Diabetes and Cycling

northern lad

Looking for a bit of advice and help if there's any insulin dependent cyclist out there.

Basically every time I go out on my bike I end up having a hypo (sugar goes too low). I've played around reducing my insulin amount and test regular, but I just can't seem to get it right.

As anyone got any advice on better diet, energy drinks suitable for my condition etc.

geoff93

I'm no expert, but can you not just drink high sugar drinks, during the ride, like lucozade to counteract what is lost?

crankycrank

I'm not sure if my experience is helpful since I'm Type 2 diabetic but my medication causes me to become severely hypo at times during med-hard riding. I've tried using different dosages etc. but the best solution I've found is to use a sugary sports drink at regular timed intervals and carry glucose tablets for emergencies because the exercise tends to make my blood sugar drop very rapidly at times. If your drink causes your blood sugar to go too high try diluting it with water until you find the right solution. Sounds like your situation may be similar so I hope this helps. Also google "Team Type 1" which is a pro race team which has several type 1 diabetics on their squad and may have some info for you.

mikeq

As you've discovered excercise has an insulin like effect, in that it gets rid of the glucose in your body.

As you know everyone's diabetes is different and you'll no doubt have your own way of managing yours, so it is probably difficult for anyone to give specific advice.

The only thing I can tell you is not to exercise at the peak of your insulin injection, you'll know when that is for you.

Just make sure you have appropriate supplies with you when out to deal with any situation.

El Imbatido

Ok, a few hopefully helpful pointers from one type 1 diabetic to another:

1. Test your sugar regularly before the ride: I check mine 4-5 times in the couple of hours leading up to my rides. Just to get an idea of the direction that my sugar level is going and then you can adjust accordingly ie. more food or insulin if needed.

2. Take your blood glucose monitor with you. Whether it be in your jersey pocket or mounted on your stem as i do, make sure you have it, so at any time you feel weird or different you can test your level to see what is happening. I use this model:

http://www.towers.net.au/shop.asp?id=1250&action=viewproduct

This model whilst it may seem a little bulky, it actually uses small white cylinders that you load into the bottom of the monitor and these hold 16 blood strips in them, which cancels out the need to carry strips as well as the monitor as it just pushes one out the bottom when you turn it on. I just zip tied it to my stem and electric tapped the finger pricker to it as well so i can actually test my sugar level without stopping which is useful if you are bunch riding.

3. Always carry plenty of carbohydrates with you Whether it be food or liquid make sure you have plenty with you. For any ride over about 35-40km i take two powerbars (at the moment i'm eating the growling dogs ones), a banana, gel and a water bottle full of gatorade as well as one with water. (I buy the gatorade powder as it is cheaper and you can make it to your desired taste strength but more importantly the carbohydrate strength you want or need.) I was always told to carry jelly beans with me but i stopped doing so as i found that energy gels take up less space in your jersey pockets but are also easier to take down if youi feel your sugar level going low and i also tended to drop alot of jelly beans and others in bunch rides don't really like jelly beans dropped into their paths.

If i know im doing longer rides i usually just take more food according to the distance. Also just make sure you have a mobile phone with you as you never know where you might get caught out.

4. carry some sort of id I know this applies to everyone but make sure you have some way to be identified as a diabetic because if for whatever reason you can't tell them it could be fatal. I said this one time before and i think people thought i was taking the piss out of them but i actually have diabetic tattooed on my arm. But i play alot of water sports and wearing a braclet or diabetic necklace just isnt practical for me as i kept loosing them.

5. Diet This may not be the answer your looking for but as for diet i just recommend eating a good healthy diet and making sure you get enough vitamins and minerals. As a diabetic i assume you get blood tests quite regularly. So just discuss with you educator about some vitamin or mineral tablets. Also make sure you are well hydrated before riding- it always helps and making sure you have a decent meal before riding should help your sugars.


Also regarding getting hypos when you ride it actually could be caused by your long acting insulin if you take one. If your ride occurs sort of in the time period of about 12+ hours after you take it, it will be in full force and could along with your short acting may be too much for your body on these days when you ride. It might be fine on non riding days but you might need to back it off a little on exercise days. It just might be something you can discuss with you diabetic educator, but i don't know your insulin regime so this thought could be way off.

Anyway hope this helps, those are just some of the things i do and this works for me but this took me time and experimenting to work ou, so just stick with it until you find something that works for you.

redvee

A site I've been told about by my nutritionist is runsweet.com. I was also sent a PDF from my nutritionist but it didn't fully come through so she is sending me a paper copy.

