title: Does type 1 diabetes mellitus affect Achilles tendon response to a 10 km run? A case control study.
abstract: BACKGROUND
  Achilles tendon structure deteriorates 2-days after maximal loading in elite athletes. The load-response behaviour of tendons may be altered in type 1 diabetes mellitus (T1DM) as hyperglycaemia accelerates collagen cross-linking. This study compared Achilles tendon load-response in participants with T1DM and controls.
  
  
  METHODS
  Achilles tendon structure was quantified at day-0, day-2 and day-4 after a 10 km run. Ultrasound tissue characterisation (UTC) measures tendon structural integrity by classifying pixels as echo-type I, II, III or IV. Echo-type I has the most aligned collagen fibrils and IV has the least.
  
  
  RESULTS
  Participants were 7 individuals with T1DM and 10 controls. All regularly ran distances greater than 5 km and VISA-A scores indicated good tendon function (T1DM = 94 ± 11, control = 94 ± 10). There were no diabetic complications and HbA1c was 8.7 ± 2.6 mmol/mol for T1DM and 5.3 ± 0.4 mmol/mol for control groups. Baseline tendon structure was similar in T1DM and control groups - UTC echo-types (I-IV) and anterior-posterior thickness were all p > 0.05. No response to load was seen in either T1DM or control group over the 4-days post exercise.
  
  
  CONCLUSIONS
  Active individuals with T1DM do not have a heightened Achilles tendon response to load, which suggests no increased risk of tendon injury. We cannot extrapolate these findings to sedentary individuals with T1DM.
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, 3199, VIC, Australia. andrea.wong90@gmail.com.
authors.forename: Andrea M Y
authors.initials: AM
authors.lastname: Wong
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, 3199, VIC, Australia. S.Docking@latrobe.edu.au.|Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia. S.Docking@latrobe.edu.au.|School of Allied Health, La Trobe University, Melbourne, Australia. S.Docking@latrobe.edu.au.
authors.forename: Sean I
authors.initials: SI
authors.lastname: Docking
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, 3199, VIC, Australia. J.Cook@latrobe.edu.au.|Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University, Ballarat, Australia. J.Cook@latrobe.edu.au.|School of Allied Health, La Trobe University, Melbourne, Australia. J.Cook@latrobe.edu.au.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Cook
authors.affiliation: Department of Physiotherapy, Monash University, Frankston, 3199, VIC, Australia. Jamie.Gaida@canberra.edu.au.|University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australia. Jamie.Gaida@canberra.edu.au.|Discipline of Physiotherapy, University of Canberra, Canberra, Australia. Jamie.Gaida@canberra.edu.au.
authors.forename: James E
authors.initials: JE
authors.lastname: Gaida
mesh_terms: D000125:Achilles Tendon / Q000503:physiopathology*; D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012420:Running / Q000502:physiology*; D016474:Weight-Bearing