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First published online February 15, 2011

Endurance Athletes and Type 1 Diabetes


The purpose of this study was to gain insight into the current diabetes management practices of endurance athletes with type 1 diabetes and to compare these practices with the guidelines for athletes established by the American Diabetes Association (ADA).
Participants included in this descriptive study were endurance athletes aged 18 years and older with type 1 diabetes. The survey questions were based on the current clinical recommendations for endurance athletes with type 1 diabetes, as established by the ADA. A link to the questionnaire was posted on the Web site of the Diabetes Exercise and Sports Association (DESA). A total of 38 questions were included in the survey, and 91 usable surveys were received. Analysis of variance was used for several comparisons using SPSS version 17.
Half of the clinical guidelines were followed by the participants. Among these, about 50% followed many of the guidelines “most of the time” or “almost always” and 40% followed the guidelines “sometimes” or “most of the time.” Results of ANOVA showed several trends (nonsignificant) in the occurrence of low blood glucose when the guidelines were not followed.
Endurance athletes with type 1 diabetes do not consistently follow the clinical guidelines for blood glucose management as recommended by the ADA. The results of this study reflect a need among athletes for diabetes management education programs that promote a better understanding of the potential negative side effects of suboptimal blood glucose control.

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Mensing C., Cypress M., Halstenson C., McLaughlin S., Walker EA The Art and Science of Diabetes Self-Management Education. Chicago, II: American Association of Diabetes Educators ; 2006:188.
Chansky ME, Corbett JG, Cohen E. Hyperglycemic emergencies in athletes. Clin Sports Med. 2009;28:469-478.
Riddell M., Perkins BA Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role of for continuous glucose monitoring. J Diabetes Sci Technol. 2009;3: 914-923.
Camacho RC, Galassetti P., Davis SN, et al. Glucoregulation during and after exercise in health and insulin-dependent diabetes. Exerc Sports Sci Rev. 2005;33:17-23.
Zinman B., Ruderman N., Campaigne BN, et al. American Diabetes Association: Physical activity/exercise and diabetes (position statement). Diabetes Care. 2004;27(suppl 1): S58-S62.
Guelfi KJ, Jones TW, Fournier PA New insights into managing the risk of hypoglycaemia associated with intermittent high-intensity exercise in individuals with type-1 diabetes mellitus. Sports Med. 2007;37:937-946.
Iscoe KE, Jonathan E., Jamnik V., et al. Efficacy of continuous real-time blood glucose monitoring during and after prolonged high-intensity cycling exercise: spinning with a continuous glucose monitoring system. Diabetes Technol Ther. 2006;8:627-635.
Colberg S. Use of clinical practice recommendations for exercise by individuals with type-1 diabetes. Diabetes Educ. 2000;26:265-271.
Toni S., Reali MF, Barni F., et al. Managing insulin therapy during exercise in type-1 diabetes mellitus. Acta Biomed. 2006;77 (suppl 1): 34-40.
Porte D. Jr, Sherwin RS, Baron AD Diabetes Mellitus. 6th ed. New York, NY: McGraw-Hill; 2003;465-466.
Mauvais-Jarvis F., Sobngwi E., Porcher R., et al. Glucose response to intense aerobic exercise in type-1 diabetes: maintenance of near euglycemia despite a drastic decrease in insulin dose. Diabetes Care. 2003 ;26:1316-1317.
Sandoval DA , Aftab Guy DL, Richardson MA, et al. Effects of low and moderate antecedent exercise on counter-regulatory responses to subsequent hypoglycemia in type-1 diabetes. Diabetes. 2004;53:1798-1806.
Sane T., Have E., Pelkonen R., et al. The adjustment of diet and insulin dose during long-term endurance exercise in type-1 (insulin-dependent) diabetic men. Diabetologia . 1988;31:35-40.
Wasserman DH , Zinman B. Exercise in individual with type-1 IDDM. Diabetes Care. 1994:17:924-937.
Peter R., Luzio SD, Dunseath G., et al. Effects of exercise on the absorption of insulin glargine in patients with type-1 diabetes. Diabetes Care. 2005;28:560-565.
McMahon SK, Ferreira LD, Nirubasini R., et al. Glucose requirements to maintain after moderate-intensity afternoon exercise in adolescents with type-1 diabetes are increased in a biphasic manner . J Clin Endocr Metabol. 2007;92:963-968.
Perkins BA, Riddell MC Type-1 diabetes and exercise: using the insulin pump to maximum advantage . Can J Diabetes. 2006; 30:72-79.
Wahren J., Felig P., Ahlborg G., Jorfeldt L. Glucose metabolism during leg exercise in men. J Clin Invest . 1971;50:2715-2725.
Macknight JM , Mistry DJ, Pastors JG, et al. The daily management of athletes with diabetes. Clin Sports Med. 2009;28:479-495.
Bussau VA, Jones TW, Ferreira LD, Fournier PA The 10-s maximal sprint: a novel approach to counter an exercise-mediated fall in glycemia in individuals with type 1 diabetes. Diabetes Care. 2006;29:601-606.
Hornsby GW, Chetlin RD Management of competitive athletes with diabetes. Diabetes Spectr. 2005;18:102-107.
Fahey PJ, Stallkamp ET, Kwatra S. The athlete with type-1 diabetes: managing insulin, diet and exercise. Am Fam Physician. 1996;53:1611-1617.
Franz MJ, Bantle JP, et al. Nutrition principles and recommendations in diabetes. American Diabetes Association. Diabetes Care. 2004;27 (suppl 1):S36-S46.
Hopkins D. Exercise-induced and other daytime hypoglycemic events in patients with diabetes: prevention and treatment. Diabetes Res Clin Pract. 2004;65:S35-S39.
Riddell M., Perkins BA Type-1 diabetes and vigorous exercise: applications of exercise physiology to patient management. Can J Diabetes. 2006 ;30:63-71.
Tull ES, Roseman JM Diabetes in African Americans. National Diabetes Data Group. In: Diabetes in America. 2nd ed. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, US National Institutes of Health;1995 :613-625.

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Article first published online: February 15, 2011
Issue published: March 2011

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Published online: February 15, 2011
Issue published: March 2011
PubMed: 21325065



Mercy Devadoss, MS, RD, LDN, CDE
Milton Hospital, Milton, Massachusetts, [email protected]
Laura Kennedy, MS, RD, LDN
Lemuel Shattack Hospital (Aramark Corp), Jamaica Plain,Massachusetts
Nancie Herbold, EdD, RD, LDN
Department of Nutrition at Simmons College, Boston,Massachusetts

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This article was published in The Science of Diabetes Self-Management and Care.


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