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The “Ups” and “Downs” of a Bike Race in People with Type 1 Diabetes: Dramatic Differences in Strategies and Blood Glucose Responses in the Paris-to-Ancaster Spring Classic
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- Author(s) / Creator(s)
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Objective: Recommendations for insulin adjustments and carbohydrate intake exist for individuals with
type 1 diabetes undertaking moderate exercise. Very few guidelines exist for athletes with type 1 diabetes
competing in higher intensity and/or longer duration events. This observational study reports the
strategies adopted by 6 habitually active men with type 1 diabetes (HbA1c = 8.3±2.0%) undertaking a
relatively intense endurance cycling event.
Methods: Participants wore continuous glucose monitoring (CGM) sensors for 24 hours before
competition, while racing and overnight post-race. They were asked to eat their regular meals and snacks,
and make their usual insulin adjustments before, during and after competition. All food intake and insulin
adjustments were recorded in detail.
Results: Participants used a variety of adjustments for exercise. Four of 6 participants decreased their
insulin dosage, and all participants consumed carbohydrate during the race (mean= 87±57g). In spite of
these strategies, three of the six participants experienced mild to moderate hypoglycemia (not requiring
assistance) during the event. Hyperglycemia was seen in all participants three hours post-exercise. There
were no incidents of nocturnal hypoglycemia.
Conclusions: Individuals with type 1 diabetes can compete in intensive long-distance athletic events
using a variety of nutritional and insulin adjustment strategies. In addition to finely tuned insulin
adjustments and increased carbohydrate intake, vigilance will always be required to maintain some
semblance of glycemic control during extended duration events. -
- Date created
- 2015-01-01
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- Subjects / Keywords
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- Type of Item
- Article (Draft / Submitted)