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Wilderness Environ Med. 2017 Sep;28(3):239-245. doi: 10.1016/j.wem.2017.04.005. Epub 2017 Jun 17.

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

Author information

1
Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences, University of Campinas, Limeira, SP, Brazil (Dr Belli, Mr Scariot, Drs dos Reis and Gobatto).
2
Laboratory of Exercise Biochemistry (LABEX), Biochemistry Department, Biology Institute, University of Campinas, Campinas, SP, Brazil (Drs de Macedo, Lazarim, and Nunes).
3
Sports Science Research Group - Federal University of Alagoas (UFAL), Maceio AL, Brazil (Dr de Araújo).
4
Laboratory of Instrumentation for Biomechanics (LIB), Faculty of Physical Education, University of Campinas, Campinas, SP, Brazil (Dr Brenzikofer).
5
Laboratory of Applied Sport Physiology (LAFAE), School of Applied Sciences, University of Campinas, Limeira, SP, Brazil (Dr Belli, Mr Scariot, Drs dos Reis and Gobatto). Electronic address: claudio.gobatto@fca.unicamp.br.

Abstract

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.

KEYWORDS:

diabetes; glycemic management; inflammation; muscle damage; ultramarathon

PMID:
28629959
DOI:
10.1016/j.wem.2017.04.005
[Indexed for MEDLINE]

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