Pro triathlete Lionel Sanders found out he's prediabetic

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I’m very confused by all of this.

  1. It would be extremely unusual to get polyuria and waking up every 45min to pee all night long from a blood glucose in the prediabetes range. You don’t get significant osmotic diuresis from glycosuria till it’s in the 12-14mmol range. A much more common (plausible?) cause of nocturia in a male cyclist this age is simply prostate problems.

  2. A blood glucose in the prediabetes range is not going to cause symptoms of chronic fatigue and low energy.

  3. I’m not sure why he thinks he has prediabetes rather than just overtraining, as overtraining can raise HbA1c. Not a rhetorical question, I’m actually not sure.

  4. Diabetes is not a disease of high blood sugar. It is a disease of insulin deficiency and/or resistance. There is no clinical evidence to date that carbohydrate intake during exercise can induce a clinical syndrome of insulin resistance (or deficiency).

  5. If he does actually have diabetes… skinny people get adult onset diabetes. It is a heterogenous clinical syndrome. Most people are used to the DM1 insulin deficient syndrome in kids vs DM2 insulin resistance in fat sedentary adults dichotomy, but there are many other phenotypes of it. This includes athletic middle aged people suddenly getting “DM2” due to new insulin deficiency for example.

  6. Even if he does truly have diabetes, it seems much more likely that it’s due to the already known disease variations that we see in clinical medicine, rather than due to a previously undiscovered medical phenomenon (high carb intake in high volume endurance athletes). Ie: it seems unlikely that he’s a case report, rather than something more common.

I say this all as someone who is not an advocate of very high carb intake for all rides.

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Lionel Sander’s career is a series of unturned stones. For someone who could turn himself inside out on almost a daily basis and suffer with the best of them his training IQ is very low. I think if he had stuck with David Tilbury-Davis or another very high level coach the outcome might have been different. But Sanders has always known better and bounced from one approach to the next seeking short-term bang for buck rather than thinking in long-term, and he has for some time been more interested in generation of social media content than delivery of results.

Having had my salt pill for the day, considering his route into triathlon (e.g. outside federations and youth development) he has had a pretty remarkable career, particularly at 70.3 level.

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Did you watch his video? The “diabetes” angle is just the click bait headline for the video and this topic.

He’s made a few lifestyle and training changes and is already feeling better and sleeping through the night.

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My comment was mostly in response to what people are saying in this thread. (And the “news” articles on him on the internet).

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Sanders is really turning it around.

I never enjoyed following the old Lionel but I’m enjoying the new Lionel.