July 5, 2002
Exercise and Sports
Question from England:
A friend who has type 1 diabetes and is on a regimen of lispro at meals with Insulatard ([ED: NPH] at bedtime wants to swim the English Channel (22 miles) which will take him approximately 20 hours, and the temperatures are cold. Previous stamina swims have resulted in hypoglycaemia (1.9 mmol/L [34 mg/dl]) following a 14 hour swim with hypothermia and a ketotic smelling breath.
He has attempted to manage his blood sugars with reduced Lispro and frequent drinks of Gatorade, but I feel this will be dangerous on a cross channel swim. Will he need smaller doses of Lispro throughout the swim? What about the variable of low water temperatures and what carb content should he be aiming for both pre swim and during?
Answer:
This is obviously dangerous for the participant. A regimen should be refined in training prior to a 20-hour swim. The modifications are only guesses at what might work rather than something that has been worked out and shown to be successful. I would not recommend this swim occur until future training reveals an acceptable regimen.
JTL
