Carbohydrate Management in Athletes with Type 1 Diabetes in a 10 km Run Competition

Abstract

The aim of this study was to identify the real consumption of CHO during a 10 km competitive run, to compare data with the recommended quantities according to current guidelines, and to analyse the clinical events associated with these different amounts. Protocol 1: observational study including 31 athletes with T1D and 127 athletes without diabetes, comparing data taken from dietary records of CHO intake on the competition day. Protocol 2: single-blind randomized trial in 18 athletes with T1D, testing a pre-exercise CHO supplement of 0.7 g CHO·kg(- 1) (n=10) or 0.35 g CHO·kg(- 1) (n=8). The results showed that T1D athletes consumed a lower quantity of CHO than athletes without diabetes at their usual breakfast and during the meal taken<1 h after the competition, but no differences were found in the supplement taken before the competition. In the randomized study, athletes consuming the higher dose of CHO (0.7 g CHO·kg(- 1)) showed increased glycemic levels, comparing with the lower dose (0.35 g CHO·kg(- 1)). In conclusion, athletes with T1D seem to increase CHO intake prior to the competition consuming similar amounts to those athletes without diabetes, but consuming smaller quantities of CHO than the recommended amounts. This appears to induce a more stable glycemic response, in comparison with supplements with high-CHO content.

Glycemic Control and Muscle Damage in 3 Athletes With Type 1 Diabetes During a Successful Performance in a Relay Ultramarathon: A Case Report

“…The results presented herein expand the limited number of findings about glycemic control in the study athletes during endurance 32,33 and ultraendurance 30,31 competitions. Additionally, 73% of the blood glucose analyses showed that these athletes were in a zone where it was safe to exercise (90–250 mg/dL or 5.0–13.9 mmol/L).…”

Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system

“…Although glycemic and PA measurements of competitive-level exercise for people with T1D are available, [42][43][44][45] less is known about T1D adults being active at an amateur level. Some of our study's limitations were related to the measurement instruments used, given by the free-living conditions study design.…”

Nutritional Strategies of an Athlete with Type 1 Diabetes Mellitus During a 217-km Ultramarathon

“…Some athletes with type 1 diabetes ingest low to moderate levels of carbohydrates during training and rest periods 4,6,7 ; however, this strategy becomes inefficient during long-distance events when high levels of carbohydrate (70–90 g·h -1 ) are ingested, aiming to prevent hypoglycemia and support performance. 4 When carbohydrate is consumed during exercise, there is an alteration of substrate utilization to energy provision, with a lower contribution of endogenous carbohydrate and a higher rate of exogenous carbohydrate oxidation.…”

“…4 In addition to daily challenges, maintaining normal glucose levels during different training protocols, especially during prolonged exercise events 4 and traveling, may present a major challenge for athletes with type 1 diabetes, 5 considering that factors other than insulin levels have an impact on glycemia, such as macronutrient intake and psychophysiological stress responses. 4 Some athletes with type 1 diabetes ingest low to moderate levels of carbohydrates during training and rest periods 4,6,7 ; however, this strategy becomes inefficient during long-distance events when high levels of carbohydrate (70-90 g•h -1 ) are ingested, aiming to prevent hypoglycemia and support performance. 4 When carbohydrate is consumed during exercise, there is an alteration of substrate utilization to energy provision, with a lower contribution of endogenous carbohydrate and a higher rate of exogenous carbohydrate oxidation.…”