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Improved glycaemic variability and basal insulin dose reduction during a running competition in recreationally active adults with type 1 diabetes-A single-centre, prospective, controlled observational study.

ABSTRACT: INTRODUCTION: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. MATERIAL AND METHODS:This 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). RESULTS:For 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%)). CONCLUSION:People 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 ID:drks.de; DRKS00019886.

SUBMITTER: Moser O

PROVIDER: S-EPMC7485886 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Improved glycaemic variability and basal insulin dose reduction during a running competition in recreationally active adults with type 1 diabetes-A single-centre, prospective, controlled observational study.

Moser Othmar O Mueller Alexander A Eckstein Max L ML Ziko Haris H Aberer Felix F Treiber Gerlies G Unteregger Christina C Kojzar Harald H Mader Julia K JK Sourij Caren C Pferschy Peter P Obermayer Anna A Tripolt Norbert N Sourij Harald H

PloS one 20200911 9

<h4>Introduction</h4>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.<h4>Material and methods</h4>This 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 g ...[more]

PMID: 32915897

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Project description:BackgroundThe percentage of sustained maximal oxygen uptake and the running economy are important factors that determine the running success of endurance athletes. Running economy is defined as the oxygen uptake required to run at a given speed and depends on metabolic, cardiorespiratory, biomechanical, neuromuscular, and anthropometric factors. With regard to anthropometric characteristics, total body mass seems to be a crucial factor for the running economy. Moreover, neuromuscular components, especially knee muscular strength and the strength balance ratio, also seem to be critical for the running economy. In addition to knee muscle strength, hip muscle strength is also an important contributor to running performance on level or hilly ground. However, the relationship between running economy and the hip muscles is unknown. Thus the aim of the present study was to verify whether hip flexor and extensor isokinetic peak torque, the isokinetic strength balance ratio, total body mass and fat free mass were associated with running economy in both sexes and to compare sex differences in physical fitness and isokinetic strength characteristics.MethodsA total of 24 male (31.0 ± 7.7 years, 176.2 ± 7.3 cm, and 70.4 ± 8.4 kg) and 15 female (31.3 ± 6.7 years, 162.9 ± 3.9 cm, and 56.0 ± 5.3 kg) recreationally-trained endurance runners were recruited. Maximal oxygen uptake, running economy, conventional (concentric flexors-to-concentric extensors) and functional (concentric flexors-to-eccentric extensors) hip isokinetic strength balance ratios, peak torque of the hip flexor and extensor muscles, total body mass, and fat-free mass were measured. Running economy was assessed on two separate days by means of the energy running cost (Ec) using a motorized treadmill at 10.0 and 12.0 km h-1 (3% gradient) and 11.0 and 14.0 km h-1 (1% gradient).ResultsThe functional balance ratio was significantly and negatively associated with Ec at 11.0 (r = - 0.43, P = 0.04) and 12.0 km h-1 (r = - 0.65, P = 0.04) when using a 3% gradient in male runners. Considering muscular strength, male runners only showed a significant relationship between Ec (assessed at 12 km h-1 and a 3% gradient) and peak torque for extensor muscle eccentric action (r = 0.72, P = 0.04). For female runners, only peak torque relative to total body mass for extensor muscles (180° s-1) was positively associated with Ec when assessed at 10 km h-1 using a 3% gradient (r = 0.59, P = 0.03). No significant relationships were found between Ec and total body mass or fat-free mass.DiscussionGiven that the functional balance ratio was associated with a better Ec, coaches and athletes should consider implementing a specific strengthening program for hip flexor muscles to increase the functional ratio.

Project description:Running is a popular activity that results in high rates of overuse injury, with less-experienced runners becoming injured at higher rates than their more-experienced peers. Although measures of joint kinematics and kinetics and ground reaction forces have been associated with overuse running injuries, similar differences across levels of running experience have not been found. Because running is a motor skill that may develop with experience, an analysis of segment coordination and its variability could provide additional insight into why injury incidence decreases with increasing experience. PURPOSE:The purpose of this study was to determine if less-experienced runners have different segment coordination and lower segment coordination variability compared with their more-experienced peers. METHODS:This retrospective analysis included 20 more-experienced (≥10 yr running) and 21 less-experienced (≤2 yr running) runners. Sagittal thigh versus shank and shank versus foot segment coordination and coordination variability were calculated using a modified vector coding approach as individuals ran on a treadmill at preferred pace. Coordination and its variability were compared between groups during terminal swing and early, mid, and late stance for both segment couples. RESULTS:Segment coordination was similar between less- and more-experienced runners. Less-experienced runners had lower segment coordination variability compared with more-experienced runners for both the thigh versus shank and shank versus foot couples. This lower variability occurred during early and mid stance. CONCLUSIONS:Runners appeared to attain stable segment coordination patterns within 2 yr of consistent running, but had lower coordination variability compared with individuals who had been running for 10 or more years. These results suggest that assessment of movement patterns and their flexibility may help inform injury prevention or treatment strategies for less-experienced runners.

