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March 14, 2017

daveI recently had a conversation with one of my riding buddies about his A1c. His doctor had recommended he go on metformin because his A1c was 5.9. This guy sometimes rides 700 miles in a week and is thin as a rail. Our conversation got a response from three other riders who also had elevated A1c’s but were in fantastic shape. Then I went and got my labs and mine came in at 6.0.

I started doing random testing and some mornings I would wake up with a reading over 125mg/dl, but every time I would check post prandial I was in the 80’s. I had a couple of these riders test as well, and to a person everyone had a lower reading after eating than before eating.

This had to be the effect of glucagon, as none of us ate enough carbs to supply the energy we needed to fuel long distance rides. I found the same thing when I looked at marathon runners and wanted to find some answers.

This week our clinical text looks at how and when the body uses glucagon to provide energy, and explains what is happening to these athletes.

Dave Joffe

Editor-in-chief