Podcast
Questions and Answers
What is a significant challenge faced by individuals with T1DM in athletic settings?
What is a significant challenge faced by individuals with T1DM in athletic settings?
- Limited access to competitive events
- Difficulty in finding appropriate exercise facilities
- Increased risk of hypoglycemia (correct)
- Inability to participate in group sports
What has contributed to the improvement in life expectancy for individuals with T1DM?
What has contributed to the improvement in life expectancy for individuals with T1DM?
- Reduction in the use of insulin injections
- Increase in the incidence of T1DM
- Decreased physical activity levels
- Advancements in insulin therapy and delivery (correct)
How do athletes with T1DM compare to their healthy peers in terms of health-related benefits from exercise?
How do athletes with T1DM compare to their healthy peers in terms of health-related benefits from exercise?
- They experience fewer benefits due to their condition
- They are unable to track their exercise benefits effectively
- They experience nearly all the same health-related benefits (correct)
- They experience more health-related benefits than healthy individuals
What role do clinicians play in managing athletes with T1DM?
What role do clinicians play in managing athletes with T1DM?
What is the trend in the incidence of T1DM based on recent data?
What is the trend in the incidence of T1DM based on recent data?
What has primarily been a mainstay of therapy for individuals with T1DM?
What has primarily been a mainstay of therapy for individuals with T1DM?
Why is it important for clinicians to have knowledge of T1DM management as life expectancy improves?
Why is it important for clinicians to have knowledge of T1DM management as life expectancy improves?
What is the recommended action if fasting blood glucose (BG) is greater than 250 mg/dL and ketosis is present?
What is the recommended action if fasting blood glucose (BG) is greater than 250 mg/dL and ketosis is present?
What is one potential outcome of improved blood glucose monitoring for individuals with T1DM?
What is one potential outcome of improved blood glucose monitoring for individuals with T1DM?
What should T1DM athletes do if their blood glucose is above 300 mg/dL without ketosis before high-intensity exercise?
What should T1DM athletes do if their blood glucose is above 300 mg/dL without ketosis before high-intensity exercise?
What is the suggested adjustment to mealtime bolus doses if a meal is eaten prior to competition?
What is the suggested adjustment to mealtime bolus doses if a meal is eaten prior to competition?
For low-intensity exercise, how should the basal insulin rate be adjusted?
For low-intensity exercise, how should the basal insulin rate be adjusted?
How long before exercise should the insulin pump be removed for athletes participating in contact sports?
How long before exercise should the insulin pump be removed for athletes participating in contact sports?
What is the recommended frequency and purpose of small boluses during exercise lasting more than one hour?
What is the recommended frequency and purpose of small boluses during exercise lasting more than one hour?
What represents around 50% of the usual hourly basal rate when adjusting boluses?
What represents around 50% of the usual hourly basal rate when adjusting boluses?
What is a potential disadvantage of reducing the pre-exercise bolus?
What is a potential disadvantage of reducing the pre-exercise bolus?
What is the recommended carbohydrate (CHO) intake for athletes with diabetes one hour before exercise?
What is the recommended carbohydrate (CHO) intake for athletes with diabetes one hour before exercise?
What type of carbohydrate sources are recommended for athletes with diabetes before events?
What type of carbohydrate sources are recommended for athletes with diabetes before events?
During exercise lasting more than 45 minutes, how much carbohydrate should an athlete consume each hour?
During exercise lasting more than 45 minutes, how much carbohydrate should an athlete consume each hour?
What is a possible consequence of high intensity or intermittent high intensity exercise for athletes with diabetes?
What is a possible consequence of high intensity or intermittent high intensity exercise for athletes with diabetes?
What carbohydrate intake is adequate for a short duration exercise lasting less than 45 minutes?
What carbohydrate intake is adequate for a short duration exercise lasting less than 45 minutes?
What effect does antecedent hypoglycemia have on subsequent exercise performance in athletes?
What effect does antecedent hypoglycemia have on subsequent exercise performance in athletes?
What should athletes with diabetes do to prevent hypoglycemia after carbohydrate loading?
What should athletes with diabetes do to prevent hypoglycemia after carbohydrate loading?
Which option is a potential response after exercising following antecedent hypoglycemia?
Which option is a potential response after exercising following antecedent hypoglycemia?
What role do alpha-adrenergic receptors play in diabetes mellitus?
What role do alpha-adrenergic receptors play in diabetes mellitus?
