oru.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Mattsson, Stig
Publications (4 of 4) Show all publications
Mattsson, S., Jendle, J. & Adolfsson, P. (2019). Carbohydrate Loading Followed by High Carbohydrate Intake During Prolonged Physical Exercise and Its Impact on Glucose Control in Individuals With Diabetes Type 1-An Exploratory Study. Frontiers in Endocrinology, 10, Article ID 571.
Open this publication in new window or tab >>Carbohydrate Loading Followed by High Carbohydrate Intake During Prolonged Physical Exercise and Its Impact on Glucose Control in Individuals With Diabetes Type 1-An Exploratory Study
2019 (English)In: Frontiers in Endocrinology, ISSN 1664-2392, E-ISSN 1664-2392, Vol. 10, article id 571Article in journal (Refereed) Published
Abstract [en]

Background: Prolonged physical exercise (PE) is a challenge in type 1 diabetes with an increased incidence of both hypoglycemia and hyperglycemia.

Purpose: To evaluate the impact of two consecutive days of carbohydrate (CHO) loading, followed by high intermittent CHO-intake during prolonged PE, facilitated by a proactive use of Real-Time Continuous Glucose Monitoring (rtCGM), on glucose control in individuals with type 1 diabetes.

Methods: Ten physically active individuals with type 1 diabetes were invited to participate in a 3-day long sports camp with the objective to evaluate CHO-loading and high intermittent CHO-intake during prolonged PE. 1.5 months later the same procedure was evaluated in relation to a 90 km cross-country skiing race (Vasaloppet). Participants were instructed to act proactively using rtCGM with predictive alerts to maintain sensor glucose values within target range, defined as 72-180 mg/dl (4-10 mmol/l).

Results: Mean glucose values during CHO-loading were: day 1; 140.4 +/- 45.0 mg/dl (7.8 +/- 2.5 mmol/l) and day 2; 120.6 +/- 41.4 mg/dl (6.7 +/- 2.3 mmol/l). Mean sensor glucose at start of PE was 126.0 +/- 25.2 mg/dl (7.0 +/- 1.4 mmol/l) and throughout PE 127.8 +/- 25.2 mg/dl (7.1 +/- 1.4 mmol/l). Percentage of time spent in range (TIR) respective time spent in hypoglycemia was: CHO-loading 74.7/10.4% and during PE 94.3/0.6%.

Conclusions: High intermittent CHO-intake during prolonged PE combined with proactive use of rtCGM is associated with good glycemic control during prolonged exercise in individuals with diabetes type 1. However, the time spent in hypoglycemia during the 2-days of CHO-loading was 10.4% and therefore a lower insulin dose might be suggested to reduce the time spent in hypoglycemia.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
blood glucose, carbohydrates, continuous glucose monitoring, insulin, physical activity, time in range, type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-76051 (URN)10.3389/fendo.2019.00571 (DOI)000482015800001 ()
Funder
Novo Nordisk
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05Bibliographically approved
Carr, A., McGawley, K., Govus, A., Andersson, E. P., Shannon, O. M., Mattsson, S. & Melin, A. (2019). Nutritional Intake in Elite Cross-Country Skiers During Two Days of Training and Competition. International Journal of Sport Nutrition & Exercise Metabolism, 29(3), 273-281
Open this publication in new window or tab >>Nutritional Intake in Elite Cross-Country Skiers During Two Days of Training and Competition
Show others...
2019 (English)In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 29, no 3, p. 273-281Article in journal (Refereed) Published
Abstract [en]

This study investigated the energy, macronutrient, and fluid intakes, as well as hydration status (urine specific gravity), in elite cross-country skiers during a typical day of training (Day 1) and a sprint skiing competition the following day (Day 2). A total of 31 (18 males and 13 females) national team skiers recorded their food and fluid intakes and urine specific gravity was measured on Days 1 and 2. In addition, the females completed the Low Energy Availability in Females Questionnaire to assess their risk of long-term energy deficiency. Energy intake for males was 65 +/- 9 kcal/kg on Day 1 versus 58 +/- 9 kcal/kg on Day 2 (p = .002) and for females was 57 +/- 10 on Day 1 versus 55 +/- 5 kcal/kg on Day 2 (p = .445). Carbohydrate intake recommendations of 10-12 g.kg(-l) .day(-1) were not met by 89% of males and 92% of females. All males and females had a protein intake above the recommended 1.2-2.0 g/kg on both days and a postexercise protein intake above the recommended 0.3 g/kg. Of the females, 31% were classified as being at risk of long-term energy deficiency. In the morning of Day 1, 50% of males and 46% of females were dehydrated; on Day 2, this was the case for 56% of males and 38% of females. In conclusion, these data suggest that elite cross-country skiers ingested more protein and less carbohydrate than recommended and one third of the females were considered at risk of long-term energy deficiency. Furthermore, many of the athletes were dehydrated prior to training and competition.

Place, publisher, year, edition, pages
Human Kinetics, 2019
Keywords
Carbohydrate, energy deficiency, hydration status, protein, winter sports
National Category
Sport and Fitness Sciences Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-74226 (URN)10.1123/ijsnem.2017-0411 (DOI)000466708800005 ()29989466 (PubMedID)2-s2.0-85065593387 (Scopus ID)
Available from: 2019-05-09 Created: 2019-05-09 Last updated: 2019-06-19Bibliographically approved
Mattsson, S., Adolfsson, P. & Jendle, J. (2017). Diabetes Sports Camps for Individuals with Type 1 Diabetes Associated with Improved Glycemic Control and Self-Estimated Level of Knowledge. Journal of Diabetes Research and Therapy, 3(2)
Open this publication in new window or tab >>Diabetes Sports Camps for Individuals with Type 1 Diabetes Associated with Improved Glycemic Control and Self-Estimated Level of Knowledge
2017 (English)In: Journal of Diabetes Research and Therapy, ISSN 2380-5544, Vol. 3, no 2Article in journal (Refereed) Published
Abstract [en]

Purpose: To evaluate the effect of a novel sports camp containing education and individualized feedback, on glycemic control and self-estimated level of knowledge in individuals with type 1 diabetes (T1DM).