I recently rode 25 miles and took 2 bottles with me, one with normal orange squash, the other with squash and some energy powder, drank evry 5-10 mins and took 2 mouths of normal and one of energy squash and also had 2 choccy biscuits which were a little soft. Ate the choccy after 30 mins, stopped after 1 hour to test my blood and have a mouthful or 2 of lucozade and stopped again 30 mins later for a bloodtest which was OK. One thing I did learn is that you need to keep concuming energy drinks after you stop, not full on like lucozade but sweet stuff as you are still burning energy. When riding to work, 20 mins, I find best to reduce my Insulin by 2 units and test approx 1 hour after arriving unless my body tells me to test sooner.

Steveorow

Everything El Imbatido and redvee. Few other pointers / tips

You can get energy Gels as part of your repeat prescriptions I think they are called "Hypo stop" . These are great for putting in the jersey pocket .
You can experiment with these in conjunction with your BG test kit to work out how often you need in what time frame .

Watch carefully the fluid intake try to drink regularly and don't get dehydrated especially if its warm ( fat chance this summer ) as this has a bad effect on Blood sugar .

When my Blood sugar starts going low I find he power in the legs starts to go ie the cadence and speed drops on the flat ; dont push through it stop and take on some fuel ; Double Deckers is my choice at these points :P . Its similar to the "Bonk" described by non diabetic cyclists .

I use a heart rate monitor to assess how hard or easy I'm going . I know that above 80% of MHR for any longer than 5 mins then I need to increase the sugar uptake or be vigilant . To do with the % of fats to sugar metabolized .

Take a mobile phone even on a short journey and put ICE ( In case of emergencies ) as one of your contacts and let someone know where you are going .

Yes monitor your Blood sugar after-wards for an hour or two for going low however watch for your Blood sugar increasing also . Seems counter intuitive but this happens to me if Ive been doing 2 X 20 sessions or Hill repeats . It was explained to me that it was a reaction to cortisol a stress hormone triggered by these high exertions sessions .

redvee

I was also told to hammer the last 5mins of a ride if possible as the burst of activity will release adrenaline and other hormones along with some stored energy and boost you BS levels.

Velonutter

Not a lot to add to the others here, I was on a 1000 yep 1000 units of insulin a day, now due to an op I no longer need insulin and am on just two injections a day of Byetta.

Byetta has been the best thing since slice bread for me.

I check before going on a ride and whereas I used to have Hypos or near Hypos, now it just don't happen.

Research up about Byetta, but it only works if you are a type 2, before a ride my count is between 5 & 7 and after 40 miles and some Electrolyte drink, Oat Bar etc it is still between 5 & 6.

Many Doctors are frightened about Byetta as it is expensive, but they are now saving all the health complications that I had and naturally 1000 units of insulin.

PM me if you need any further advice.

neilmacd

As el Imbatido said your long acting insulin could be playing a big part in your hypos.

I'm type 1 and find that if I'm doing a long ride I need to cut the long acting dose back by about 25% the day I've done a ride and then cut it by about 10% from normal levels the following day.

Take a sports drink ou ton the bike with you i.e. PSP 22 or similar. It's probably better to run your BS high for a short time than to go hypo mid ride and keel over.
Eating some high slow acting carbohydrate before going to bed can also avoid hypos the following morning which form experience can be worse particulalry if you sleep through the warning signs.

I've been type1 since I was 8 and with a bit of trial and error eventually managed to sort my food/ insulin/ exercise levels to keep my BS pretty stable and also to keep my HbA1c under better control..

Runsweet is a pretty good website and there's lots of useful info on there.

I'm doing a DAFNE course in a couple of weeks time and my consultant reckons it could make a massive difference to my control so it might be worth asking your Diabetes team if this is something they run at your local hospital.

redvee

Slow-N-Old wrote:

I was on a 1000 yep 1000 units of insulin a day

:shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: That is 20x what I'm on now per day.

Velonutter

redvee wrote:

Slow-N-Old wrote:

I was on a 1000 yep 1000 units of insulin a day

:shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: :shock: That is 20x what I'm on now per day.

Yep, that is why I had an op to sort it as I put 10 stone on due to the side effects of insulin.

Since the op and new drugs I have lost nearly seven stone.

northern lad

Thanks Guys. Good to know there's people out there in the same situation. Just gets a bit annoying sometimes when you have to stop your mates every 20mins to test or when I get a fuzzy head (Hypo).

