Sweet 452 km – a report on the first type 1 diabetes patient to finish Double Ironman, a 30-hour endurance triathlon race

Vlahek, Pavao; Car, Siniša; Ostroški, Ivanka

doi:10.3325/cmj.2013.54.306

Cited by 14 publications

(18 citation statements)

References 3 publications

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“… (4.9% vs 3±8%, respectively). Whilst there are only limited data concerning the glycaemic profiles of exercising athletes with Type 1 diabetes, in the literature that is available hyperglycaemia is commonplace because of a tendency to adjust carbohydrate and insulin amounts in an effort to avoid hypoglycaemia .…”

Section: Discussionmentioning

confidence: 99%

“…The overall duration of hyperglycaemia (blood glucose >10 mmol/l) was comparable to that observed in 11 individuals consuming <50 g of carbohydrate per day studied by Leow et al [14] (4.9% vs 3AE8%, respectively). Whilst there are only limited data concerning the glycaemic profiles of exercising athletes with Type 1 diabetes, in the literature that is available hyperglycaemia is commonplace because of a tendency to adjust carbohydrate and insulin amounts in an effort to avoid hypoglycaemia [7,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous variables must be considered, including exercise intensity, type, duration, time of day, circulating insulin, insulin absorption and carbohydrate intake, among a host of others [6][7][8][9][10][11]. Difficulties in pre-empting and accounting for these factors in real time, can lead to prolonged and significant hyperglycaemia, hypoglycaemia, or both [7,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Glycaemic stability of a cyclist with Type 1 diabetes: 4011 km in 20 days on a ketogenic diet

2019

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Background Maintaining glycaemic control during exercise presents a significant challenge for people living with Type 1 diabetes. Significant glycaemic variability has been observed in athletes with Type 1 diabetes in competitive contexts. While very‐low‐carbohydrate ketogenic diets have been shown to minimize glycaemic excursions, no published data have examined if this translates to exercise. Case report We report the case of a 37‐year‐old man with Type 1 diabetes who successfully undertook a 4011 km cycle across Australia over 20 consecutive days whilst consuming a very‐low‐carbohydrate ketogenic diet. Continuous glucose monitoring data capture was 98.4% for the ride duration and showed remarkable glycaemic stability, with a standard deviation of 2.1 mmol/l (average interstitial glucose 6.1 mmol/l) and 80.4% of time spent within a range of 3.9–10 mmol/l. Interstitial glucose was <3 mmol/l for 2.1% of this time, with only a single episode of symptomatic hypoglycaemia prompting brief interruption of exercise for carbohydrate administration. Conclusion This case demonstrates the viability of a very‐low‐carbohydrate ketogenic diet in an individual with Type 1 diabetes undertaking exercise. While the effect of a very‐low‐carbohydrate ketogenic diet is yet to be examined more broadly in athletes with Type 1 diabetes, the glycaemic stability observed suggests that fat adaptation may attenuate glycaemic swings and reduce reliance on carbohydrate consumption during exercise for maintaining euglycaemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Glycaemic stability of a cyclist with Type 1 diabetes: 4011 km in 20 days on a ketogenic diet

2019

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“…Our results showed that the athletes in this study, running $ 65 to 85 km over episodic periods, had similar increases in muscle damage and inflammatory biomarkers, as reported previously where 1 athlete was evaluated after a 452-km triathlon competition. 31 Different from triathlon competitions, mountain ultramarathons are performed on off-road trails, coastal mountains, and paths with considerable cumulative downhill courses, 5,34 resulting in substantial muscle damage and subsequent inflammatory responses. 22 High serum CK values are common after ultramarathons, but rarely result in adverse consequences among healthy ultrarunners.…”

Section: Discussionmentioning

confidence: 99%

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

Belli

Macedo

Scariot

et al. 2017

Wilderness & Environmental Medicine

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Ultramarathon races are fairly demanding and impose substantial physiological stress on healthy athletes. These competitions may thus be considerably more challenging for individuals with diabetes. This case study aims to describe glycemic control, muscle damage, inflammation, and renal function in 3 athletes with type 1 diabetes during a successful performance in a relay ultramarathon. The team completed the race in 29 hours and 28 minutes, earning third place. The total distance covered by each athlete was 68.7, 84.5, and 65.1 km. Most blood glucose levels showed that athletes were in a zone where it was safe to exercise (90-250 mg/dL or 5.0-13.9 mmol/L). Creatine kinase, lactate dehydrogenase, and aspartate aminotransferase serum levels increased 1.2- to 50.7-fold prerace to postrace, and were higher than the reference ranges for all the athletes postrace. Blood leukocytes, neutrophils, and serum C-reactive protein (CRP) increased 1.6- to 52-fold prerace to postrace and were higher than the reference ranges for 2 athletes after the race. Serum creatinine increased 1.2-fold prerace to postrace for all the athletes but did not meet the risk criteria for acute kidney injury. In conclusion, our main findings show evidence of satisfactory glycemic control in athletes with type 1 diabetes during a relay ultramarathon. Moreover, elevation of muscle damage and inflammatory biomarkers occurred without affecting renal function and challenging the maintenance of blood glucose among athletes. These findings are novel and provide an initial understanding of the physiological responses in athletes with type 1 diabetes during ultramarathon races.

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“…We agree with the authors of the wound management guidelines that there is scant evidence supporting blister preventive measures. However, they overlooked Blist-O-Ban (Seaberg Company Inc, Newport, OR), which has proven efficacy, 6 and also neglected to mention that 57% of the participants who used antiperspirant for blister prevention reported unpleasant skin irritation (vs 6% in the placebo group). 7 Although not available at the time of the practice guidelines' publication, a recent study found that application of paper tape for blister prevention resulted in high user satisfaction (84% would use again), although no statistical significance was found and application appeared to increase the odds of blister occurrence in those with Injinji socks.…”

Section: Blisters: the Enemy Of The Feetmentioning

confidence: 99%

Ultraendurance Athletes With Type 1 Diabetes: Leadville 100 Experience

Khodaee

Riederer

VanBaak

et al. 2015

Wilderness & Environmental Medicine

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Sweet 452 km – a report on the first type 1 diabetes patient to finish Double Ironman, a 30-hour endurance triathlon race

Cited by 14 publications

References 3 publications

Glycaemic stability of a cyclist with Type 1 diabetes: 4011 km in 20 days on a ketogenic diet

Glycaemic stability of a cyclist with Type 1 diabetes: 4011 km in 20 days on a ketogenic diet

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

Ultraendurance Athletes With Type 1 Diabetes: Leadville 100 Experience

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