Diabetes and Sports

There are many articles in medical magazines and journals about diabetes and sports, but most of it is from the perspective of the medical community, not from the diabetics actually taking part in the sport.  Below we share some of these articles and also describe some of the experiences that our group has encountered taking part in, and training for sports.

* 'Diabetes, Sport and Heart Rate Monitors' - Petr Michalik

* 'Type 1 Diabetes and Sports Participation, Strategies for Training and Competing Safely'  Martin B. Draznin, MD, The Physician and Sportsmedicine - Vol 28 - NO. 12 - December 2000

Diabetes and Climbing

Not much has been written on the topic of diabetes and climbing, although we know there are more than 30 insulin dependent diabetics worldwide who have spent time at altitudes above 5000 meters.  Diabetics have climbed 8000 meter peaks and have climbed the biggest walls in the world.  Here are some references we are aware of and some additional thoughts - 

*Diabetes Mellitus and Mountain Sports, Jordi Admetlla Batlle, Conxita Leal Tort, Antoni Ricart de Mesones.

* 'Diabetes and Exercise' N S Peirce, from the British Journal of Sports Medicine 1999.

* 'Diabetes and Extreme Altitude Mountaineering' , K Moore and C Thompson Department of Diabetes, Beaumont Hospital, Dublin, Ireland.

* 'Handling Diabetes in the Mountains' ,  David S. Panofsky publised in the American Alpine News 2002.

* 'Some Considerations For the Diabetic Climber', David S. Panofsky, last updated February 2, 2001

* 'Predicting Cerebral Edema during Diabetic Ketoacidosis' - The New England Journal of Medicine -- January 25, 2001 -- Vol. 344, No. 4

* 'Diabetes and Cold Weather, tips and considerations' - Katherine M. Brandt-Wells, Isabelle Emery and Bob McQueen. Presented at the IDAA meeting Vancover July 2000.

* 'Calculating an Insulin-Carbohydrate Ratio for Prolonged Exercise' - Katherine M. Brandt-Wells
Article for IDAA Newsletter December 14, 1999

* DKA on Mt Rainier: A Case Study - Dr. Herter, 
Diabetes Spectrum, Volume 12, Number 4, Winter 1999, pp. 198-200

* Dr Shlim of The CIWEC Clinic, Travel Medicine Center of Kathmandu, Nepal provides the following insight from a 1997 publication:

"Stable diabetics can travel safely to high altitude if they are comfortable with self-monitoring and are willing to pay closer attention than usual to their glucose balance. High altitude can be associated with severe ketoacidosis for reasons that are not yet clear. However, Shlim reported 5 cases of ketoacidosis associated with high altitude (above 16,000 feet), and 3 of these people died. Risk factors for developing ketoacidosis at altitude include intercurrent illness (gastroenteritis, respiratory infection, and altitude illness), and the possible adverse interplay of respiratory alkalosis which could mask a deepening metabolic acidosis. Acetazolamide was used in at least two of these cases, and may have further blocked the body's attempt to correct the acidosis. A further practical problem for diabetics is the need to keep their insulin supplies at close hand and unfrozen during a long, cold backcountry journey."

*The UIAA's Official Guidline Of The UIAA Medical Comission VOL7 People with pre-existing conditions going to the mountains by J. S. Milledge says this regarding climbing and diabetes:

"Altitude itself probably does not have any effect of diabetes and many diabetics have enjoyed holidays in the mountains. However the increased exercise is likely to reduce the insulin requirements and, if this is not allowed for, hypoglycemia is a risk. Both the patient and companions need to be aware of the risks of hypo- and hyperglycemia and know how to recognize and treat these problems in the absence of medical help. Individuals on insulin injections should have a through review of their situation with both their own doctor and the expedition or trek leader."

*Dr. Charles Houston, in his book Going Higher: Oxygen, Man, and Mountains, published by The Mountaineers in 1998, states the following regarding diabetes and climbing:

"...As climbing and skiing became more popular, many persons with chronic illnesses began to go to mountain resorts and then to higher and higher mountains.  A good deal of reliable information has come from experience and from a few careful studies, but we need more - and no two individuals are quite the same.....Diabetes isn't a contra-indication, but may be more difficult to control during a climb.  Exertion will use up blood and liver sugars and thus decrease the need for insulin, and even cause insulin shock.  At altitude, however, people show an increase in blood sugar during or after exertion, indicating that the insulin dose may need to be increased for some people.  Persons with severe or "brittle" diabetes planning to exercise in the mountains might be wise to take frequent fingertip blood samples and adjust insulin accordingly..."

Links to other sites.

Diabetes and Climbing are extensive subjects, here we provide some links to allow further investigation into the subjects.

Diabetes

International Diabetes Issues

Climbing 


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