Thursday, 12 September 2013

Why are we here?

When we were waiting on a mountainside yesterday for the next van to relieve us, so we could race ahead
Our own private mountainside
with the water and fructose gels for the lead riders, and we’d been waiting for the better part of an hour, it was natural for me to say to Dr Dan, “Why are we here?”

Not in the van, on the Tour.

Diabetes is group of diseases characterised by a defect in how someone’s body either produces or responds to insulin – the hormone responsible for regulating what our bodies do with the energy we consume, particularly sugars and carbohydrates (which convert to sugars immediately in the bloodstream).

Why does this matter? For you to be healthy, the level of sugar in your blood needs to stay within a fairly narrow range. Too low, and the brain starts functioning erratically. You may have experienced this when you were too hungry to think properly. Too high, and the sugars can damage your more delicate cells, such as the eyes and the kidneys. Too high for too long, and you can develop kidney or heart disease, lose your eyesight, have a stroke or require limb amputation. Not fun.

There is no cure for diabetes, although with good management, people with the disorder can live long, healthy and full lives.

Roughly 90 percent of the people with diabetes in the UK have what is called Type 2. These are the people whose bodies don’t respond correctly to insulin, and they generally develop the condition later in life. The remaining 10 percent don’t produce insulin at all – they have Type 1 diabetes. When they eat, their blood sugar levels go up, but they have no natural insulin to bring it down again quickly enough for good health, so these people are dependent on insulin injections.

Type 1 is generally developed in childhood, although the appearance of Type 1 in previously healthy young adults is growing. As yet, we don’t know why.

A recreational rider discovers just how hard this is.
For obvious reasons, the majority of research and funding goes toward helping the 90 percent with Type 2 diabetes. For the folks with Type 1, there has long been anecdotal evidence of the value of exercise in management of their condition, but very little published research regarding exactly how the physiology of this works – when, how much, how often, how to balance exercise with nutrition and what kind of nutrition…

Mobile technologies have given us this opportunity to track the blood sugar levels and heart rates of brave athletes with diabetes as they undertake multi-day, endurance exercise, as well as chart their nutrition, distance travelled, speed, cadence…and upload all that information not just to the web portal but also to the cloud for later analysis by our clinical study team.

Empty field? Perfect place to stop for lunch.

Dr Dan West, the lead field investigator on the clinical study, is hoping to gather key information from the recreational cyclists with diabetes – those more closely related to the general population. At what times of day do they struggle the most? Under what circumstances? How does this compare with the elite riders with diabetes, who have exceptionally good control of their blood sugar levels? Can we generate clinical guidance from these data?

So tomorrow, when we’re back on the road, and we discover that the third feed stop in a row has no toilets, I’ll remind myself that’s why we’re here.

Lauren Sarno is the marketing dogsbody for the mHealth Grand Tour.

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