Association between pre-exercise food ingestion timing and reactive hypoglycemia: Insights from a large database of continuous glucose monitoring data

Andrea Zignoli, Federico Y. Fontana, David J. Lipman, Kristina Skroce, Felipe M. Maturana, Howard C. Zisser
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Abstract

Using a large database of continuous glucose monitoring (CGM) data, this study aimed to gain insights into the association between pre-exercise food ingestion timing and reactive hypoglycemia. A group of 6,761 users self-reported 48,799 pre-exercise food ingestion events and logged minute-by-minute CGM, which was used to detect reactive hypoglycemia (<70 mg/dL) in the first 30 min of exercise. A linear and a non-linear binomial logistic regression model was used to investigate the association between food ingestion timing and the probability of experiencing reactive hypoglycemia. An analysis of variance was conducted to compare the predictive ability of the models. On average, reactive hypoglycemia was detected in 8.34 ± 3.04% of the total events, with <15% of individuals experiencing hypoglycemia in >20% of their events. The majority of the reactive hypoglycemia events were found with pre-exercise food timing between ∼30 and ∼90 min, with a peak at ∼60 min. The superior accuracy (62.05 vs 45.1%) and F-score (0.75 vs 0.59) of the non-linear vs the linear model were statistically superior (P < 0.0001). These results support the notion of an unfavourable 30-to-90 min pre-exercise food ingestion time window which can significantly impact the likelihood of reactive hypoglycemia in some individuals.

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运动前食物摄入时间与反应性低血糖之间的关系:来自连续血糖监测数据的大型数据库的见解。
利用一个大型连续血糖监测(CGM)数据数据库,本研究旨在深入了解运动前食物摄入时间与反应性低血糖之间的关系。一组6761名用户自我报告了48799次运动前的食物摄入事件,并记录了每分钟的CGM,用于检测反应性低血糖(20%的事件)。大多数反应性低血糖事件发生在运动前进食时间为~ 30 ~ ~ 90分钟之间,在~ 60分钟达到峰值。非线性模型与线性模型的准确度(62.05 vs 45.1%)和f评分(0.75 vs 0.59)均有统计学上的差异(P
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