Let's quickly see what our health coach and also a woman athlete, Jackie Cohen, has to say about this in preface to the article below:
The use of continuous glucose monitors in competitive sports took center stage when Kristin Faulkner was recently disqualified from the women’s Strade Bianche bike race. The UCI (Union Cycliste Internationale), the governing body that establishes and oversees the rules all elite-level athletes must adhere to while training and racing, does not allow the use of CGM’s during competition as it views them as an unfair advantage. The basis for this decision is that the cost of CGM usage is prohibitive for some athletes. While the UCI’s interest in attempting to “level” the playing field are understandable, it is also very unrealistic. Well-funded cyclists can (and do) spend thousands of dollars to shave a few grams of weight off their race bikes. There are no limits on what can be spent on training, (allowed) nutritional supplements and supportive therapies such as massage.
How much of an advantage does the use of a CGM offer? For some athletes (both male and female), the results can be game-changing or life-altering, particularly for those who are using blood glucose data to understand and improve their foundational health.
While I have not competed in a UCI level event for many years, the use of a CGM has prompted a 180 degree shift in my approach to fueling for training and racing in the master’s field. Using a CGM has allowed me to understand exactly how much of what kind of food my body requires to optimally fueled for both “on hours” hard training and racing efforts as well as “off hours” recovery. I now know that I had been under fueling my efforts for years. And while I still sometimes struggle to maintain an optimal blood glucose level, I am experimenting and learning. Since no two athletes are alike, results will absolutely vary. What has worked for me probably won’t work for you. This is exactly why the use of a CGM is such an advantage. Without the ability to measurable and accurately assess the unique glucose needs and responses happening inside your own body, you’re flying blind. Relying on guesswork.
While I struggle to maintain a glucose level that is high enough to support my activity and recovery, others struggle with keeping their levels in check. Frequent spikes and chronically elevated glucose levels are health and performance depleting. Running below empty is just as bad, especially for women who are genetically predisposed to requiring the safety of carrying an energy buffer on board.
Is your fueling strategy helping or hindering your ability to reach your health and/or performance goals? The use of a CGM is a simple (and relatively affordable) tool that will allow you to find out for sure.
“If I can have a similar mission and purpose in my life as a pro athlete, that's even more meaningful to me. This has given me a purpose behind my riding that is much greater than a third place at Strade Bianche,” Faulkner told Rouleur
“In training, I followed conventional guidelines and ate a gel every 15 minutes on intensity days, and every 20 minutes on endurance days, but even that led to spikes and crashes, which perpetuated my problem. Within a few months of using Supersapiens to track my glucose levels, my period came back. For me, that was a really important health moment,” Faulkner said.
“I'm nervous that I'm going to lose my period again and that's quite concerning from a health standpoint for me, especially when I tried different things for so many years and I finally found something that really helped me.
“It's pretty demoralising as a woman to have this organisation of mostly men tell me what I can and cannot use. They haven't cited any sources about women's health, they have no idea what causes amenorrhea, the relationship between glucose and yet, without that information, they still have the authority to govern it.”
Faulkner finished third at Strade Bianche after a 31km solo attack. However, her result was soon overshadowed after a glucose monitor sensor was seen underneath her jersey on her left arm.
The UCI opened an investigation and then disqualified her from the Strade Bianche results for wearing a continuous glucose monitoring sensor throughout the race. Faulkner claimed the sensor on her arm was never connected to the app, and so no data was ever downloaded or used.
She told Rouleur that she asked a member of her team’s staff if she would be allowed to keep her glucose monitoring patch on and was told that it would be "fine" as long as it didn’t record data.
“After the race, my team doctor came up to me. And he's like, Kristen, why are you wearing this? It was all over the news. I was like, what are you talking about? I've been wearing it all week, and no one said anything. I had no idea. I thought as long as there was no data, it was fine. I didn’t actually think I was going to get DQ’d. I just thought I might get a fine or penalty," Faulkner said.
The UCI approved the devices in training, and there have been calls from a number of teams to use the technology in racing. However, the UCI introduced a rule in the summer of 2021 to ban CGM devices in competition. At the time, the UCI claimed: “there is no evidence proving that it could improve the safety of the non-diabetic riders.”
Faulkner has accepted her disqualification but found fault with the UCI and the disciplinary process, including the lack of involvement and support of the UCI Ethics Committee. She also called for consistency in punishment.
"Without naming specifics, people taking off their helmets, people wearing illegal skin suits, they were not disqualified, even though those impacted the race performance," Faulkner said.
Faulkner believes continuous glucose monitors can help women avoid damaging their health.
The UCI allows riders exemptions to wear glucose monitors in competition if there is medical proof that an athlete suffers from amenorrhea, but Rouleur suggested the UCI has not approved any to date.
“None of their justifications [for banning glucose monitors] are actually that valid. I don't think the UCI put any kind of weight on the health of their riders, especially women's health,” Faulkner said.
“It's much more complicated for women than it is for men because we burn different amounts of fat versus glucose throughout the month, depending on where we are in our [menstrual] cycle.
“The second thing is that the risks for women of not getting it right are much deeper. If a man doesn't fuel properly, he bonks, but if a woman doesn't fuel properly, she could lose her period. That creates a whole host of hormonal deficiencies.
“Any governing body that forbids me from staying informed about my food uptake is preventing me from taking care of my body in a natural and healthy way.”