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KBD is characterized by the degeneration of articular cartilage between joints (osteoarthritis) that can result in joint deformities and dwarfism in the most severe forms of the disease

Starting dose: 100 mcg subcutaneous once daily at bedtime

But then when it actually comes down to the marathon and it comes down to the actual activity, you might need to be flexible and do a shorter fast or make sure you're fueling enough

6 to 20 units per day on a 1 ml insulin syringe, equal to 0.6 to 2 mg per injection

Modern formulations and dosing strategies have improved safety, and current guidelines emphasize individualized decision-making rather than generalized avoidance