Abstract
IntroductionTo investigate the glycaemic response, macronutrient intake and insulin management in people with type 1 diabetes (T1D) compared to healthy individuals around a running competition.Material and methodsThis was a single-centre, prospective, controlled observational study performed in individuals with T1D and healthy people. 24 people (12 T1D) were included in this study (age: T1D 41±12 vs. healthy 38±6 years, females: 3 vs. 6, BMI: 25.53.0 vs. 22.9±2.8 kg/m2). Both groups received an intermittently scanned continuous glucose monitoring (isCGM; FreeStyle Libre 1, Abbott, USA) system to assess glycaemia 24 hours before, during and 24 hours after a running competition. During this period, participants recorded their food intake and insulin administration. Data were analysed via ANOVA and mixed model analyses with post-hoc testing (p≤0.05).ResultsFor overall glycaemic ranges in comparison of groups, significant differences were found for time in range (T1D 63±21% vs. healthy 89±13%, p = 0.001), time above range (TAR) 1 (T1D 21±15% vs. healthy 0±0%, p<0.001) and TAR 2 (T1D 8 [0–16%] vs. healthy 0±0%, p<0.001). When glycaemic variability was assessed, people with T1D had a higher glycaemic variability compared to healthy individuals (p<0.0001). Basal insulin dose was significantly reduced when compared against the regular pre-study basal insulin dose (pre-study 22±6 vs. pre-competition day 11±9 (-50±41%), p = 0.02; competition day 15±5 (-32± 1%)).ConclusionPeople with T1D have impaired glucose responses around a running competition compared to healthy individuals. However, basal insulin dose reductions were sufficient to prevent further dysglycaemia.Clinical trial IDdrks.de; DRKS00019886
Highlights
To investigate the glycaemic response, macronutrient intake and insulin management in people with type 1 diabetes (T1D) compared to healthy individuals around a running competition
Our study showed that people with T1D have unsurprisingly higher sensor glucose levels around a running competition, the glucose pattern in preparation to, during and after a running competition were similar to those seen in healthy individuals
These slightly elevated sensor glucose levels during the competition are in line with data from professional cyclists during a race, where ~20─25% of total race time was spent in time above range (TAR) 1 [14,23] in our data, time in range (TIR) during the competition was found at ~40% of total race time, which is lower than seen in previously published studies in controlled settings for cycling [24], running [25,26] and as observed in our healthy group (~100%)
Summary
The aim of the present study was to investigate glycaemic responses, macronutrient intake and insulin management in people with T1D and healthy individuals before, during and after a running competition
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