Speciality Medical Dialogues
    • facebook
    • twitter
    Login Register
    • facebook
    • twitter
    Login Register
    • Medical Dialogues
    • Education Dialogues
    • Business Dialogues
    • Medical Jobs
    • Medical Matrimony
    • MD Brand Connect
    Speciality Medical Dialogues
    • Editorial
    • News
        • Anesthesiology
        • Cancer
        • Cardiac Sciences
        • Critical Care
        • Dentistry
        • Dermatology
        • Diabetes and Endo
        • Diagnostics
        • ENT
        • Featured Research
        • Gastroenterology
        • Geriatrics
        • Medicine
        • Nephrology
        • Neurosciences
        • Nursing
        • Obs and Gynae
        • Ophthalmology
        • Orthopaedics
        • Paediatrics
        • Parmedics
        • Pharmacy
        • Psychiatry
        • Pulmonology
        • Radiology
        • Surgery
        • Urology
    • Practice Guidelines
        • Anesthesiology Guidelines
        • Cancer Guidelines
        • Cardiac Sciences Guidelines
        • Critical Care Guidelines
        • Dentistry Guidelines
        • Dermatology Guidelines
        • Diabetes and Endo Guidelines
        • Diagnostics Guidelines
        • ENT Guidelines
        • Featured Practice Guidelines
        • Gastroenterology Guidelines
        • Geriatrics Guidelines
        • Medicine Guidelines
        • Nephrology Guidelines
        • Neurosciences Guidelines
        • Obs and Gynae Guidelines
        • Ophthalmology Guidelines
        • Orthopaedics Guidelines
        • Paediatrics Guidelines
        • Psychiatry Guidelines
        • Pulmonology Guidelines
        • Radiology Guidelines
        • Surgery Guidelines
        • Urology Guidelines
    LoginRegister
    Speciality Medical Dialogues
    LoginRegister
    • Home
    • Editorial
    • News
      • Anesthesiology
      • Cancer
      • Cardiac Sciences
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endo
      • Diagnostics
      • ENT
      • Featured Research
      • Gastroenterology
      • Geriatrics
      • Medicine
      • Nephrology
      • Neurosciences
      • Nursing
      • Obs and Gynae
      • Ophthalmology
      • Orthopaedics
      • Paediatrics
      • Parmedics
      • Pharmacy
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
    • Practice Guidelines
      • Anesthesiology Guidelines
      • Cancer Guidelines
      • Cardiac Sciences Guidelines
      • Critical Care Guidelines
      • Dentistry Guidelines
      • Dermatology Guidelines
      • Diabetes and Endo Guidelines
      • Diagnostics Guidelines
      • ENT Guidelines
      • Featured Practice Guidelines
      • Gastroenterology Guidelines
      • Geriatrics Guidelines
      • Medicine Guidelines
      • Nephrology Guidelines
      • Neurosciences Guidelines
      • Obs and Gynae Guidelines
      • Ophthalmology Guidelines
      • Orthopaedics Guidelines
      • Paediatrics Guidelines
      • Psychiatry Guidelines
      • Pulmonology Guidelines
      • Radiology Guidelines
      • Surgery Guidelines
      • Urology Guidelines
    • Home
    • Practice Guidelines
    • Diabetes and Endo Guidelines
    • Diabetes Management in...

    Diabetes Management in wilderness athlete: WMS Guidelines

    Written by Hina Zahid Published On 2019-12-26T19:00:32+05:30  |  Updated On 26 Dec 2019 7:00 PM IST
    Diabetes Management in wilderness athlete: WMS Guidelines

    Strenuous exercise and wilderness environments can complicate glycemic control in diabetes. Wilderness Athletes including mountaineers with diabetes have great challenges as glycemic control is more challenging in extreme conditions, requiring additional monitoring, treatment adjustments, and careful pre-trip planning. Athletes with diabetes may also be at increased risk of altitude-related illness. However, the benefits of exercise for people with diabetes are numerous and well documented, including improved HbA1c, lower body mass index, improved blood pressure levels, improved lipid profiles, and decreased all-cause mortality. Despite these challenges to date, at least 3 individuals with diabetes have successfully summited Mount Everest.


    The Wilderness Medical Society has developed a set of evidence-based clinical guidelines for the recognition, prevention, and treatment of diabetes and its complications in the wilderness athlete. These clinical practice guidelines define a “wilderness athlete with diabetes” as an individual with type 1 or type 2 diabetes who participates in mild- to vigorous-intensity exercise in a wilderness environment with limited medical access, at altitudes greater than 2500 m (8250 ft), in climatic extremes, and/or with limited access to immediate medical care and supplies. The guidelines have been published in the Journal of Wilderness & Environmental Medicine.