Which type of exercise is associated with increased GLUT-4 translocation in human skeletal muscle?
Which type of exercise is associated with increased GLUT-4 translocation in human skeletal muscle?
What was the focus of the Eurodiab Study Group's research?
What was the focus of the Eurodiab Study Group's research?
In which publication did the research about fuelling athletes with type 1 diabetes appear?
In which publication did the research about fuelling athletes with type 1 diabetes appear?
What effect does norepinephrine have on adipose tissue during exercise according to the literature?
What effect does norepinephrine have on adipose tissue during exercise according to the literature?
Which factor is identified as a predictor of cardiovascular disease mortality among men with diabetes?
Which factor is identified as a predictor of cardiovascular disease mortality among men with diabetes?
What was observed with alpha-adrenergic blockade in non-insulin-dependent diabetes mellitus?
What was observed with alpha-adrenergic blockade in non-insulin-dependent diabetes mellitus?
What is the primary subject of the study by Egan and Zierath?
What is the primary subject of the study by Egan and Zierath?
What effect does antecedent hypoglycemia have on exercise responses in insulin-dependent diabetes?
What effect does antecedent hypoglycemia have on exercise responses in insulin-dependent diabetes?
Which gland's hormone response is impaired in diabetic autonomic neuropathy during graded exercise?
Which gland's hormone response is impaired in diabetic autonomic neuropathy during graded exercise?
What is a recommended strategy to prevent exercise-induced hypoglycemia in type 1 diabetes?
What is a recommended strategy to prevent exercise-induced hypoglycemia in type 1 diabetes?
What is a significant factor in managing children with diabetes in a school setting?
What is a significant factor in managing children with diabetes in a school setting?
Which approach is NOT effective for managing late onset post-exercise hypoglycemia in type 1 diabetic patients?
Which approach is NOT effective for managing late onset post-exercise hypoglycemia in type 1 diabetic patients?
What physiological parameter is assessed by the new carbohydrate intake algorithm for diabetes management?
What physiological parameter is assessed by the new carbohydrate intake algorithm for diabetes management?
What is a common outcome of exercising with improper glycemic control in individuals with type 1 diabetes?
What is a common outcome of exercising with improper glycemic control in individuals with type 1 diabetes?
Which of the following hormones will likely show an impaired response to exercise in those with diabetes?
Which of the following hormones will likely show an impaired response to exercise in those with diabetes?
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Study Notes
Type 1 Diabetes Management in Athletes
- Individuals with Type 1 Diabetes Mellitus (T1DM) require continuous exogenous insulin injections for survival.
- Advances in insulin therapy and blood glucose monitoring have improved the life expectancy of T1DM patients, enabling participation in competitive sports.
- The incidence of T1DM is on the rise, necessitating better management strategies for athletic individuals.
Exercise and Glycemic Control
- Athletes with T1DM can gain almost all health benefits from exercise, similar to their healthy peers.
- Pre-exercise carbohydrate (CHO) loading (200-350 g) is recommended but requires close monitoring of blood glucose (BG) levels to prevent hypoglycemia.
- Recommended pre-event CHO intake is about 1 g CHO/kg body weight one hour before exercise; low-fat sources are preferred.
Recommendations for Pre-Exercise and Exercise Management
- For short-duration exercise (< 45 mins), a pre-exercise snack of ~15 g CHO 15-30 minutes prior is sufficient.
- During prolonged or high-intensity exercise, intake of 30 g CHO for every 60 minutes is advisable to prevent hypoglycemia.
- Athletes should avoid exercise if fasting BG is > 250 mg/dL and ketosis is present; caution is advised if BG exceeds 300 mg/dL without ketosis.
Insulin Management During Exercise
- Athletes using Continuous Subcutaneous Insulin Infusion (CSII) should reduce the basal rate by approximately 50% an hour before high-intensity exercise.
- Mealtime insulin bolus doses should be halved if a meal is consumed prior to competition.
Hypoglycemia Prevention Strategies
- Strategies for preventing exercise-associated hypoglycemia include:
- Reducing pre-exercise bolus insulin.
- Administering small hourly boluses during activities longer than an hour.
- Removing the insulin pump 30 minutes prior to contact or collision sports to mitigate insulin effects.
Summary of Prevention Strategies
- Regular monitoring and appropriate carbohydrate management are essential for maintaining glycemic control during physical activity.
- Implementation of individualized therapy considering the type and intensity of exercise can help in managing the unique challenges faced by athletes with T1DM.
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