Nutritional Strategies of an Athlete with Type 1 Diabetes Mellitus During a 217-km Ultramarathon.

Considering the challenges in meeting the high nutritional demand during ultramarathons, the aim of this study was to analyze the nutritional strategies and glycemic response of an athlete with type 1 diabetes (DM1) during participation in a 217-km ultramarathon. A 36-y-old male athlete who was diagnosed with DM1 15 y earlier was studied during participation in the Brazil 135 ultramarathon. Food consumption and blood glucose were recorded during the race, and nutritional intake was calculated after the race. The athlete completed the race in 51 h 18 min. He consumed a total of 15.0 MJ (3593 kcal), 532 g carbohydrate, 166 g protein, 92 g lipid, and 14 L of water during the race. Glycemic values ranged from 3.6 to 18.2 mmol·L-1. Most glycemic values (47%) ranged from 3.9 to 10 mmol·L-1, whereas 5% were <3.9 mmol·L-1, 16% were >10 to 13.9 mmol·L-1, and 32% were >13.9 mmol·L-1. This case report describes the dietary profile of an athlete with DM1 during a 217-km ultramarathon. Although the athlete implemented strategies that differed from those recommended in the literature, food and nutrient intake and the glycemic management strategy adopted allowed him to successfully finish the race. These results suggest that past personal experiences can be considered and that nutritional recommendations for athletes with DM1 should be individualized.