    Key Recommendations are-




    • Diabetes-specific healthcare maintenance should be up to date prior to wilderness activity. Athletes with diabetes may need to undergo additional and more frequent speciality evaluations

    • Individuals with diabetes should undergo comprehensive risk assessment for cardiovascular disease with their primary care provider and/or endocrinologist prior to wilderness travel

    • Individuals with pre-existing diabetes complications (including nephropathy, peripheral neuropathy, and retinopathy) should be counselled on minimizing additional risks to these organ systems with wilderness activity

    • Wilderness athletes should be counselled on a complete packing list of routine and emergency diabetes supplies

    • For glucometers and other monitoring equipment, the product guide should be reviewed carefully before an expedition. Individuals should carry a backup monitor and battery supply

    • In the wilderness, insulin should be protected from environmental extremes, such as high or low temperatures, light exposure, and physical agitation. Any method of physical and/or temperature protection should be tested in a low-risk environment prior to use in the wilderness. A contingency supply of insulin should be kept in a separate location

    • Those with insulin-dependent diabetes travelling to high altitude should be counselled on the potential for increased insulin requirements. Athletes should consider close monitoring on shorter trips to learn about their own glycemic trends prior to a major high altitude expedition

    • Those with insulin-dependent diabetes travelling to high altitude should be counselled on the potential for increased insulin requirements. Athletes should consider close monitoring on shorter trips to learn about their own glycemic trends prior to a major high altitude expedition

    • Acetazolamide should be used with caution in individuals with diabetes

    • In wilderness athletes with diabetes, oral corticosteroids should be used with caution in light of the risk of hyperglycemia

    • There are insufficient data to describe the effect that cold exposure has on diabetes management

    • Wilderness athletes with diabetic peripheral neuropathy and peripheral vascular disease are at increased risk of frostbite

    • There are insufficient data to describe the effect that heat exposure has on diabetes management

    • Wilderness athletes with diabetes are at increased risk for heat illness

    • In insulin-dependent diabetes, blood glucose should be monitored before, during, and after intense and/or prolonged exercise

    • Those planning protocols for glucose monitoring and carbohydrate intake in exercise should understand how to adjust carbohydrate intake based on blood glucose and exercise. This plan should be individualized based on patients’ medical and exercise history and the environmental stressors to which they are exposed

    • Individual hydration strategies should be developed prior to embarking on wilderness activities and should be adjusted based on real-time factors, including environmental temperature, altitude, and exercise type and duration

    • Wilderness athletes with type 1 diabetes should understand how to adjust insulin doses via either MDI or CSII. This should be individualized based on their medical and exercise history and the environment to which they are exposed. This should be discussed in detail with their primary care provider and/or endocrinologist prior to embarking on wilderness activities. Any device should be explained thoroughly prior to an expedition

    • Use of noninsulin diabetes medications should not be considered a contraindication to wilderness athletic involvement, though participants should be cautious regarding side effects. Particular attention should be paid to the individual risks of each specific class of medication

    • Wilderness athletes with diabetes should have a plan and carry supplies for treating hypoglycemia. They should be prepared to use a glucose repletion and glucagon strategy

    • Wilderness athletes with diabetes should have experience with individualized methods for managing nocturnal hypoglycemia prior to wilderness activity

    • Those with insulin-dependent diabetes should know the signs and symptoms of ketosis, carry a serum and/or urine ketone testing kit, and know how to treat ketones during wilderness activities. It may be prudent to carry both as a contingency in the event of failure due to environmental conditions

    • Ketosis may be safely managed in the wilderness if an athlete with diabetes and the athlete’s healthcare provider are comfortable with a treatment protocol and if the patient is able to take oral hydration and nutrition and shows no signs of altered mental status

    • Those with insulin-dependent diabetes should understand how to adjust insulin doses when hyperglycemia occurs during activity. This should be based on their individual experiences during exercise, training, and previous exposures to environmental stressors. This should be discussed in detail with their endocrine provider prior to embarking on a wilderness adventure

    • Although it is insufficient in vivo data on continuous glucose monitoring or novel hybrid closed-loop insulin delivery systems to recommend their use for wilderness athletes with diabetes, the use of such technology may be considered after discussion with an individual’s endocrine provider


    Wilderness & Environmental Medicine


    For more details click on the link: DOI: https://doi.org/10.1016/j.wem.2019.10.003
    acute kidney injurydiabetesdiabetes managementMount EverestWilderness & Environmental Medicine
    Source : Wilderness & Environmental Medicine.

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    Hina Zahid
    Hina Zahid
      Show Full Article
      Next Story
      Similar Posts
      NO DATA FOUND

      • Email: info@medicaldialogues.in
      • Phone: 011 - 4372 0751

      Website Last Updated On : 12 Oct 2022 7:06 AM GMT
      Company
      • About Us
      • Contact Us
      • Our Team
      • Reach our Editor
      • Feedback
      • Submit Article
      Ads & Legal
      • Advertise
      • Advertise Policy
      • Terms and Conditions
      • Privacy Policy
      • Editorial Policy
      • Comments Policy
      • Disclamier
      Medical Dialogues is health news portal designed to update medical and healthcare professionals but does not limit/block other interested parties from accessing our general health content. The health content on Medical Dialogues and its subdomains is created and/or edited by our expert team, that includes doctors, healthcare researchers and scientific writers, who review all medical information to keep them in line with the latest evidence-based medical information and accepted health guidelines by established medical organisations of the world.

      Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription.Use of this site is subject to our terms of use, privacy policy, advertisement policy. You can check out disclaimers here. © 2025 Minerva Medical Treatment Pvt Ltd

      © 2025 - Medical Dialogues. All Rights Reserved.
      Powered By: Hocalwire
      X
      We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok