The impact of prolonged walking exercise on blood glucose levels in patients with type 1 diabetes: The Four Days Marches Study.

Twenty-four-hour glycemic control will be assessed in 10 patients with type 1 diabetes. These patients will be monitored over the 2 days prior to and during the 'Four Days Marches Nijmegen' event. The 2 days prior to the Four Days Marches will provide a reference frame for patients’ 24-h glycemic control (non-exercise control period). The subsequent 4-day period will be used to assess changes in patients’ glycemic control (hyperglycemia, hypoglycemic, glycemic variability) and insulin administration in response to ultra-endurance exercise. The unique character of the Four Days Marches event will provide novel insight into patients’ glycemic response to ultra-endurance exercise.

We hypothesize that exogenous insulin requirements will be substantially reduced during the days with prolonged physical activity as opposed to the control condition. Moreover, we expect that these reduced insulin requirements will not be accompanied by an increased occurrence of hyperglycemic episodes.

Measurements are conducted over the 2 days prior to the marching event, and over the 4 subsequent days of the marching event.

Twenty-four-hour blood glucose homeostasis will be assessed by continuous glucose monitoring in type diabetic patients participating in the world’s largest marching event: The Four Days Marches Nijmegen.



Continuous glucose monitoring will be applied on the 2 days prior to (reference period), and during 4 subsequent of prolonged walking exercise.