scholarly journals Glycemic responses to strenuous training in male professional cyclists with type 1 diabetes: a prospective observational study

2020 ◽  
Vol 8 (1) ◽  
pp. e001245 ◽  
Author(s):  
Olivia McCarthy ◽  
Max L Eckstein ◽  
Sam N Scott ◽  
Federico Y Fontana ◽  
Mark P Christiansen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Exercise Training ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Strenuous Exercise ◽  
Physiological Data ◽  
P Value ◽  
Nocturnal Hypoglycemia ◽  
Increased Risk

IntroductionThis prospective observational study sought to establish the glycemic, physiological and dietary demands of strenuous exercise training as part of a 9-day performance camp in a professional cycling team with type 1 diabetes (T1D).Research design and methodsSixteen male professional cyclists with T1D on multiple daily injections (age: 27±4 years; duration of T1D: 11±5 years; body mass index: 22±2 kg/m2; glycated hemoglobin: 7%±1% (50±6 mmol/mol); maximum rate of oxygen consumption: 73±4 mL/kg/min) performed road cycle sessions (50%–90% of the anaerobic threshold, duration 1–6 hours) over 9 consecutive days. Glycemic (Dexcom G6), nutrition and physiological data were collected throughout. Glycemic data were stratified into predefined glycemic ranges and mapped alongside exercise physiology and nutritional parameters, as well as split into daytime and night-time phases for comparative analysis. Data were assessed by means of analysis of variance and paired t-tests. A p value of ≤0.05 (two-tailed) was statistically significant.ResultsHigher levels of antecedent hypoglycemia in the nocturnal hours were associated with greater time spent in next-day hypoglycemia overall (p=0.003) and during exercise (p=0.019). Occurrence of nocturnal hypoglycemia was associated with over three times the risk of next-day hypoglycemia (p<0.001) and a twofold risk of low glucose during cycling (p<0.001). Moreover, there was trend for a greater amount of time spent in mild hypoglycemia during the night compared with daytime hours (p=0.080).ConclusionThe higher prevalence of nocturnal hypoglycemia was associated with an increased risk of next-day hypoglycemia, which extended to cycle training sessions. These data highlight the potential need for additional prebed carbohydrates and/or insulin dose reduction strategies around exercise training in professional cyclists with T1D.Trial registration numberDRKS00019923.

66-LB: Greater Time Spent in Hypoglycemia during Night Compared with Day during Intensified Training in Professional Cyclists with Type 1 Diabetes—A Prospective Observational Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 66-LB ◽  
Author(s):  
OTHMAR MOSER ◽  
MAX L. ECKSTEIN ◽  
OLIVIA MCCARTHY ◽  
MICHAEL RIDDELL ◽  
FEDERICO Y. FONTANA ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Observational Study ◽  
Prospective Observational Study

scholarly journals Association of glycemic variability and hypoglycemia with distal symmetrical polyneuropathy in adults with type 1 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ziyang Shen ◽  
Hemin Jiang ◽  
Rong Huang ◽  
Yunting Zhou ◽  
Qian Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
C Peptide ◽  
Nocturnal Hypoglycemia ◽  
Increased Risk ◽  
Distal Symmetrical Polyneuropathy

AbstractPrevious studies exploring the influence of glycemic variability (GV) on the pathogenesis of distal symmetrical polyneuropathy (DSPN) in type 1 diabetes (T1DM) produced conflicting results. The aim of this study was to assess the relationship between GV and DSPN in T1DM. Adults with T1DM were included in this cross-sectional study and asked to undergo 3-day CGM. GV quantified by coefficient of variation (CV) and mean amplitude of glucose excursions (MAGE) were obtained from CGM. Clinical characteristics and biochemical assessments were collected for analysis. The study comprised 152 T1DM patients (53.9% males) with mean age of 44.2 year. Higher levels of age and duration of diabetes and lower levels of total cholesterol, LDL, fasting C-peptide and postprandial C-peptide were observed in DSPN subjects. DSPN groups displayed a higher blood glucose between 00:00 and 12:59 according to the CGM profile. Higher MAGE and CV were associated with increased risk of DSPN in the fully adjusted model. Meanwhile, a significant association between measurements of hypoglycemia, especially nocturnal hypoglycemia, and DSPN was found after multiple tests. CGM parameters describing the glycemic variability and hypoglycemia were potential risk factors for DSPN in adults with T1DM.

