确保安全的运动表现。
