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Acta Diabetol. 2017 Apr;54(4):403-409. doi: 10.1007/s00592-017-0964-3. Epub 2017 Feb 2.

Striving for control: lessons learned from a successful international Type 1 Diabetes Youth Challenge.

Author information

1
Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Janusz-Korczak-Allee 12, 30173, Hannover, Germany. kordonouri@hka.de.
2
P&A Kyriakou Children's Hospital, Athens, Greece.
3
Centro de Diabetes Curitiba, Division of Pediatric Endocrinology os Hospital Nossa Senhora Das Graças, Curitiba, Brazil.
4
Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Janusz-Korczak-Allee 12, 30173, Hannover, Germany.
5
Department of Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, Ljubljana, Slovenia.
6
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Abstract

AIMS:

To demonstrate whether young people with T1D using modern insulin treatment and CGM could successfully participate in extreme sport activity while maintaining good glycemic control.

METHODS:

The challenge took place in Crete/Greece over 4 days combining a long-distance trek of different levels of severity with final destination the summit of the White Mountains at 2080 m. Eleven participants (5/6 female/male, age 18.2 ± 1.3 years, T1D duration 7.9 ± 3.5 years, HbA1c 7.3 ± .7% (56 ± 16 mmol/mol); mean ± SD) from 11 SWEET centers in Belgium, Brazil, Canada, Germany, Greece, France, India, Italy, Portugal, Slovenia and Sweden participated to the challenge. Five participants were on CSII, six on MDI; all were wearing a continuous glucose monitoring system. The glycemic targets during trekking were defined as 80-180 mg/dl (4.4-10 mmol/l).

RESULTS:

All participants completed the challenge. In total, the group walked 54.5 km under varying climate conditions (temperature 14-35 °C). During the challenge, insulin requirements decreased significantly compared to baseline: total daily insulin by 31.1 ± 16.7% (p < .001), basal by 30.8 ± 14.9% (p < .001), and prandial by 32.5 ± 28.0% (p = .023), with no differences between participants with CSII or MDI. No episode of severe hypoglycemia or DKA occurred. Mean glucose levels were 170.7 ± 60.1 mg/dl with 61.5 ± 18.7% of CGM values in the target range, 5.4 ± 5.4% under 80 mg/dl and 32.8 ± 16.6% above 180 mg/dl.

CONCLUSIONS:

The results of this SWEET Initiative activity demonstrated that well-educated adolescents and young adults with T1D using modern insulin treatments are able to perform successfully even extraordinary physical challenges while maintaining good glycemic control without diabetes-related acute complications.

KEYWORDS:

CGM; CSII; Sports; Type 1 diabetes; Youth

PMID:
28154987
DOI:
10.1007/s00592-017-0964-3
[Indexed for MEDLINE]

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