Continuous glucose monitoring to measure metabolic impact and recovery in sub-elite endurance athletes

Pushing the limits of insulin delivery 100 years later: A case study of a race across Canada

“…Another case study of an Ultraman triathlete with T1D also showed postexercise hyperglycaemia, along with significant increases in creatine kinase, C‐reactive protein, and aldosterone levels, which could help to explain the apparent increase in insulin resistance postevent 8 . Other studies have shown glycaemic and insulin dose variability in endurance athletes with T1D who are not using AID systems, thereby suggesting that some forms of endurance exercise may promote some level of whole‐body insulin resistance 3,4,18,19 . Notably, in the 1 week following the ride, the study participant spent considerably less percentage TIR (49.6% ± 17.0%), with a markedly elevated percentage TAR2 (19.4% ± 10.3%), compared with the preride (2.0% ± 4.1%) and in‐ride (12.6% ± 9.1%) periods.…”

“…8 Other studies have shown glycaemic and insulin dose variability in endurance athletes with T1D who are not using AID systems, thereby suggesting that some forms of endurance exercise may promote some level of whole-body insulin resistance. 3,4,18,19 Notably, in the 1 week following the ride, the study participant spent considerably less percentage TIR (49.6% ± 17.0%), with a markedly elevated percentage TAR2 (19.4% ± 10.3%), compared with the preride (2.0% ± 4.1%) and in-ride (12.6% ± 9.1%) periods. Bolus, basal, and total daily insulin were also elevated throughout this 7-day recovery time, suggesting that the athlete may have been in a comparatively insulin-resistant state.…”

“…We observed numerous predictive low‐glucose insulin delivery suspensions and repeated correction boluses given by the AID in the in‐ride and postride periods, thereby illustrating the unique features of a hybrid closed loop insulin delivery system for ultra‐endurance exercise. Interestingly, elevated glycaemia and a greater insulin resistance postexercise have been shown after prolonged exhaustive exercise in individuals without diabetes 19 . Another case study of an Ultraman triathlete with T1D also showed postexercise hyperglycaemia, along with significant increases in creatine kinase, C‐reactive protein, and aldosterone levels, which could help to explain the apparent increase in insulin resistance postevent 8 .…”

“…Interestingly, elevated glycaemia and a greater insulin resistance postexercise have been shown after prolonged exhaustive exercise in individuals without diabetes. 19 Another case study of an Ultraman triathlete with T1D also showed postexercise hyperglycaemia, along with significant increases in creatine kinase, C-reactive protein, and aldosterone levels, which could help to explain the apparent increase in insulin resistance postevent. 8 Other studies have shown glycaemic and insulin dose variability in endurance athletes with T1D who are not using AID systems, thereby suggesting that some forms of endurance exercise may promote some level of whole-body insulin resistance.…”

Continuous Glucose Monitoring in Healthy Adults—Possible Applications in Health Care, Wellness, and Sports

“…CGM systems can be used to monitor the effects of intense physical exertion on glucose concentration in the recovery period. In a study with 10 athletes, both glucose dynamics after carbohydrate intake and overnight basal glucose values were altered following intense exercise to exhaustion [83]. CGM data can be used to determine when the glucose profile is normalized and returns to the pre-exercise profile.…”