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Continuous Glucose Monitoring For Athletes

What Did We Do

BARWIS Pro Sports Training w/ Mike Barwis & Levels (Continuous Glucose Monitoring)

We recruited eight non-diabetic recreational athletes who regularly participate in running and resistance-based training . A concurrent validity study design was employed to assess the validity of a CGM system against finger prick measures, which was considered as the reference method. The protocol, as well as the HIIT session used in this study, are displayed in Figure 1.

Figure 1.Schematic representation of the study design and the HIIT session .

For a comprehensive view of the results, you can read the full paper here.

Validity during the HIIT session

Figure 2. Continuous glucose monitoring and finger prick measures during each standardized condition, when ingesting a carbohydrate- and protein- oriented breakfasts, with the 2 days of each breakfast condition pooled for each participant . Data are presented as mean .

Effect of Nutrition

Similar results were observed for the carbohydrate and protein feedings, suggesting that the CGM validity was not affected by the breakfast content during non-exercise periods . Consequently, the use of this CGM device could be considered by practitioners willing to monitor glycemic responses before and after competition or training, to ensure the efficacy of the nutritional strategies employed.


  • Hall H, Perelman D, Breschi A, et al. Glucotypes reveal new patterns of glucose dysregulation. PLoS Biol. 2018 16:1-23. doi:10.1371/journal.pbio.2005143
  • The Nutrisense App Is A Powerful Tool That Lets You Track Your Daily Activity To See How Food Sleep Exercise And Stress Impact Your Glucose

    Real-time insights from a continuous glucose monitor give you a view into your blood glucose trends. Paired with the Nutrisense app, you get personalized, data-backed insights into your blood sugar levels. Your dietitian provides guidance, helps you interpret the data, and build sustainable healthy habits.

    Tweak your diet to dial in what fuels your body.

    Glucose Control In Your Body

    Before I get into the science that either supports or refutes the use of these devices, we need to first understand the basic physiology of glucose control in the body then we can discuss whether or not monitoring it makes any sense.

    The nutrients that we take in when we eat serve many purposes but one of the principal ones is to provide metabolic fuel for our cells. Fuel comes in many forms but the preferred form for all of our cells is glucose and that is obtained through the consumption of carbohydrates. Most of our cells can make use of alternative fuels like free fatty acids or ketones but these are much less efficient fuels. Some cells specifically those in highly metabolic active tissues such as the heart, nerves, kidneys, and white blood cells will only make use of glucose except in rare instances.

    The body has developed a means of ensuring that when there is a shortage of glucose available, those cells that can utilize alternative fuels will not use the available glucose. Conversely, when glucose is plentiful, this same system ensures that all cells get access to the preferred fuel. This process is tightly controlled through the secretion of insulin when glucose is plentiful, and through counter-regulatory hormones like glucagon when it is not. Insulin is required for cells to be able to access glucose in the blood, except for those cells that are mandatory users of glucose.

    Read Also: 1 Hour Glucose Test Pregnancy

    Dcouvrez Les Vritables Besoins Nergtiques Pour Une Meilleure Performance Athltique

    Quil sagisse dentraînement ou de compétition, il est essentiel de savoir comment faire le plein dénergie pour maintenir votre performance athlétique.

    En lisant en continu1 et en temps réel vos taux de glucose moléculaire, le biocapteur de glucose pour le sport Abbott Libre Sense, lorsquil est utilisé avec une application ou un produit de partenaire compatible, aide les athlètes à optimiser la façon dont ils salimentent en vue de leurs performances athlétiques, en rendant linvisible visible.

    When Might I Need To Do A Fingerstick Check When Using A Cgm Device

    How to Insert a Dexcom CGM in the Upper Arm (Without Help)

    You may need to do fingerstick checks to calibrate a CGM device. Either way, youll likely still need to do fingerstick checks to look at your blood glucose in certain situations.

    For example, a fingerstick check may give you peace of mind if your CGM device shows rising or falling numbers, but you feel OK. It can also provide answers if you dont feel well, but the CGM says your glucose levels are in target.

    Read Also: Natural Herbs To Lower Blood Sugar

    What Types Of Fuel Are Used In Exercise And How Do They Cause Fatigue

    Fuel during exercise comes from, predominantly, three sources:

  • Fat already in your body
  • Glycogen stored in your muscle cells and liver
  • Carbohydrates that you ingest before or during exercise
  • Stored fat is primarily used for low-intensity exercise, meaning exercise under approximately 60% VO2max . Minimal to no glycogen is used during very low-intensity exercise . As you increase in intensity, the proportion of glycogen used for fuel gradually increases, but fat is still the predominant fuel source for exercise under about 60% VO2max.

    Your stored fat gives you the largest bang for your buck in terms of energy. You can exercise for hours at this pace since your body has a huge store of calories stored as fat, making fat a great fuel source for long sustained efforts. The caveat is that fat is primarily usable under intensities of approximately 60% VO2max. Thus, while you may be able to travel a long distance, you wont be able to travel it at max speed.

    In that scenario, you have two main options:

  • If you continue to exercise, you deplete your muscle and liver reserves, and muscle cells wont be able to produce energy rapidly enough to maintain exercise intensity, and you bonk. This option is neither pleasant nor conducive to a strong performance.
  • Avoid the unpleasantries, increase your performance capabilities, and either ingest carbohydrates or try a carbohydrate mouth rinse.
  • What Is The Abbott Libre Sense Glucose Sport Biosensor

    The Abbott Libre Sense Glucose Sport Biosensor is designed for sport use only and offers streaming glucose data with a dynamic range of 55 200 mg/dL for performance athletes to monitor their glucose levels. It is specifically designed for sports use. The biosensor is not for medical use and is not intended for the diagnosis, treatment, or management of diabetes or any other disease.

    Through non-exclusive partnerships, Abbott plans to make the biosensor compatible with sports companies mobile apps and products which will provide glucose levels, trends and metrics to provide insights to support optimal fueling strategy and performance for athletes.

    Don’t Miss: What Is The Cause Of Type 1 Diabetes

    How To Design A Cgm Experiment

    Before testing the blood sugar impacts of fancy modalities and therapies, start by establishing your baseline. Notice any patterns throughout your first day or so.

    According to NutriSense, the big four factors that influence glucose include: stress, sleep, food, and meal timing. Follow the scientific method by controlling these and as many of the basic variables as possible:

    • Timing: when you eat certain foods, exercise, sleep, or where you are in your menstrual cycle
    • Quantity: shoot for the same proportions
    • Sleep: sleep dramatically impacts blood sugar. Be as consistent as possible
    • Meal composition: types of foods, and percentages of each macro
    • Supplementation & medication: certain compounds can drastically alter blood sugar
    • Exercise: particular exercise styles can either increase or decrease levels
    • Stress management: I found stress levels to be the biggest factor in my experiments

    Basically try to make the trials as similar as possible so that the intervention becomes the primary explanation for differences in blood glucose.

    Some services actually rate and score your days. Others dont. Regardless, heres a quick primer on healthy glucose scores.

    Grassroots Networks And The Future Of Cgms

    CGM and Energy Management for Athletes

    Brandon Lopez says when he was younger, using a CGM was a dream.

    Now he’s running a grassroots effort to help others fulfill that dream, one that big CGM companies say is aligned with their mission, but that some patients say still isn’t reaching them.

    Lopez was diagnosed with diabetes at age 7. While he was living with his parents, he had an insulin pump until he went on a hike, the pump broke, and he had to switch to multiple daily insulin injections.

    I thought was something I’d never be able to afford, Lopez said. Something that only rich people can afford. That was a fantasy for me.

    In 2019, he got a job that had better health insurance and that dream of being able to use a CGM became a reality.

    Its life-changing, he said.

    But he didnt stop there. In 2017, he had started to raise awareness about the need for unused diabetic supplies, and every so often he would get a donated package from someone offering up insulin, a CGM or other medical equipment for people who needed it.

    During the pandemic, things started to pick up. More packages started coming in, and the Embrace Foundation was born.

    The Embrace Foundations website describes CGM supplies as limited, and Lopez says that he has to make difficult decisions about how to allocate supplies.

    Dexcom confirmed that the company is not experiencing a device shortage.

    As of this summer, there were 16 people in Arizona on the Embrace Foundations waiting list for CGMs. Six of those 16 have gotten them so far.

    Read Also: Does Diabetes Cause Low Blood Pressure

    What I Learned From Wearing A Continuous Glucose Monitor

    While wearing the biosensor and exploring athlete data, the most eye-opening findings for me disproved some of my longstanding nutrition bylaws.

    I learned that the easy-to-digest, simple carb meals Ive relied upon to provide fast, preworkout fuel , lead to significant post-meal spikes in glucose and a reactive energy low. If I add fat, protein, and fiber to the meal, though, the drastic spike and valley disappears.

    If my stomach demands only simple carbs before a workout, I learned to eat earlier, allowing time for the food to be absorbed. Eating within an hour of a workout is off limits the practice results in an energy spike and then valley as insulin gets to work shuttling glucose into the cells. As insulin is a fat-depositing hormone, high levels of circulating insulin also mean that I can neither freely access sugar, nor fat for an energy kick. The end result? I feel like Ive hit the wall a few miles into a run while waiting for my glycogen stores to be released.

    Thankfully, theres a simple fix. Skroe explains that eating many hours prior to the workout leaves time for digestion and absorption, recovering from any post-meal energy plummet, and ultimately results in readily accessible fuel on board once the workout starts.

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    Recovering with adequate nutrition postworkout can prevent nocturnal lows, too, that might otherwise disrupt sleep and also impede recovery.

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    When Should I Call The Doctor

    Reach out to your provider if you have any questions about how to use a CGM device safely.

    Very high or low blood sugar levels can be dangerous when left untreated for too long. In the most severe cases, this can lead to seizures, coma or even death. You can avoid these complications by keeping blood sugar levels in a healthy range. Call your provider if you have any symptoms youre worried about.

    Common symptoms of high blood sugar include:

    • More frequent urination .

    Read Also: What Is The Quickest Way To Lower Blood Sugar

    Engage With Your Blood Glucose Levels With Nutrisense

    Your blood sugar levels can significantly impact how your body feels and functions. Thatâs why stable blood glucose levels can be an important factor in supporting overall wellbeing.

    With Nutrisense, youâll be able to track your blood glucose levels over time using a CGM, so you can make lifestyle choices that support healthy living.

    When you join the program, our team of credentialed dietitians and nutritionists are available for additional support and guidance to help you reach your goals.

    Ready to take the first step? Start with our quiz to see how Nutrisense can support your health.

    Find the right Nutrisense program to help you discover and reach your health potential.

    Why Is Continuous Glucose Monitoring Effective For Athletes

    How to Restart Your Dexcom Continuous Glucose Monitor  The Type One ...

    You likely know of fasting blood glucose since this is a pretty standard blood test. Blood glucose, also known as blood sugar, is a type of sugar that your body uses for various processes. When youâre active, your body uses glucose to fuel muscles.

    Glucose is also an important fuel source for your heart, kidneys, nerve cells, and white blood cells. Glucose comes from carbohydrate foods such as grains, starchy foods, milk products, fruits, and sugary foods such as candies and soda. Many carbohydrate foods contain many glucose or sugar molecules linked together, which enzymes in your gut then have to unlink. Glucose is then absorbed and goes into the bloodstream.

    When you eat carbohydrates throughout the day, your body uses glucose as fuel. The rest is stored as liver and muscle glycogen . However, if you exceed the capacity of the glycogen deposits, the glucose remains in the blood until it can be stored as fat, which leads to high blood glucose levels.

    Most athletes use carbs as the primary source of energy before their training. Still, they also consume carbs after the exercise to restore glycogen deposits. Most athletes base the number of carbohydrates they consume on estimations of their energy and macronutrient needs and subjective measurements of how they feel during and after the training session. But a glucose monitoring system can help here.

    Read Also: Best Fiber Supplement For Diabetics

    What Benefit Will The Biosensor Provide To Athletes

    The biosensor is designed to provide a glucose monitoring experience that will enable athletes to understand the efficacy of their nutrition choices during training and competition. It will therefore inform athletes about how to fuel appropriately, to fill their glycogen stores prior to a race and to know when to replenish during a race to maintain athletic performance.9,10

    Is Cgm Accurate And Precise During Exercise

    using CGM for assessing blood glucose during exercise is an area of debateCGM accuracy during higher intensity exercise is poorest during the earlier stages of a bout, even in the newest modelsCGM accuracy is reasonable during low-intensity walkingDexcom G6 has shown slightly better and more consistent accuracyCGM accuracy during exercise was generally poor for all deviceset al.meta-analysismassive variability between devices and that CGM devices overestimate blood glucose during exercisemoderate effect size of 0.35the more recent sensor used, the better the technology and more accurate the CGM devices areMoser et al. Diabetologiaan accurate but imprecise tool might not be a useful tool when wanting to make daily decisions about your carb intake during exerciseCGM precision is rather poor at rest and during meals

    Also Check: Low Blood Sugar When Pregnant

    Are Continuous Glucose Monitoring Devices Easy To Use

    CGM devices are complex little machines. They do require some upfront time to understand their technical aspects.

    For example, you will need to learn how to:

    • Insert the sensor properly.
    • Transfer data to a computer or your phone.
    • Respond to and make changes to your care plan based on the collected data.

    Cgm Use In Athletes Welcome To Supersapiens And Their Glucose Performance Zone

    Continuous glucose monitoring | Ohio State Medical Center

    Abbotts Libre Sense Glucose Sport BiosensorSupersapiens~150 for 4-weeksinitial capital searching raised $13.5 millionIneos GrenadiersJumbo VismaEliud Kipchogehome pageeducation hub blog pagesactsupporting evidenceunA bowl of gels for breakfast is not conventionally accepted as a good start to the day, yet we seem to find this ideal when exercising in the morning.

    Read Also: How To Fix Blood Sugar

    The Proof Is In The Eating

    During the free-for-all Christmas period, though perhaps not surprising, it was quite shocking to see how regularly I bust my glucose exposure target. My glucose variability was high and I spent more time in the upper glucose zones. I found being able to visualise all of this very powerful and somewhat addictive. It was easy to discover which types of food and alcohol spiked my sugars worst clementines and cider seemed particularly spikey. It also revealed just how much the festive season messed up my glucose levels.

    To get a real contrast, for a fortnight from New Years Day, I worked hard to get my glucose variability number down, finding foods through trial and error that promoted stable blood sugar throughout the day. Green veg, eggs, salmon and walnuts all worked well for me. I obsessively monitored the real-time charts with brief hourly check-ins, to weed out anything that caused spikes and crashes.

    In two weeks, I cut my variability from an average of 16mg/dL to 10mg/dL, managed to meet my daily glucose exposure targets with pleasing regularity and saw my average glucose drop to that Supersapiens default target. But it was the knock-on effects of religiously following the numbers that really impressed.

    How To Fuel Properly

    To determine how to properly fuel your exercise, we need to specify the duration and intensity of your workout. Please keep in mind that we are talking about fueling during competitions for optimal performance. We will dive into the intricacies of fueling for training, health/metabolic goals, reducing fatigue, and building muscle in future blog posts. Additionally, pre and post-exercise are different beasts and will also be discussed in future blog posts. This post is about what you need during your athletic event.

    While traditional fueling guidelines provide a range of carbohydrate intake per hour for optimal performance, which is a good starting point, newer tools exist that may help track carbohydrate needs even more. For instance, continuous glucose monitors can report real-time glucose levels in the body during a workout. This technology provides a unique opportunity to personalize and dial in your fueling strategy to ensure that it is most effective and least damaging. These quantitative tools can give a snapshot of how the body is utilizing different sources of energy.

    Duration Less Than 45 Min, Low Intensity

    E.g., easy bike ride/run/swim, walking the dog, yoga, curling

    Fueling insights: No extra fuel is needed, nor will additional fuel enhance performance. These exercises low intensity and short duration indicate that glucose already in circulation and stored fat will be preferentially utilized as fuel.

    Duration Less Than 45 Min, Power Sports

    Also Check: Normal Blood Sugar Level Chart For Adults Without Diabetes

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