A case study was reported on a 1 -type diabetes athlete's nutritional strategy that challenged the 135 miles (217 km) ultra marathon.He completed the race with a different nutritional strategy from the content recommended in literature.The authors have stated that individualization is important for the nutritional strategy of type 1 diabetes athlete.
What is the nutrition strategy necessary for type 1 diabetes athletes to participate in the race for a long time?
The popularity of ultra durable sporting events has increased, and the population of Ultra Marathon is increasing globally.Many type 1 diabetic patients participate in the Ultra Marathon due to the renewal of records in harsh races and the extremes of reaching the extreme.It is difficult for patients with type 1 diabetes to complete such a harsh long -term race, but it is not impossible to take appropriate insulin administration and nutritional strategies.However, the elements that need to be considered are extremely wide.
Some of the type 1 diabetic athletes takes a strategy of suppressing blood glucose fluctuations in a small amount of training and carbohydrate intake before competition.However, in sports with long competitive time that require high -level carbohydrate intake (for example, 70 to 90 g/time), the strategy increases hypoglycemic risk and is disadvantageous for performance.
In sports for a long time, the use of energy substrates changes during exercise, and the oxidation rate of external causative carbohydrates increases.In addition, other major nutrients may also affect blood sugar.For example, ingestion of protein can stimulate glucagon secretion and cause hyperglycemia by glucose freshmen.Lipid intake can also cause early hypoglycemia due to delay in gastric content, reduced insulin sensitivity, and hyperglycemia due to enhancement of liver guru course production.
Of course, it must be considered on the impact on blood sugar levels due to the load of the exercise, the impact of exercise to digestion and absorption speed, and hydration, and it is a practical useful nutritional strategy in long -range races of type 1 diabetes athlete.There is only a few information.
Contents of case athletes and ultra marathons that participated
Type 1 diabetes athlete, which is introduced in the paper, is a 36 -year -old man, who has participated in the marathon 38 times since he was diagnosed with type 1 diabetes 15 years ago, and the best time is 3 hours and 38 minutes, 100-00 ~.He has four participation in 217km Ultra Marathon.Weight 71.1kg, height 1.It has been 66m and a body fat percentage of 10 %, and has been training 40 to 100 km per week for 14 years.
This research report summarizes the nutritional strategy when this athlete participated in the Brazil 135 Ultra Marathon.The Brazil 135 Ultra Marathon repeats abdowns at a mileage of 217 km and an altitude of about 800 to 1,650m.With a time limit of 60 hours, 62 people participated in this year's tournament.There were 44 finished runners and the race record was 27 hours 59 minutes to 59 hours and 23 minutes.
The record of the first type 1 diabetic athlete was 51 hours and 18 minutes, finishing 27th.The average speed is 4.It was 2km/time.Participants can always eat and drink and sleep at any time during the race, and this research athlete consumes some food and drinks 16 times over three days, and has been 7 times in total..I got a 6 -hour sleep.
The blood sugar management during the race was caused by insulin administration by a pen -type insulin injection and a blood glucose self -measurement by a simple blood glucose measuring instrument.A total of 10 units (4U, 6U) were divided into two basis insulin, 10Us at 116 km at 116 km, and 20 U in 2 hours after the race.
In addition, the weight was measured at 78km, 175km, and the goal point, and the dehydration level was evaluated.
Nutrition strategy and blood sugar fluctuation
This type 1 diabetic athlete consumed 532 g of carbohydrates, 166 g proteins, and 92g of lipids during racing, and had a total of 3,592 kcal.In weight conversion, 7g/kg, 2g/kg, 1g/kg, 50kcal/kg in the same order.The amount of energy intake in 24 o'clock was 1,714kcal.
Looking at the day of the day, the first day takes eight meals and drinks eight times after starting 2 hours to 14 hours, and the total is 372g of carbohydrates, 33g protein, 38g of lipids, and 1,957 kcal, which is intake of 1,957 kcal.5g/kg, 0 in the same order.5g/kg, 0.5g/kg, 28kcal/kg.
On the second day, 6 times, 123g of carbohydrates, 130g protein, 40g of lipids, 1,347 kcal in total, and in the same order in weight conversion, 2g/kg, 2g/kg, 0.6g/kg, 19kcal/kg.The number of foods on the third day is two times, 37g carbohydrates, 3g protein, 14g of lipids, and 288 kcal in total, and in the same order in weight..5g/kg, 0.0g/kg, 0.2g/kg, 4kcal/kg.
In the paper, the type of food and drink taken during the race and the timing of ingestion are displayed.
The weight just before the start is 71 as mentioned above.It is 1kg, 69 at 78km.2kg ( % δ -2).7) * 69 at 175km.9kg ( % δ -1).7) 69 immediately after the race.0kg ( % δ -3).0) It was.On the other hand, the hydration amount was 14L in total, and the time conversion was 263 ml/time.
* % Δ: The percentage of the amount of change (hereinafter referred to as)
Generally, weight loss is -2.It is recommended that water intake within 0 % is recommended, but the authors are -2 in a situation like an ultra marathon..He states that weight loss exceeding 0 % is natural, and it may be necessary to avoid overdose of water.
This athlete is divided into two times, 116km and 195km, in total..I got a 6 -hour sleep.いずれも3～6時という時間帯だった。これは、概日レリズムを考慮したものであり、パフォーマンスの維持にも有効と考えられた。同様の睡眠戦略は、他のランナーにも観察された。
Blood sugar level 3.9-13.The goal was to maintain it in the range of 9 mmol (70-250 mg/dl).Actually, 3 through the race.6 to 18.It was in the range of 2mmol (65-328 mg/dl), but nearly half of the measurement results (47 %) 3.It was in the range of 9 to 10 mmol (70-180 mg/dl).
3.In the hypoglycemic range of less than 9 mmol (70 mg/dl), 5 % of all measurement points, 13.32 % was more than 9mmol (250 mg/dl).Overall, it was a bit higher than the target range, which was considered to be a strategy for athlete to avoid the risk of hypoglycemic.
Type 1 diabetes athlete's nutritional strategy is important for individualization
Based on the above results, the authors have added the following considerations about the nutritional strategy.
First, the amount of energy ingested during the competition is at the same level as the general athlete intake found in triathlon racing, which has a average record of about 12 hours, and is about one -quarter of the time conversion.Only.In addition, it has been reported as a result of a double -signed water method that the amount of energy consumed during the ultra marathon is reached more than 8 times the rate of rest.In other words, the intake of the athlete subject to this research was much less than shown in other documents.
On the other hand, the rise in blood sugar levels during the race was observed not only after consuming carbohydrates but also after protein intake.According to the previously reported literature, if a type 1 diabetic patient consumes a large amount of protein or a large amount of protein, blood sugar levels may rise 2 to 5 hours after eating.Based on these knowledge, insulin can also be needed for blood sugar management after ingesting foods with abundant proteins.
It has also been pointed out that the effects of lipid intake on blood sugar levels have been pointed out.However, this study did not observe the effects of lipid intake on blood sugar levels.
In conclusion, "In this case, the athlete of Type 1 Diabetes has been able to finish the Ultra Marathon safely, despite the use of a different strategy from the content recommended in the literature.The nutritional recommendation for athletes suggests that it needs to be individualized in consideration of past personal experiences. "
Literature information
The title of the original title is "Nutritional Strategies of An AtHLETE WITHLETE WITH TYPE 1 DIABETES MELLITUS DURING A 217-Km Ultramaraton".[Wilderness Environ Med.2022 JAN 4; S1080-6032 (21) 00208-8] Click here for the original text (elsevier)
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