A lot of what has been said I'm doing anyway, but at least I know I'm going in the right direction.

There's a few links in there to keep me busy.


All I need now is for the bloody rain to stop!!

redvee

redvee wrote:

I was sent a PDF from my nutritionist but it didn't fully come through so she is sending me a paper copy.

Said paper copy arrive in the post yesterday. Today I've scanned it and created a PDF from the scans. If you need a PDF reader then opt for Foxit PDF Reader, does the same jos as Adobe but much smaller program.

The file is hosted on Rapidshare.com

http://rapidshare.com/files/276588906/D ... _Sport.pdf

El Imbatido

Thank you will have a good read of that later.

carrock

El Embatido's advice is superb- wish someone had told me that years ago

I also am type 1- and remember when cycling coast to coast fully laden ( about 17 stone of body and luggage ) I couldnt physically eat enough to keep my BS above 5 unless I stopped taking insulin altogether.

Thing is, I assume we need to take in more food than is simply required to top up blood sugar, and then take insulin to force the excess sugar into the muscles- otherwise we run out of muscle energy...

I take a family size bag of jelly babies in my saddlepack, plus the obligatory glucose tablets

Also worth looking at team type 1's website for inspiration- some of these guys are diabetics and pro cyclist... and then of course there's sir steve redgrave....so yes you can compete at a high level with diabetes

redvee

In the PDF above from Gwent Healthcare trust it says to have 10-20g of cabo for every 30 mins of excercise.

tomxc

try find out when your blood sugars start to drop when your riding, e.g. 10 mins into a ride and make sure you have at least 20g of carbohydrate ten minutes before that time...if that makes sense. This worked for me

neilmacd

There's a meter you can get here in the UK.
It's on prescription in Scotland - not sure about the rest of the country.
It's called Trueone and combines a meter and a pot of 50 strips into a device about the size of and old camera film container so is ideal to bung in a jersey pocket or saddle pack.
You'd still need the finger pricking device but it's a bit more convenient than carting a full size meter with you on a ride.

If your local hospital diabetes team run a DAFNE course I'd suggest trying to get onto one of those as the week long course really makes you look at what you're eating, exercise and the effect insulin has in relation to your carbohydrate intake and BG levels.
I've just completed one and it's been a real eye opener.
Upshot is I'm now on about 50% less insulin than I was before but I've got a really clear idea of how to approach exercise and manage my diabetes effectively.
Exercise can also make you more sensitive to your insulin too so you need to less.

fuelex

Some great advice above.
I only tend to have problems when riding if I go out 2-3 hrs after a meal and my short acting insulin is working hard.
Always take a bottle with energy drink and as many packets of dextrose as you can carry.
Nice to know I'm also not the only one who feels like a pain in the arse when everyone has to wait for me.

daveclow

afternoon everyone!

this is the best place to ask advice seeing as all the diabetics are in one room

ive had a few problems over the years, nothing too extreme. but occasionally after eating a meal, say within 20 minutes i'd feel a bit ropey and then 5 minutes following i'd be laid out flat on my back absolutely F$£%ed and almost unable to walk for shaking, before putting away a whole multi pack of penguines or what ever was to hand til i felt ok again.

i dont get episodes like this anymore, im assuming because i eat as Much as possible. ive never gained a pound though! my main sport is rowing, which gives me a ferocious appetite. as the saying goes, rowers don't eat as much as they like - they eat as much as they can!

BUT, since cycling, ive found that i can easily fall into the 'shaky area' when putting that much energy into it. rowing is ok as it last for 6 minutes of hell lol - however i can be out on a bike for a couple hours. 2 months ago i was on a long ride, for which i wasnt properly prepared. i started to feel a bit dodgy, then as happened before, it was a matter of minutes before i 'bonked' and collapsed - dropping my bike on the side of the road. luckily a friend was with me, who raced off the to nearest village to get a lucazade and a packet of jelly tots. these made me right as rain! infact i carried on for another 30 miles and it felt good!

im dropping in a sample to the docs in the next couple days, but wanted to ask if my experiences sounds familiar to any of you guys? or am i very paranoid?

Velonutter

Dave are you a type 1 or 2?

What are your counts starved in the morning?

I'd be tempted not to take any insulin before a ride out if this was likely to happen or just a very small amount to allow for the duration before you ride.

Ideally you should not be eating anything between 1 & 2 hours before a ride out and then I eat every 15-20 miles such as an oatcake bar.

