Weijer Vera, van der Werf Rob, van der Haijden Myrthe, Jeukendrup Asker, van Loon Luc J C, Dijk Jan-Willem van
School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands.
Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands.
Eur J Sport Sci. 2024 Dec;24(12):1809-1819. doi: 10.1002/ejsc.12220. Epub 2024 Nov 25.
Continuous glucose monitoring (CGM) is an emerging tool for dietary counseling in athletes. This study aimed to explore blood glucose profiles in Para cyclists and evaluate CGM accuracy at rest and during exercise. Thirteen Para cyclists, comprising eight hand bikers and five cyclists, wore a CGM sensor (Abbott) for 2 weeks. Participants recorded the timing of meals and regular training sessions and executed one standardized training session. Fifteen capillary blood glucose reference values (seven at rest and eight during the standardized training) were obtained by finger pricks. Mean glucose concentrations and time spent in hypoglycemia (<3.9 mmol/L), euglycemia (3.9-7.8 mmol/L), and hyperglycemia (>7.8 mmol/L) were calculated over 24 hrs and during daytime, nighttime, exercise, and 2 hrs postprandial periods. Mean absolute relative differences (MARD) were calculated between the CGM and capillary blood glucose. The mean glucose concentration over the 24 hr-period was 5.7 (5.6-5.8) mmol/L. Athletes were in the euglycemia range 91% of the time. Hyperglycemia was almost exclusively observed postprandially and during exercise. Hypoglycemia was restricted to the night and was particularly observed in athletes with a spinal cord injury. CGM accuracy was acceptable at rest (MARD: 12%) but markedly lower during exercise (MARD: 34%; p = 0.01), especially for hand bikers (MARD: 41%) compared with cyclists (MARD: 24%; p = 0.01). Para cyclists generally do not display signs of disturbed glucose regulation. However, the increased risk for nocturnal hypoglycemia in athletes with a spinal cord injury warrants attention. Furthermore, CGM accuracy is compromised during exercise, especially if the sensor is in proximity to highly active muscles.
持续葡萄糖监测（CGM）是一种新兴的运动员饮食咨询工具。本研究旨在探索残奥会自行车运动员的血糖谱，并评估静息和运动期间CGM的准确性。13名残奥会自行车运动员，包括8名手摇自行车运动员和5名自行车运动员，佩戴CGM传感器（雅培）2周。参与者记录饮食时间和常规训练课程，并进行一次标准化训练课程。通过手指采血获得15个毛细血管血糖参考值（静息时7个，标准化训练期间8个）。计算24小时、白天、夜间、运动期间和餐后2小时内的平均血糖浓度以及低血糖（<3.9 mmol/L）、血糖正常（3.9-7.8 mmol/L）和高血糖（>7.8 mmol/L）的持续时间。计算CGM与毛细血管血糖之间的平均绝对相对差异（MARD）。24小时期间的平均血糖浓度为5.7（5.6-5.8）mmol/L。运动员91%的时间处于血糖正常范围。高血糖几乎仅在餐后和运动期间观察到。低血糖仅限于夜间，尤其在脊髓损伤的运动员中观察到。静息时CGM准确性可接受（MARD：12%），但运动期间明显较低（MARD：34%；p = 0.01），与自行车运动员（MARD：24%；p = 0.01）相比，手摇自行车运动员（MARD：41%）尤其如此。残奥会自行车运动员一般不表现出葡萄糖调节紊乱的迹象。然而，脊髓损伤运动员夜间低血糖风险增加值得关注。此外，运动期间CGM准确性受到影响，尤其是当传感器靠近高活性肌肉时。
