Management and Medical Care for Individuals with Type 1 Diabetes Running a Marathon

Area of Science:

• Endocrinology
• Sports Medicine
• Diabetology

Background:

• Limited data exist on managing type 1 diabetes mellitus (T1DM) in endurance events.
• Marathon running presents unique glycemic control challenges for individuals with T1DM.

Purpose of the Study:

• To assess glycemic control and participant safety during a marathon.
• To evaluate the effectiveness of management strategies for T1DM during endurance events.

Main Methods:

• Five male T1DM participants completed a marathon with pre-race insulin dose reduction and specific meal timing.
• Glycemic monitoring utilized self-monitoring blood glucose (SMBG), two continuous glucose monitoring (CGM) systems, and ketone level checks.
• A dedicated medical team provided carbohydrate and fluid supplementation based on a pre-approved protocol.

Main Results:

• All participants successfully completed the marathon.
• Mean SMBG was 125.6 mg/dL, while CGM readings ranged from 149.6 to 155.4 mg/dL.
• Two participants experienced hypoglycemia, one prolonged and undetected by CGM, highlighting potential monitoring gaps.

Conclusions:

• Safe marathon completion for T1DM individuals necessitates individualized insulin adjustments and carbohydrate supplementation.
• Dedicated medical support and a combination of CGM with SMBG are crucial for detecting and managing glycemic excursions.