Glen

An answer from a sport med physician on the Canadian Academy of Sport
Medicine listserv. Hope this helps.


Ian Shrier MD, PhD, Dip Sport Med, FACSM
Associate Professor, Dep't of Fam Med, McGill University
Past-President, Canadian Academy of Sport Medicine
Check out: www.casm-acms.org
SKYPE name: ian.shrier

Centre for Clinical Epidemiology and Community Studies
SMBD-Jewish General Hospital
3755 Cote Ste-Catherine Rd
Montreal, Qc H3T 1E2
Tel: 514-340-7563
Fax: 514-340-7564

Begin forwarded message:

> From: "Douglas W. Stoddard" <douglas.stoddard@...>
> Date: June 2, 2008 9:55:29 AM GMT-04:00
> To: "'CASM LISTSERV'" <Casm-listserv@...>
> Cc: glen_cqu@...
> Subject: RE: [Casm Member List Serve] question
> Reply-To: douglas.stoddard@...
>
> Glen,
>
> We would expect a higher than normal SG reading in a poorly
> controlled diabetic, due to extra glucose in the urine. Most
> important to ensure optimal glucose control in this athlete. Other
> explanations for your findings would be far less likely.
>
> Dehydration would of course contribute, and we may expect a poorly
> controlled diabetic who is training/sweating regularly to also be
> chronically dehydrated. Despite these possibilities, it’s amazing
> what physiological deficiencies some athletes can compensate for,
> especially those that are younger and more elite in their sport.
> Makes one wonder that if better glycemic control is achieved, and
> better hydration status, what he may be capable of.
>
> Finally, sodium is key to hydration and rehydration. Current
> research supports a level of 900-1000 mg/litre in one’s recovery
> fluid to optimize rehydration (Sherrifs and Maughan)-very few
> athletes achieve this.
>
> This link touches on SG in diabetes mellitus:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1831666
> .
>
>
>
> Kind regards,
>
> Douglas W. Stoddard MD, M SPORT MED, DIP SPORT MED, ES.
>
> Medical Director-Toronto Sports & Exercise Medicine Institute (SEMI)
> Medical Director-Medion (e load, ENERGY GEL, eDISCS, FLY, EMEND,
> ZONE CAPS)
>
>
> Toronto Sports & Exercise Medicine Institute (SEMI)
> 4779 Yonge Street
> Toronto, Ontario
> M2N 5M5 CANADA
>
> T: 416-223-SEMI (7364) F: 416-223-8048 E:
douglas.stoddard@...
> W: www.semisportmed.com
>
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>
> From: casm-listserv-bounces@...
[mailto:casm-listserv-bounces@...
> ] On Behalf Of Ian Shrier
> Sent: Monday, June 02, 2008 7:57 AM
> To: CASM LISTSERV
> Subject: [Casm Member List Serve] question
>
> The question below came across a different listserv and I thought
> maybe some CASM members might have an answer?
>
> Ian Shrier MD, PhD, Dip Sport Med, FACSM
> Associate Professor, Dep't of Fam Med, McGill University
> Past-President, Canadian Academy of Sport Medicine
> Check out: www.casm-acms.org
> SKYPE name: ian.shrier
>
> Centre for Clinical Epidemiology and Community Studies
> SMBD-Jewish General Hospital
> 3755 Cote Ste-Catherine Rd
> Montreal, Qc H3T 1E2
> Tel: 514-340-7563
> Fax: 514-340-7564
>
> Begin forwarded message:
>
>
> From: "glen_cqu@..." <glen_cqu@...>
> Date: June 2, 2008 2:01:08 AM GMT-04:00
> To: Ian Shrier <ian.shrier@...>
> Subject: Re: Type 1 Diabetic in Colts Rugby League
>
> Hi Ian
>
>
> Yes, I repeated the test 3 times (twice with re-calibration of the
> device and once without) with the same result 1.037.
>
>
> I think I have narrowed my question a little further...
>
>
> 1) Is this particular athlete really dehydrated considering the
> player played well and showed no contraindications? (I might think
> not based on his performance on the day)
>
> 2) Is a type 1 diabetic able to be sufficiently euhydrated (intra
> and extra cellular) whilst having a significantly raised Urine SG
>
> 3) Would the heavier constituents be solutes such as glucose,
> urinary albumin and/or proteins etc?
>
> 4) If the above is so; what would be a more appropriate (non
> invasive - bloods) way of ascertaining hydration status for a type 1
> diabetic...Bio Electrical Impedance?
>
>
> thanks again for your response Ian. I'd appreciate any thoughts you
> might have.
>
>
> Glen
>
>
> ----- Original Message ----
> From: Ian Shrier <ian.shrier@...>
> To: glen_cqu <glen_cqu@...>
> Sent: Monday, 2 June, 2008 1:53:29 PM
> Subject: Re: Type 1 Diabetic in Colts Rugby League
>
> Glen
>
> just curious. did you repeat the result when you got the severely
> dehydrated reading? There is no test that is 100%. The usual procedure
> with any unexpected result is to repeat the test to make sure it isn't
> just a measurement error.
>
>
> Ian Shrier MD, PhD, Dip Sport Med, FACSM
> Associate Professor, Dep't of Fam Med, McGill University
> Past-President, Canadian Academy of Sport Medicine
> Check out: www.casm-acms.org
> SKYPE name: ian.shrier