Method: Participants with T1DM attended a three-day sports camp with education and individualized feedback on insulin and carbohydrate adjustments. Continuous Glucose Monitoring (CGM) and carbohydrate counting was used. A1c was assessed at baseline, 3 and 12 months after the sports camps. Questionnaires using Visual Analogue Scale (VAS) were used before and after the camp to estimate attitudes and knowledge regarding insulin and carbohydrate adjustments in relation to exercise.

Results: During eight sports camps 105 TIDM participants were included, 53% females, mean age 40.5 ± 10.0 years.

A1c was significantly reduced from 7.5 ± 3.0% (58.7 ± 9.2 mmol/mol) at baseline to 7.3 ± 2.9% (56.2 ± 8.1 mmol/mol), P<.005, after 3 months and maintained after 12 months 7.3 ± 2.9% (56.4 ± 8.1 mmol/mol), P<.005. Self-estimated level of knowledge was significantly improved in the area of insulin adjustments, P<.001 and carbohydrate intake, P<.001, in connection to exercise.

99% of the participants wanted to continue on CGM and 85% of the participants stated they would like to continue with carbohydrate counting after the sports camp.

Conclusion: Sports camps for adults with T1DM, was associated with improved glycemic control and increased self-estimated knowledge regarding insulin and carbohydrate adjustments in relation to exercise. This improvement in A1c, might be linked to the participants’ increased level of knowledge but also to increased use of CGM and carbohydrate counting.

Abbreviations: A1c: Glycated Hemoglobin; BG: Blood Glucose; BMI: Body Mass Index; CGM: Continuous Glucose Monitoring; CHO: Carbohydrates; CSII: Continuous Subcutaneous Insulin Infusion; DSME: Diabetes Self-Management Education; IFCC: International Federation of Clinical Chemistry; IG: Interstitial Glucose; MDI: Multiple Daily Injections; NGSP: National Glycohemoglobin Standardization Program; PG: Plasma Glucose; PE: Physical Exercise; RPE: Rate of Perceived Exertion; SMBG: Self-Monitoring of Blood Glucose; T1DM: Type 1 Diabetes; VAS: Visual Analogue Scale.

Place, publisher, year, edition, pages
Sci Forschen, 2017
Keywords
A1c, Blood glucose, Carbohydrates, Continuous glucose monitoring, Diabetes sports camp, Diabetes mellitus type 1, Education´, Insulin, Physical activity, Self-management
National Category
Medical and Health Sciences Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-64461 (URN)10.16966/2380-5544.127 (DOI)
Available from: 2018-01-23 Created: 2018-01-23 Last updated: 2019-04-01Bibliographically approved
Adolfsson, P., Mattsson, S. & Jendle, J. (2015). Evaluation of glucose control when a new strategy of increased carbohydrate supply is implemented during prolonged physical exercise in type 1 diabetes. European Journal of Applied Physiology, 115(12), 2599-2607
Open this publication in new window or tab >>Evaluation of glucose control when a new strategy of increased carbohydrate supply is implemented during prolonged physical exercise in type 1 diabetes
2015 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, no 12, p. 2599-2607Article in journal (Refereed) Published
Abstract [en]

Purpose: In healthy individuals, high carbohydrate intake is recommended during prolonged exercise for maximum performance. In type 1 diabetes (T1D), this would alter the insulin requirements. The aim of the study was to evaluate the safety of high glucose supplementation during prolonged exercise and the glucose control when a novel strategy of increased carbohydrate supply was implemented during prolonged exercise in T1D.

Methods: Eight subjects with T1D participated in a sports camp including sessions of prolonged exercise and individualized feedback during three consecutive days. This was later followed by a 90 km cross-country skiing race. Large amounts of carbohydrates, 75 g/h, were supplied during exercise and the insulin requirements were registered. Glucose was measured before, during and after exercise aiming at euglycaemia, 4-8 mmol/L (72-144 mg/dL). During the race, continuous glucose monitoring (CGM) was used as an aspect of safety and to allow direct and individual adjustments.

Results: Compared to ordinary carbohydrate supply during exercise, the high carbohydrate supplementation resulted in significantly increased insulin doses to maintain euglycaemia. During the cross-country skiing race, the participants succeeded to reach mean target glucose levels; 6.5 ± 1.9 mmol/L (117 ± 34 mg/dL) and 5.7 ± 1.5 mmol/L (103 ± 27 mg/dL) at the start and finish of the race, respectively. Episodes of documented hypoglycemia (<4 mmol/L/72 mg/dL) were rare. CGM was used for adjustments.

Conclusion: In this study, large carbohydrate supplementation in T1D individuals during prolonged aerobic exercise is safe and allows the subjects to maintain glycaemic control and indicates the feasibility of CGM under these conditions.

Place, publisher, year, edition, pages
New York, USA: Springer, 2015
Keywords
Blood glucose, CGM, carbohydrates, diabetes mellitus type 1, exercise, hypoglycemia, insulin
National Category
Medical and Health Sciences Physiology Sport and Fitness Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-51055 (URN)10.1007/s00421-015-3251-4 (DOI)000367610800012 ()26341091 (PubMedID)2-s2.0-84946499557 (Scopus ID)
Available from: 2016-06-28 Created: 2016-06-28 Last updated: 2018-01-10Bibliographically approved

Search in DiVA

Show all publications