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Diabetes Insipidus in Endurance Athletes
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Several years ago I was diagnosed with diabetes insipidus. This is not type I or type II diabetes, it has to do with water retention (or lack thereof). For the past few years I have started getting involved in longer distance events. With a lot of trial and error I have figured out how to handle nutrition for half and full marathon distance with growing success. This year I plan on competing in my first 70.3, but without previous experience am nervous about meeting my hydration/nutrition needs. For people taking the medication for my condition there is a very fine line between over and under hydrating. Heat has also proven a huge issue for me in the past. I have reached out to doctors for advice but based on their responses, they have never met an endurance athlete with this condition. I myself have never met anyone at all who is similarly diagnosed. Its a long shot, but does anyone out there have any advice to share?
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Re: Diabetes Insipidus in Endurance Athletes [wmdmulti] [ In reply to ]
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Unfortunately I can not give you any first hand advice but as a father who's three year old son has DI I would love to hear about how you manage half and full marathons.

"What was the secret, they wanted to know; in a thousand different ways they wanted to know The Secret. And not one of them was prepared, truly prepared to believe... The Trial of Miles, Miles of Trials. How could they be expected to understand that?"
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Re: Diabetes Insipidus in Endurance Athletes [dtnrunner] [ In reply to ]
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I found that if I drink high volumes before bed and not much race morning I feel much better than if I drink normally before a race. Because the medicine causes water to be absorbed differently, drinking even a small glass of water an hour before a run can cause me to feel sick and bloated. On the race course I drink small amounts of extremely concentrated drinks. This translates to a sip every 3-5 miles. Probably not the healthiest course of action, but the only one I have found successful. All of this goes out the door once it hits 90 degrees outside though.

My doctor told me when I was younger that I would probably never be able to exercise for longer than 30 mins at a time. I haven't found this to be true at all. Its definitely possible with a little extra caution.
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Re: Diabetes Insipidus in Endurance Athletes [wmdmulti] [ In reply to ]
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I haven't posted to this forum in a long time, but I am AMAZED to meet another endurance athlete with this. I've had several endocrinologists over the 8 years that I've had it and am generally one of maybe 2-3 patients on their whole caseload that has it, and the only endurance athlete. I've spent several visits telling the docs about how I manage it when I was hoping for more help managing things. I'll give you my whole story, as it may be relevant to your case.

I have what's been classified as insidious onset of centrally induced diabetes insipidis (it's related to a dysfunction in my pituitary, rather than in the kidneys). Nobody can say how it developed, but with a lot of the reading I've done, I'm inclined to think it's from a concussion. When I was first diagnosed, they started with essentially 0.05mg of desmopressin that I took three times per day. Over the first year, we finally figured out that 0.1 mg works for me and I take it at breakfast, lunch and dinner. This works really well if I drink normally throughout the day, but it seems like if I drink a lot shortly after taking a dose (6-8 ounces in 5 minutes) it seems like it flushes the medicine out of me. If this happens, I'll generally take an extra dose, or half a dose and it doesn't seem to adversely affect me. Also, if I know I'll be having several beers in the evening, I'll take an extra dose. I'll also cheat if I'm taking a long car trip and take an extra dose so I don't have to stop as frequently.

As for managing races, here's how I generally do it. As a caveat, I've done 2 marathons, 2 ultras and a few half irons since being diagnosed. The day before, I'll generally take my medicine normally, but I'll try to drink a bit more throughout the day. I will make a conscious effort to evenly space my drinking through the day as it seems to be absorbed better and doesn't "flush out" the medicine I just took. The morning before the race, I'll generally double what I take. Also, I generally try to drink a little more than I normally do, but I'm very conscious of avoiding drinking a big dose at once. I don't really do this for half marathons as hydration isn't absolutely as critical, but I will for anything longer.
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Re: Diabetes Insipidus in Endurance Athletes [wmdmulti] [ In reply to ]
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wmdmulti wrote:
I found that if I drink high volumes before bed and not much race morning I feel much better than if I drink normally before a race.

This is good practice even though you likely have more-than-average catching up with fluids after the swim. Triathletes in general should avoid over hydration just before the swim leg. (The extra fluid volume consumed indirectly puts more stress on the heart and lungs during the swim until the excess is urinated.)
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Re: Diabetes Insipidus in Endurance Athletes [wmdmulti] [ In reply to ]
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I'm T1D and started a thread for Diabetic triathletes a while back.

You might try posting to it.

http://forum.slowtwitch.com/...ng=diabetes;#5360895



"Keep those feet moving!" Me
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Re: Diabetes Insipidus in Endurance Athletes [Pedalhead] [ In reply to ]
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I’m in the process of being diagnosed and I’ve felt like shit running for the past year :( terrified I would have to give up my sport. Sounds like you all have central DI? Which I think is diagnosed much earlier.
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