Training/racing with Type 1 diabetes

Kirklet

Hi, i'm after a little advice from people who either ride/race with or have rode/raced with type 1 diabetes in the past. I'm fairly new to the sport but not new to playing sport with diabetes, I played amatuer football to a good level for 6 years with diabetes before I decided to have a crack at cycling. I'm hoping to do 10 + 25 mile tt's this year and a few longer events, the white rose challenge in particular. The furtherest I've ridden on club runs is 50 miles up to now and I've been beasting a little 15 mile loop fairly regualar for the last 12 months, so apart from that i'm pretty green to the sport.

Anyways, I'm 36 but have only been diabetic for the last 7 years. Always been fit through football and weight training, then fate singled me out and whacked me with the diabetes stick :?

I run a tight ship generally with my sugar levels but I find cycling really zaps my sugar levels and plays havoc with my insulin regime. I've yet to pass out through low sugars on a bike or in any other form of sport and I get plenty of warning and on the odd occastion have run my levels pretty low (sub 2 ! :oops: ) and still remain fairly lucid. I'm getting my head round it but I was just looking for a little advice in general on a few points, mainly how to deal with the longer rides/races if anything.

I can manage my sugars fine over the shorter runs (sub 25mile) by using a bottle of lucozade to top me up if I feel myself running low, I've not really had any probs with these up to now but when it comes to the longer ones I was wondering if it's the done thing to take insulin whilst still racing?

Obviously I eat well the day before to make sure i'm fully carbed up etc and I tend to start rides running a tad high (8-11) and usually around 90 minutes after I've taken my fast acting insulin, longer if possible as I find the first two hours is when it's at it's most effective.

So my question is once your muscles have used up the energy they have on board and if I maintain my sugar levels around the 5-7 mark, at what point would I (assuming thats what riders do) have to take any insulin to make the most of any food that I take in whilst out riding? Obviosuly I need the insulin to refuel my muscles and I'm guessing I'd have to take a nominal amount if I did take anything, so as to avoid going hypo.

I hope that makes sense and I await any advice that you guys can offer me.

Cheers

Scott

datsunman

I'm on a pump now so my regime is probably a little different to yours (I can now effectively change my 'long acting' on the fly) but had similar challenges when I was on MDI.

First thing I changed was the amount of insulin I took pre ride. If I had (for example) a 40g breakfast my normal dose would be 5 units, if I'm riding within an hour or so of breakfast then I'll now drop this by half. Wherever possible I try not to have any bolus insulin on board at all as it makes BG drop too quickly. My BG would be a little high to start with as expected, but the bolus insulin means it drops a lot quicker than it would usually.

For long rides I don't need to take any insulin on board at all. In fact, it would be nice to be able to take a little out! If I have a reasonably high paced ride then I need to take on around 15-20g every fifteen minutes to maintain a stable BG, I haven't done any rides over three hours using my current method yet but so far this has served me well. For low intensity rides its about 20g every half an hour.

Strangely, I know if I've got things right by the rise in BG after I stop. As soon as I get off my bike I have to have a large bolus to stop my BG shooting through the roof. If it's a short hard ride (1h or less) I have to have more than a longer ride. (I'm assuming this is due to having less glycogen left in my system, although it could just be the time of day i'm doing my training!)

It's interesting that you say you remain 'lucid' at sub 3 BG's. I did too, but my cycling performance was absolutely abysmal! My legs were hopeless and I couldn't ride the simplest of hills. I also found that once I'd hit that point I could pretty much write off the entire ride unless I sat out for half an hour and took on 50g +.

In answer to your question, it really depends on you and your reaction/sensitivity. I've been trying a number of different methods recently and the above seems to work for me. A little fine tuning left to do but going well so far.

Have you got a turbo? If so set up a table next to it with your testing gear and experiment. I've been doing that for a little while now to find the sweet spot, doing regular tests (every fifteen minutes on one ride) and trying to anticipate the next move and change. Don't even have to stop pedalling.

If you haven't got a turbo *make* some time to do a couple of test rides (even if you miss out on a normal club run) where you can stop and test every half hour. It is a pain in the behind but definitely worth it.

Have a look at www.runsweet.com there's a few bits on there that may give you some pointers.

Kirklet

Cheers mate, thats a great reply, just what I was after ! thanks for taking the time to type that out.
Just one point I'd like to add, when I said I was still 'lucid' when my sugars run sub 2, it was more in reference my mental state as opposed to my physical state. I'm much the same as you when I run sub 3, I just go to bits and have to juice up on lucozade asap but I usually find I'm good to go within a minute or two. I've never actually got to the point where I havn't been able to bring my sugars back up, hopefully I never will

datsunman

No problem, if you can get anything helpful out of it at all then it was worth typing.

One thing I forgot to type out was the effect of 'pre race nerves' (ie adrenalin). Only seen it a couple of times before but my BG went sky high just before the race - did a huge bolus (which seemed really odd) and it came down nicely once I started riding. A little unnerving if you've never had it before, but apparently perfectly natural.