(P32-017-23) Recovery Phase Nutrition and Insulin Strategies for a Collegiate Distance Runner With Type 1 Diabetes Mellitus: A Case Study

Objectives: 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 outcomes associated with a moderate-carbohydrate (ModCHO) diet and 24 hr insulin adjustment during recovery phases 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. Athlete well-being was determined using the Student-Athlete Well-Being Scale (SAWS) TM at baseline, and days 1, 3, and 7.

Results: Throughout the 8-day period, mean TIR increased (77% versus < 50%) and the magnitude of glycemic excursions decreased (~3.8–15.0 versus ~3.0–26.0 mmol/L) relative to a prior comparison period. Minimal pre-exercise CHOsup was employed and CHOsup during exercise was not required. Additionally, the athlete achieved a new lifetime best in the 5,000m run and maintained positive well-being.

Conclusions: 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 considerations for nutrition and insulin strategies for use by athletes and coaches.

Funding Sources: N/A