Diabetic to Dietetics Podcast Episode 5 features Dr. Michael Riddell providing a glimpse into the world of T1D and exercise research
Additional article below.
Researcher behind T1D and exercise research
Many people will go through a period of denial or rebellion when diagnosed with type-1 diabetes, but not Dr. Michael Riddell. He dove deep into this disease, attempting to unravel every inch of it in order to grow his own knowledge andĀ the knowledge of others.
Dr. Riddell is arguably the most leading-edge researcher of type-1 diabetes in exercise and metabolism.
He has a PhD in physiology and pharmacology. He’s a professor at the School of Kinesiology and Health Science Muscle Health Research Centre at York University. And he’s a senior scientist with LMC Diabetes and Manna Research.
Over the course of 25 years, he has completed more than 200 studies in diabetes metabolism and exercise. He has seen his name in print at least 70 times. And he is one of the lead researchers that helped develop the most up-to-date consensus guidelines for managing exercise in type-1 diabetes.
This scientist knows his T1D stuff.
Dr. Riddell: The backstory
Dr. Riddell was diagnosed with type-1 diabetes in 1982.
He was 14 years old, and already heavy into sports. In an effort to get back to his sports quickly, he became a star pupil in T1D.
“That’s what started my journey of knowledge gathering,” he said.
However, researching type-1 diabetes was not a top-of-mind career for Dr. Riddell initially. He considered becoming a chiropractor, but the science didnāt fascinate him. He also considered becoming a diabetes educator. But, once he started university, the research pulled him in quick.
“I wanted to help people who were diagnosed,” he said. “I wanted to understand why exercise was so tricky for many of us to manage.
“Here I am, 40 years after my diagnosis, and I still want to learn as much as I possibly can about this interesting metabolic condition that makes exercise a bit tricky, but also gets the benefits of exercise.”
All about the T1D research
Dr. Riddell’s research lab is based at York University in Toronto. It has explored a multitude of angles – big and small – on how sport stress impacts diabetes metabolism. To list a handful, his team:
- Flagged the beneficial use of temporary basals for insulin pump users during endurance exercise
- Highlighted nocturnal hypoglycemia post exercise, which can occur 7-11 hours after exercise
- Identified the strengths and challenges of closed-loop insulin delivery systems during exercise
- Investigated the accuracy of CGMs during different types of exercise
- Analyzed the effects of acute caffeine supplementation on reducing exercise-associated hypoglycemia
“My research team is trying a bunch of different things to make exercise safer from a blood sugar control perspective,” Dr. RiddellĀ said. “These studies are really important, because they’re helping a lot of people manage exercise better.”
Including himself.
Dr. Riddell continues to be enthusiastically active.
He enjoys basketball, hiking, mountain trekking, and cycling. He’s climbed Mont Blanc, the highest mountain in the French Alps, summited Mt. Kilimanjaro in Africa, and conquered the Inca trail to Machu Picchu in Peru ā all with T1D.
“If I’m preaching about exercise as an important part of our therapy, I have to kind of practice what I preach,” he said.
Labs and ice rinks
When Dr. Riddell’s son was also diagnosed at 13 years old, his drive for bettering the outcomes of T1D through research and community efforts was amplified.
Dr. Riddell is the education director for DSkate, a hockey program for active kids with T1D. This program allows kids to learn about their diabetes, and the effects of exercise on their diabetes, on the ice, in the moment.
“When my son was diagnosed, that changed my lens,” he said. “It made me realize that we need to do more for families and parents. We need to do more for educating kids and allowing them to cope with their diabetes. And that’s when I thought that doing work outside the lab is critical too.”
Although Dr. Riddell has lived this disease both personally and professionally, adding T1D to his role as a parent took its toll.
“It was tough for me because I was living, thinking and breathing type-1 diabetes all day, and my family was a bit of a break from that,” he said. “I do research in type-1 one, I live with type-1, and now I’m a parent of type-1. Where am I going to get a break from all of this?
“That took some getting used to,” he said. “Maybe two or three months before I had the energy to come back and try even harder to make a difference.”
Evolution of Diabetes
Over 40 years, Dr. Riddell has seen the evolution of diabetes, both in the context of management guidelines and management tools.
When he was diagnosed, people with type-1 were still testing their blood sugars via their urine. He remembers early glucose meters that took more than a minute to show a reading, and used colour change technology to determine if blood sugars were high or low. He also remembers pressure injections for insulin administration.
“In my lab I have a drawer of antique diabetes paraphernalia that I’ll sometimes show my students,” he said.
It’s his way to show how far T1D has come.
Dr. Riddell’s verbal reminders are also insightful in showing the evolution of T1D.
“Very early on I remember being told that your blood sugar was a balance beam that had insulin and exercise on one side and food on the other,” he said. “As if these were the only three variables that impact blood sugars. Maybe they are the three main ones, but there are so many other little factors that can influence blood sugar levels. There are dozens, if not hundreds of different factors.”
Research has helped bring those additional variables out to the public eye.
If you live in the Toronto area and want to participate in future T1D and exercise research, contact Dr. Michael Riddell at mriddell@yorku.ca. Dr. Riddell also noted that one of his graduate students is conducting a remote project that would be open to residents outside of the Ontario region. If this interests you, contact the aforementioned email.
Previous Diabetic to Dietetic episodes:
- Raising a toddler with T1D
- Trials of thru hiking with T1D
- Life of an actor with type-1 diabetes
- Relationships with type-1 diabetes
Update:
Following the publication of this post and airing of the podcast, Dr. Riddell sent me a link to this latest review in the benefits of T1D and exercise conducted by him and Anne Peters that was just released to the public last month. Click the bolded link: Exercise in adults with type-1 diabetes
Great interview.
It is amazing how many of these I had to figure out myself. I’ve been active a majority of my life and yes keep making mistakes. I am still amazed at the difference in insulin sensitivity when exercising and not exercising. For me it is often 5-10x stronger. It really forces one to plan things out 2-4hrs ahead to ensure there isn’t too much IoB, and then try to get a bunch in prior to finishing so that when normal sensitivity returns there’s enough.
Thank you! I’ve had to learn most by my own trial and error as well. It’s like we’re all our own personal lab rats š
I find it interesting the changes in insulin sensitivity depending on the exercise. Although both result in heightened insulin sensitivity, for me, running increases my sensitivity significantly more than cycling while running. But cycling for me has a more prolonged effect of sensitivity than running.
Running makes very sensitive too, I’ve been off for a few years and getting back using cycling until I get stronger/lighter as I can do a lot more. Running was about 10-20% of normal too. Both of them, if I don’t do a big temp basal/bolus 15-30min prior to completion, I will have a large glucose increase. I’ve seen it go from 5mmol/L to 25mmol/L in 45min in the past(sucks for eating). All this plus the wrenches that get thrown in gears. That probably the worst parse, the work that goes into planning/accounting for. Being able to just throw on shorts and work out/run for an hour or two without thinking about glucose would be amazing.
Our strategies for preventing low blood sugars during exercise, which are super important, definitely play a role in post-exercise high blood sugars requiring additional strategies. It’s definitely a cat and mouse game with T1D and exercise!
What a dream it would be to not have to think about any of it prior to starting exercise, hey!