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Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race.

ABSTRACT: BACKGROUND:The current study intended to evaluate the feasibility of the application of continuous glucose monitoring to guarantee optimal intake of carbohydrate to maintain blood glucose levels during a 160-km ultramarathon race. METHODS:Seven ultramarathon runners (four male and three female) took part in the study. The glucose profile was monitored continuously throughout the race, which was divided into 11 segments by timing gates. Running speed in each segment was standardized to the average of the top five finishers for each gender. Food and drink intake during the race were recorded and carbohydrate and energy intake were calculated. RESULTS:Observed glucose levels ranged between 61.9-252.0 mg/dL. Average glucose concentration differed from the start to the end of the race (104 ± 15.0 to 164 ± 30.5 SD mg/dL). The total amount of carbohydrate intake during the race ranged from 0.27 to 1.14 g/kg/h. Glucose concentration positively correlated with running speeds in segments (P < 0.005). Energy and carbohydrate intake positively correlated with overall running speed (P < 0.01). CONCLUSION:The present study demonstrates that continuous glucose monitoring could be practical to guarantee optimal carbohydrate intake for each ultramarathon runner.

SUBMITTER: Ishihara K

PROVIDER: S-EPMC7230511 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race.

Ishihara Kengo K Uchiyama Natsuki N Kizaki Shino S Mori Emi E Nonaka Tsutomu T Oneda Hiroshi H

Nutrients 20200417 4

<h4>Background</h4>The current study intended to evaluate the feasibility of the application of continuous glucose monitoring to guarantee optimal intake of carbohydrate to maintain blood glucose levels during a 160-km ultramarathon race.<h4>Methods</h4>Seven ultramarathon runners (four male and three female) took part in the study. The glucose profile was monitored continuously throughout the race, which was divided into 11 segments by timing gates. Running speed in each segment was standardize ...[more]

PMID: 32316458

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Project description:INTRODUCTION:The aim of this study was to objectively analyze the correlation between dietary components and blood glucose variation by means of continuous glucose monitoring (CGM). METHODS:Patients with type 1 diabetes mellitus (T1DM) who received CGM to manage their blood glucose levels were enrolled into the study, and the components of their total caloric intake were analyzed. Glycemic variation parameters were calculated, and dietary components, including percentages of carbohydrate, protein and fat in the total dietary intake, were analyzed by a dietitian. The interaction between parameters of glycemic variability and dietary components was analyzed. RESULTS:Sixty-one patients with T1DM (33 females, 28 males) were enrolled. The mean age of the participants was 34.7 years, and the average duration of diabetes was 14 years. Glycated hemoglobin before CGM was 8.54%. Participants with a carbohydrate intake that accounted for < 50% of their total caloric intake had a longer DM duration and a higher protein and fat intake than did those with a carbohydrate intake that accounted for ≥ 50% of total caloric intake, but there was no between-group difference in total caloric intake per day. The group with a carbohydrate intake that accounted for < 50% of their total caloric intake also had lower nocturnal continuous overlapping net glycemic action (CONGA) 1, - 2 and - 4 values. The percentage of protein intake had a slightly negative correlation with mean amplitude of glycemic excursions (MAGE) (r = - 0.286, p < 0.05) and a moderately negative correlation with coefficient of variation (CV) (r = 0.289, p < 0.05). One additional percentage of protein calories of total calories per day decreased the MAGE to 4.25 mg/dL and CV to 0.012 (p < 0.05). The optimal dietary protein percentage for MAGE < 140 mg/dL was 15.13%. The performance of predictive models revealed the beneficial effect of adequate carbohydrate intake on glucose variation when combined with protein consumption. CONCLUSIONS:Adequate carbohydrate consumption-but not more than half the daily total calories-combined with protein calories that amount to approximately 15% of the daily caloric intake is important for glucose stability and beneficial for patients with T1DM.

Project description:BackgroundType 2 diabetes mellitus (T2DM) is a leading cause of morbidity and mortality globally, with adverse health consequences largely related to hyperglycemia. Despite clinical practice guideline recommendations, effective pharmacotherapy, and interventions to support patients and providers, up to 60% of patients diagnosed with T2DM are estimated to have hemoglobin A1c (HbA1c) levels above the recommended targets owing to multilevel barriers hindering optimal glycemic control.ObjectiveThe aim of this study is to compare changes in HbA1c levels among patients with suboptimally controlled T2DM who were offered the opportunity to use an intermittently viewed continuous glucose monitor and receive personalized low-carbohydrate nutrition counseling (<100 g/day) versus those who received usual care (UC).MethodsThis was a 12-month, pragmatic, randomized quality improvement program. All adult patients with T2DM who received primary care at a university-affiliated primary care clinic (N=1584) were randomized to either the UC or the enhanced care (EC) group. Within each program arm, we identified individuals with HbA1c >7.5% (58 mmol/mol) who were medically eligible for tighter glycemic control, and we defined these subgroups as UC-high risk (UC-HR) or EC-HR. UC-HR participants (n=197) received routine primary care. EC-HR participants (n=185) were invited to use an intermittently viewed continuous glucose monitor and receive low-carbohydrate nutrition counseling. The primary outcome was mean change in HbA1c levels from baseline to 12 months using an intention-to-treat difference-in-differences analysis comparing EC-HR with UC-HR groups. We conducted follow-up semistructured interviews to understand EC-HR participant experiences with the intervention.ResultsHbA1c decreased by 0.41% (4.5 mmol/mol; P=.04) more from baseline to 12 months among participants in the EC-HR group than among those in UC-HR; however, only 61 (32.9%) of 185 EC-HR participants engaged in the program. Among the EC-HR participants who wore continuous glucose monitors (61/185, 32.9%), HbA1c was 1.1% lower at 12 months compared with baseline (P<.001). Interviews revealed themes related to EC-HR participants' program engagement and continuous glucose monitor use.ConclusionsAmong patients with suboptimally controlled T2DM, a combined approach that includes continuous glucose monitoring and low-carbohydrate nutrition counseling can improve glycemic control compared with the standard of care.

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Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race.

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Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race.

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