Recovery phase nutrition and insulin strategies for a female collegiate distance runner with type 1 diabetes mellitus: a case study

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Abstract

Background: There is scant published research regarding nutrition and insulin strategies for athletic performance in collegiate distance runners with Type 1 Diabetes Mellitus (CDRT1). Acute carbohydrate supplementation (CHOsup) and insulin reduction used to minimize hypoglycemia during exercise may result in deteriorated glycemic control post-exercise in CDRT1. The present case study of a CDRT1 investigated the effectiveness of a moderate-carbohydrate (ModCHO) diet and 24 hr insulin adjustment during the recovery phase for improved glycemic control and reduced use of acute strategies. Methods: During an 8-day period, a female CDRT1 followed a ModCHO (~4 g/kg/day) nutrition program. Recovery phase adjustments to insulin doses were made using an equation developed to estimate reduced insulin needs post-exercise, as a function of exercise intensity and duration. Daily training was performed in the fasted-state at 6:00 a.m. and included additional exercise strategies to reduce glycemic variability when needed. Daily blood glucose time in range (TIR) and use of CHOsup were assessed. Additionally, athlete well-being was determined using the Student-Athlete Well-Being Score survey at baseline, and days 1, 3, and 7. Results: Throughout the 8-day case study, the athlete’s mean TIR increased (77% versus < 50%) and the magnitude of glycemic excursions decreased (~3.8–15 versus ~3.0–26 mmol/L) relative to a prior comparison period. Minimal pre-exercise CHOsup was employed and CHOsup during exercise was not required. The athlete achieved a new lifetime best in the 5,000 m run and maintained positive well-being during the 8-day period. Conclusion: The present case study provides examples of recovery phase strategies (i.e., ModCHO diet and 24-hour insulin adjustments) that may support glycemic control and athletic performance in CDRT1 and provides potential starting points for nutrition and insulin strategies for use by athletes and coaches.

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Type 1 diabetes mellitus, Nutrition, Insulin, Distance runner, Strategies, Recovery phase

Graduation Month

May

Degree

Master of Science

Department

Department of Food, Nutrition, Dietetics and Health

Major Professor

Sara Rosenkranz

Date

2022

Type

Report

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