Physiological Characteristics of Type 1 Diabetes Patients during High Mountain Trekking

Abstract

In this study, the aim was to provide observational data from an ascent to the summit of Mount Damavand (5670 meters above sea level (m.a.s.l), Iran) by a group of people with type 1 diabetes (T1DM), with a focus on their physiological characteristics. After a 3-day expedition, 18 T1DM patients, all treated with personal insulin pumps, successfully climbed Mount Damavand. Information was collected on their physiological and dietary behaviors, as well as medical parameters, such as carbohydrate consumption, glucose patterns, insulin dosing, and the number of hypo- and hyperglycemic episodes during this time frame. The participants consumed significantly less carbohydrates on day 3 compared to day 1 (16.4 vs. 23.1 carbohydrate units; p=0.037). Despite this, a gradual rise in the mean daily glucose concentration as measured with a glucometer was observed. Interestingly, the patients did not fully respond to higher insulin delivery as there was no significant difference in mean daily insulin dose during the expedition. There were more hyperglycemic episodes (≥180 mg/dL) per patient on day 3 vs. day 1 (p<0.05) and more severe hyperglycemic episodes (>250 mg/dL) per patient on days 2 (p<0.05) and 3 (p<0.05) vs. day 1. In summary, high mountain trekking is feasible for T1DM patients with good glycemic control and no chronic complications. However, some changes in dietary preferences and an observable rise in glucose levels may occur. This requires an adequate therapeutic response.

Beta Cell Death Mechanism in Type 2 Diabetes: An Overview

“…Beta cells, however, are unable to adjust to the long-term demands of peripheral insulin resistance when T2D develops, and the hyperinsulinemia state transforms into a condition of relative insulin insufficiency. As a result, hyperglycemia happens following the consumption of many carbs [16]. Some of the mechanisms involved in beta cell dysfunction and death in T2D are as follows:…”

Evaluation of selected psychological parameters: Perception of happiness and hope of success in patients with type 1 diabetes mellitus

“…The metabolic parameters measured with the percentage of HbA1c were worse in patients with depressive-anxiety disorders and with a high level of B-PaidBM [7]. In recently published papers, we have shown that the combination of specific personality traits, social skills, family support, sports traditions, inheritance factors and access to new technologies in the treatment of T1DM under the supervision of a highly qualified specialist diabetolo-gist may result in a unique and inspiring successful success in life, sport and treatment of diabetes [10,11].…”

Nutritional support for a person with type 1 diabetes undertaking endurance swimming

“…There will be overlap with those experienced in other endurance exercise events. Dietary changes, glycaemia and different insulin delivery systems have been explored in extreme events such as high-altitude mountain trekking ( 11 , 12 ), a 1008km bicycle event ( 13 ) and ultramarathon running ( 14 ). The unique and overlapping factors impacting long-distance swimming will be explored in this paper, drawing on published papers, clinical guidelines, and the personal account of an endurance swimmer with type 1 diabetes.…”