Project description:Long-distance running competitions impose a large amount of mechanical loading and strain leading to muscle edema and delayed onset muscle soreness (DOMS). Damage to various muscle fibers, metabolic impairments and fatigue have been linked to explain how DOMS impairs muscle function. Disruptions of muscle fiber during DOMS exacerbated by exercise have been shown to change muscle mechanical properties. The objective of this study is to quantify changes in mechanical properties of different muscles in the thigh and lower leg as function of running distance and time after competition. A custom implementation of Focused Comb-Push Ultrasound Shear Elastography (F-CUSE) method was used to evaluate shear modulus in runners before and after a race. Twenty-two healthy individuals (age: 23 ± 5 years) were recruited using convenience sampling and split into three race categories: short distance (nine subjects, 3-5 miles), middle distance (10 subjects, 10-13 miles), and long distance (three subjects, 26+ miles). Shear Wave Elastography (SWE) measurements were taken on both legs of each subject on the rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), soleus, lateral gastrocnemius (LG), medial gastrocnemius (MG), biceps femoris (BF) and semitendinosus (ST) muscles. For statistical analyses, a linear mixed model was used, with recovery time and running distance as fixed variables, while shear modulus was used as the dependent variable. Recovery time had a significant effect on the soleus (p = 0.05), while running distance had considerable effect on the biceps femoris (p = 0.02), vastus lateralis (p < 0.01) and semitendinosus muscles (p = 0.02). Sixty-seven percent of muscles exhibited a decreasing stiffness trend from before competition to immediately after competition. The preliminary results suggest that SWE could potentially be used to quantify changes of muscle mechanical properties as a way for measuring recovery procedures for runners.

Project description:AIM:To assess the effects of once-weekly exenatide on 24-hour glucose control and variability. MATERIALS AND METHODS:This double-blind, placebo-controlled trial randomized metformin-treated adults with type 2 diabetes to once-weekly exenatide 2.0 mg or placebo. Continuous glucose monitoring (CGM) was performed at baseline and weeks 4 and 10. The primary outcome was change in CGM-measured 24-hour mean glucose level. RESULTS:In the once-weekly exenatide (n = 60) and placebo (n = 56) groups (modified intention-to-treat population), the baseline glycated haemoglobin (HbA1c) concentrations were 8.2% and 8.0%, respectively, and the fasting plasma glucose (FPG) concentration was 9.86 and 9.32 mmol/L, respectively. Once-weekly exenatide significantly (p < 0.001) reduced 24-hour mean glucose level versus placebo (week 4, -1.44 vs -0.29 mmol/L; week 10, -1.71 vs -0.17 mmol/L), with consistent control throughout the week. Once-weekly exenatide significantly reduced FPG and 2-hour postprandial glucose (PPG) levels versus placebo at week 4 (FPG, -1.65 vs -0.11 mmol/L; PPG, -1.79 vs -0.11 mmol/L) and week 10 (FPG, -2.32 vs -0.28 mmol/L; PPG, -2.46 vs -0.33 mmol/L). At week 10, once-weekly exenatide reduced the mean amplitude of glucose excursions (MAGE; -0.84 vs 0.16 mmol/L) and standard deviation (s.d.) of mean glucose (-0.35 vs 0.04 mmol/L). By week 10, once-weekly exenatide-treated participants spent more time in euglycaemia (once-weekly exenatide, 77% vs placebo, 58%), less time in hyperglycaemia (22% vs 42%), and a similar time in hypoglycaemia (0.7% vs 0.3%). Common adverse events were injection-site nodule (once-weekly exenatide, 10.0% vs placebo, 0.0%), urinary tract infection (6.7% vs 8.9%) and nausea (6.7% vs 0.0%). CONCLUSIONS:In metformin-treated participants with type 2 diabetes, once-weekly exenatide significantly improved daily glucose control and reduced glycaemic variability at weeks 4 and 10, as shown by reductions in 24-hour glucose, FPG and PPG levels, MAGE and s.d., and increased time spent in euglycaemia.

Dataset Information

Improved glycaemic variability and basal insulin dose reduction during a running competition in recreationally active adults with type 1 diabetes-A single-centre, prospective, controlled observational study.

Publications

Improved glycaemic variability and basal insulin dose reduction during a running competition in recreationally active adults with type 1 diabetes-A single-centre, prospective, controlled observational study.

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