Abstract P224: The Haptoglobin (Hp) Genotype Predicts Coronary Artery Disease (CAD) During 25 Years of Follow-up in Type 1 Diabetes: Potential Pole of Impaired HDL Cholesterol Efflux Capacity

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tina Costacou ◽  
Jay W Heinecke ◽  
Tomas Vaisar ◽  
Trevor J Orchard
Keyword(s):  
Coronary Artery Disease ◽  
Type 1 Diabetes ◽  
Coronary Artery ◽  
Pilot Study ◽  
Cholesterol Efflux ◽  
P Value ◽  
Increased Risk ◽  
Artery Disease

Background: The Hp 2-2 genotype has been associated with increased cardiovascular risk in type 2 diabetes, potentially relating to dysfunctional HDL mediated cholesterol efflux. We have shown that the Hp 2 allele predicts the development of both coronary artery disease (CAD) and kidney dysfunction also in childhood onset type 1 diabetes over 18 years of follow-up in the Epidemiology of Diabetes Complications (EDC) study. We now present results on the Hp-CAD association after an additional 7 year follow-up and Hp’s relation to impaired sterol efflux capacity, a proposed cardioprotective effect of HDL. Methods: Participants free of CAD at baseline and with Hp determined were studied (n=565; mean age, 27 and duration, 19 years; 11.5% Hp 1-1, 42.5% Hp 2-2). CAD was defined as EDC physician diagnosed angina, ischemic ECG changes (MC 1.3, 4.1-4.3, 5.1-5.3, 7.1), confirmed MI (MC 1.1, 1.2 or validated medical records), stenosis >50%, revascularization or CAD death. In a pilot study, serum HDL sterol efflux was assessed in Mifepristone stimulated ABCA1-BHK cells among 20 individuals (6 Hp 1-1; 7 Hp 2-1; 7 Hp 2-2) attending the 25 year exam. Results: During follow-up, 186 (32.9%) developed CAD. Incidence increased with the number of Hp 2 alleles (24.6% in Hp 1-1, 31.1% in Hp 2-1 and 37.1% in Hp 2-2, p-trend=0.04; Fig. 1). Multivariably, Hp 2-2 significantly increased risk by almost 80% (HR=1.79, 1.03-3.09). The risk associated with Hp 2-1 did not reach significance (HR=1.46, 0.85-2.53). In the pilot study, serum HDL sterol efflux was lower in Hp 2 allele carriers: 14.0% in Hp 1-1, 12.5% in Hp 2-1, 12.4% in Hp 2-2, p-trend=0.06, p-value Hp 1-1 vs Hp 2-1/2-2 =0.04. Conclusion: These results extend our previous findings of increased CAD risk associated with the Hp 2 allele in type 1 diabetes and further suggest that this allele associates with impaired sterol efflux capacity. These results support the hypothesis that sterol efflux explains the increased Hp 2 risk for CAD and should be confirmed prospectively. Figure 1. CAD-free survival curves by Hp genotype

scholarly journals Progression of microalbuminuria in type 1 diabetes: Ten-year prospective observational study

2005 ◽  
Vol 68 (4) ◽  
pp. 1446-1450 ◽  
Author(s):  
Peter Rossing ◽  
Philip Hougaard ◽  
Hans-Henrik Parving
Keyword(s):  
Type 1 Diabetes ◽  
Observational Study ◽  
Prospective Observational Study
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