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Managing type 1 diabetes in the active population
British Journal of Sports Medicine, Volume: 54, Issue: 13, Pages: 809 - 810
Swansea University Author:
Richard Bracken
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DOI (Published version): 10.1136/bjsports-2019-101368
Abstract
Many high-profile athletes participate across a wide range of sports with type 1 diabetes. Team Type 1 encourages and supports those with type 1 diabetes to participate in physical activity, with professional cycling’s Team Novo Nordisk composed entirely of individuals with type 1 diabetes. Type 1 d...
Published in: | British Journal of Sports Medicine |
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ISSN: | 0306-3674 1473-0480 |
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BMJ
2020
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URI: | https://cronfa.swan.ac.uk/Record/cronfa52862 |
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2023-03-14T09:22:45.2951973 v2 52862 2019-11-25 Managing type 1 diabetes in the active population f5da81cd18adfdedb2ccb845bddc12f7 0000-0002-6986-6449 Richard Bracken Richard Bracken true false 2019-11-25 STSC Many high-profile athletes participate across a wide range of sports with type 1 diabetes. Team Type 1 encourages and supports those with type 1 diabetes to participate in physical activity, with professional cycling’s Team Novo Nordisk composed entirely of individuals with type 1 diabetes. Type 1 diabetes is likely to present early in an athlete’s career, a time when athletes may present with fatigue due to increased training loads. All physicians need to distinguish between possible causes of fatigue in these athletes.Type 1 diabetes is an autoimmune condition with T-cell-mediated destruction of the pancreatic β cells of the islets of Langerhans, resulting in failure to produce sufficient insulin. The clinical outcome is an inability to adequately control glucose metabolism. Effective glucose metabolism is crucial in long-duration and high-intensity exercise. Self-administered exogenous insulin is required as a treatment to manage blood glucose.The physiological response to exercise is a progressive decrease in insulin and increase in the pancreatic α-cell-derived antagonist hormone glucagon, while exercise also increases insulin sensitivity (increased ‘sensitivity’ means that for a given dose, there is a more pronounced effect—insulin does its job ‘better’). In addition, there is an exercise-induced rise in sympathoadrenal hormones (epinephrine and norepinephrine). This hormonal response influences circulating glucose and fat use, and is usually well-regulated. This is not the case in athletes with type 1 diabetes, where there is a substantial risk of both hyperglycaemia and hypoglycaemia. Patients often have the low bottom of range blood glucose for many hours after exercise. Individual with type 1 diabetes often need 48 hours to reset their autonomic function and replenish glycogen stores. Journal Article British Journal of Sports Medicine 54 13 809 810 BMJ 0306-3674 1473-0480 17 6 2020 2020-06-17 10.1136/bjsports-2019-101368 http://dx.doi.org/10.1136/bjsports-2019-101368 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2023-03-14T09:22:45.2951973 2019-11-25T10:52:33.6275522 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Nicola Keay 0000-0001-6663-7010 1 Richard Bracken 0000-0002-6986-6449 2 52862__15949__f69011bcdaa44fe9a569029aecb861f3.pdf keay2019.pdf 2019-11-25T10:56:03.0414008 Output 442964 application/pdf Version of Record true 2019-11-25T00:00:00.0000000 false © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. |
title |
Managing type 1 diabetes in the active population |
spellingShingle |
Managing type 1 diabetes in the active population Richard Bracken |
title_short |
Managing type 1 diabetes in the active population |
title_full |
Managing type 1 diabetes in the active population |
title_fullStr |
Managing type 1 diabetes in the active population |
title_full_unstemmed |
Managing type 1 diabetes in the active population |
title_sort |
Managing type 1 diabetes in the active population |
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f5da81cd18adfdedb2ccb845bddc12f7 |
author_id_fullname_str_mv |
f5da81cd18adfdedb2ccb845bddc12f7_***_Richard Bracken |
author |
Richard Bracken |
author2 |
Nicola Keay Richard Bracken |
format |
Journal article |
container_title |
British Journal of Sports Medicine |
container_volume |
54 |
container_issue |
13 |
container_start_page |
809 |
publishDate |
2020 |
institution |
Swansea University |
issn |
0306-3674 1473-0480 |
doi_str_mv |
10.1136/bjsports-2019-101368 |
publisher |
BMJ |
college_str |
Faculty of Science and Engineering |
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|
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facultyofscienceandengineering |
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Faculty of Science and Engineering |
hierarchy_parent_id |
facultyofscienceandengineering |
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Faculty of Science and Engineering |
department_str |
School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences |
url |
http://dx.doi.org/10.1136/bjsports-2019-101368 |
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description |
Many high-profile athletes participate across a wide range of sports with type 1 diabetes. Team Type 1 encourages and supports those with type 1 diabetes to participate in physical activity, with professional cycling’s Team Novo Nordisk composed entirely of individuals with type 1 diabetes. Type 1 diabetes is likely to present early in an athlete’s career, a time when athletes may present with fatigue due to increased training loads. All physicians need to distinguish between possible causes of fatigue in these athletes.Type 1 diabetes is an autoimmune condition with T-cell-mediated destruction of the pancreatic β cells of the islets of Langerhans, resulting in failure to produce sufficient insulin. The clinical outcome is an inability to adequately control glucose metabolism. Effective glucose metabolism is crucial in long-duration and high-intensity exercise. Self-administered exogenous insulin is required as a treatment to manage blood glucose.The physiological response to exercise is a progressive decrease in insulin and increase in the pancreatic α-cell-derived antagonist hormone glucagon, while exercise also increases insulin sensitivity (increased ‘sensitivity’ means that for a given dose, there is a more pronounced effect—insulin does its job ‘better’). In addition, there is an exercise-induced rise in sympathoadrenal hormones (epinephrine and norepinephrine). This hormonal response influences circulating glucose and fat use, and is usually well-regulated. This is not the case in athletes with type 1 diabetes, where there is a substantial risk of both hyperglycaemia and hypoglycaemia. Patients often have the low bottom of range blood glucose for many hours after exercise. Individual with type 1 diabetes often need 48 hours to reset their autonomic function and replenish glycogen stores. |
published_date |
2020-06-17T04:05:29Z |
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1763753411890642944 |
score |
11.021648 |