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Bolus insulin dose depends on previous‐day race intensity during 5 days of professional road‐cycle racing in athletes with type 1 diabetes: A prospective observational study
Author(s) -
Moser Othmar,
Dietrich Marlene,
McCarthy Olivia,
Bracken Richard M.,
Eckstein Max L.
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14083
Subject(s) - medicine , insulin , type 1 diabetes , bolus (digestion) , diabetes mellitus , repeated measures design , body mass index , endocrinology , post hoc analysis , type 2 diabetes , prospective cohort study , statistics , mathematics
Aims 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 .Material and methods In this prospective observational study, seven professional cyclists with T1D (age 28 ± 4 years, body mass index 20.9 ± 0.9 kg/m 2 , 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). Results 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). Conclusions 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.