Document Detail

Risks of marathon running and hypoglycaemia in Type 1 diabetes.
MedLine Citation:
PMID:  20536956     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Exercise-induced hypoglycaemia is common in people with insulin-treated diabetes and if severe can provoke neurological morbidity including coma and seizures. Depending on the duration and demands of the physical activity, various strategies can be used to limit the risk of hypoglycaemia with strenuous exercise. However, metabolic events occurring in the 48 h before the exercise can influence the risk and responses to exercise-induced hypoglycaemia. CASE REPORT: A 27-year-old man with Type 1 diabetes suffered an episode of nocturnal hypoglycaemia which provoked a tonic-clonic seizure. Despite this he ran in a marathon the following day during which he collapsed with severe hypoglycaemia and a further associated seizure. He subsequently developed severe myalgia accompanied by a pronounced and persistent elevation of plasma creatine kinase, indicating rhabdomyolysis, and deranged liver function, suggestive of hypoxic hepatitis. The biochemical abnormalities and symptoms lasted for several weeks. CONCLUSIONS: The case highlights the dangers of intense and prolonged physical exercise following severe hypoglycaemia, demonstrating the risks of acute damage to skeletal muscle and to organs such as the liver, in addition to the risk of severe neuroglycopenia and the induction of seizures. The mechanisms underlying these problems are discussed. People with insulin-treated diabetes should be advised not to undertake prolonged intensive exercise after severe hypoglycaemia.
A J Graveling; B M Frier
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  27     ISSN:  1464-5491     ISO Abbreviation:  Diabet. Med.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  585-8     Citation Subset:  IM    
Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK.
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MeSH Terms
Blood Glucose / analysis
Diabetes Mellitus, Type 1 / complications*
Hypoglycemia / drug therapy,  etiology*
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Treatment Outcome
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 11061-68-0/Insulin

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