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018 Diabetes and Cycling

Diabetes and Cycling

Diabetes mellitus is a common and chronic metabolic disorder, classically ascribed to an absolute or relative deficiency of insulin. Simplistically stated, this is "typical" of insulin- dependent or type-1 diabetes (ie. Individuals, usually juveniles, that need insulin). Type-2, or " maturity- onset" diabetes is characterized by peripheral insulin resistance.

Major Problems of Diabetes Mellitus

Increased incidence of pyogenic and fungal skin infections
Hyperglycaemia, abnormal carbohydrate metabolism, propensity to ketoacidosis, glucose- control dysfunction and coma
Infection, that may precipitate ketoacidosis and or coma
Increased incidence of premature coronary artery disease, heart- attacks, angina and heart- failure
Hypercholesterolaemia and peripheral vascular disease
Renal failure, needing dialysis or renal transplantation
Peripheral neuritis (polyneuropathy)
Dangers of developing a "diabetic foot" (circulation problems, gangrene and or ulceration)
Chronic ill- health, obesity, and feeling of illness (ie don't feel well)

Benefits of Moderate Cycling or Cycle Training

Insulin utilization is improved, resulting in less "brittleness" and in some individuals, reduced insulin requirements
Reduced incidence of premature secondary complications
Improvement in mindset, and outlook on life
Reduced propensity to obesity
Maintenance of muscle tone, strength and vitality
Problems Facing Diabetic Cyclists on Long Funrides or Tours
Glucose control: hypo- or hyperglycaemia (check your sugar!)
Dehydration, dizziness and fatigue (keep hydrated!)
Electrolyte disorders (sodium, potassium)
Muscle cramps, paresthesia, painful calves and feet
Exhaustion and collapse (keep hydrated!), eat breakfast
Perineal pressure, saddle sores (abscesses or boils/ folliculitis)- personal hygiene is very important in diabetes. Use soap and water to wash with.

Guidelines for the Argus Tour over 109 kilometers

Cycle training before hand is advised. A doctors clearance is vital.
Glucose control is critically important. For long tours blood glucose levels (Haemogluca Test on finger prick) should be performed before and after the tour. This is what is expected in cycle tours in the USA.
Glucose containing sportsdrinks/ beverages are essential to prevent hypoglycaemia. Drink frequently and start early. Go for sips.
Diabetics should stop and take a "breather" in the middle of the tour. More than one, "pitstop" is advisable.
Fluids at a rate of 150-300 ml/ hr should be considered to prevent heat exhaustion, dehydration, cramps, fatigue and collapse. Be cautious of hot weather.
Active infection or a focus of infection is a contraindication to riding the Argus- the danger of hyperglycaemia or ketoacidosis is a very real danger.
In older, male diabetics (> 50- years), a complete cardiovascular check- up including blood pressure, ECG, blood lipids and renal function is critical. If a diabetic does not feel well, don't attempt the Argus.
 Do not underestimate the Argus.

A near normal HbA1C reflects previous good glucose control. This is a good idea, if the diabetic plans to do the Argus. Advice from a physician or a diabetologist should be considered before entering for such a strenuous tour.

Diabetic individuals with secondary complications of target organs eyes, heart, blood levels, nerves and kidneys) should re- consider riding.

Maturity onset, male diabetics (45- years, plus) who experience chest pain while cycling, should avoid the Argus Cycle Tour, until the cause thereof is disclosed by a specialist. Don't leave this important problem, until the week before the Argus. This could be tell- tale symptoms of severe underlying, ischaemic heart disease and coronary artery occlusive disease. This is a common sequelae of diabetes and needs exclusion.

Follow a strict diabetic diet and obtain advice and counselling from a dietician. This not only reduces the risk of a heart attak, but improves cholesterol levels. Don't neglect your blood sugar control!

Diabetics also need supplementation, magnesium, calcium and vitamins if a rigid cycle training program is anticipated.

The fitter the diabetic cyclist, the better the ride in the Argus. Potential harmful sequelae are also drastically minimized. Keep your weight down and avoid obesity that is a problem in maturity- onset diabetes.

If the diabetic feels weak, stop and rest. Hypoglycaemia is a possibility and is potentially harzardous. Always take a sweet or biscuit with. Two water bottles are a prerequisite.

Report to a doctor if you do not feel well or experience chest pain/ discomfort. Report to the medical tent at the finish if you feel ill. Adequate emergency medical cover is always available during the duration of the Argus Cycle Tour. The organizers, have an impeccable record, spanning decades. If the diabetic does not feel well at the start, he or she should not continue.

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