I used to take upto a 1000 units of insulin a day!

I have an electrolyte drink before every ride and usually consume at least another 750ml on a 50 mile ride.

Hope this helps?

daveclow

well thats the thing, i dont know if i am diabetic or not, i havent been tested yet!

do it sound likely?

Velonutter

daveclow wrote:

well thats the thing, i dont know if i am diabetic or not, i havent been tested yet!

do it sound likely?

Dave sounds quite strange as eating a large meal and having a hypo afterwards should not theoretically be happening, in fact quiet the opposite and to recover by eating a pack of penguins is not to me the symptoms of a diabetic.

In addition as a rower I am presuming that you are fit and not massively overweight?

No, I think from what you are saying that there is some other reason for this, I'd get down top your docs ASAP and get a few tests done?

Steveorow

Daveclow ....

You describe the syptoms of hypoglycemia or low blood sugar levels but if you dont know one way or the other then you have done the right thing in putting in a sample to try and find out whats going on .

I aint no doctor or anything but been type 1 diabetic for 27 years and Hypoglycemia as you describe is the exact opposite of what you get as an untreated diabetic type 1 or type 2 ie you get Hyperglycemia which is High blood sugar levels the syptoms of which are normaly a combination of some or all of the follwoing . Excessive Thirst in so much as you are drinking litres of anything you can find ; peeing profusely day and night ; weight loss ( more type 1 ) ; extreme tiredness . There are other symptoms but these are the most common .

Diagnosed and treated diabetics get the symptoms you desribe if they have taken to much of there medication ie insulin or tablets to stimulate insulin production which is then not balanced correctly by eating to little or unplanned exercising which uses sugar and not compensating accordingly resulting in low bood sugars .

Regards..........Steve

daveclow

Slow-N-Old wrote:

daveclow wrote:

well thats the thing, i dont know if i am diabetic or not, i havent been tested yet!

do it sound likely?

Dave sounds quite strange as eating a large meal and having a hypo afterwards should not theoretically be happening, in fact quiet the opposite and to recover by eating a pack of penguins is not to me the symptoms of a diabetic.

In addition as a rower I am presuming that you are fit and not massively overweight?

No, I think from what you are saying that there is some other reason for this, I'd get down top your docs ASAP and get a few tests done?

yes your right i have always been a bag of bones, but beefed out a bit now mainly through training for rowing. bmi is 23, so in ideal. but if i took my eye off the game and ate less then i would definitely loose weight.

daveclow

Steveorow wrote:

Daveclow ....

You describe the syptoms of hypoglycemia or low blood sugar levels but if you dont know one way or the other then you have done the right thing in putting in a sample to try and find out whats going on .

I aint no doctor or anything but been type 1 diabetic for 27 years and Hypoglycemia as you describe is the exact opposite of what you get as an untreated diabetic type 1 or type 2 ie you get Hyperglycemia which is High blood sugar levels the syptoms of which are normaly a combination of some or all of the follwoing . Excessive Thirst in so much as you are drinking litres of anything you can find ; peeing profusely day and night ; weight loss ( more type 1 ) ; extreme tiredness . There are other symptoms but these are the most common .

Diagnosed and treated diabetics get the symptoms you desribe if they have taken to much of there medication ie insulin or tablets to stimulate insulin production which is then not balanced correctly by eating to little or unplanned exercising which uses sugar and not compensating accordingly resulting in low bood sugars .

Regards..........Steve

thanks steve thats a great help.

the next port of call is the docs to get it looked at. lll look into Hypoglycemia too.

cheers again,

Dave.

Pross

I'm sure none of you need me to say this but take care and if you feel the effects coming on get off your bike and somewhere safe. I lost a friend who had a hypo while on his motorbike, the police spotted him swerving and thought he was drunk - by time they got to him he'd gone under a lorry

daveclow

ah gosh thats terrible. im sorry to hear that. i sure will be look after myself!

d

Kirklet

I'm a type 1 diabetic and has been said above, I think it's just a matter of finding out what's good for you and going with it. At the end of the day, advice is always welcomed but you/we have to figure out how our body reacts to the differeing stresses of our rides/runs.
On our club runs on a Sunday (usually 40-60 miles), I'll have a decent breakfast at 7.30 (four weetabix or a big bowl of porridge usually). Take usually only 3 units of inuslin as opposed to a normal 6 on a working day. Check my bloods at 8.45, decide if I've over done it. If they are around 10-12 im happy, if they are under that i'll scram a quick cereal bar or something similar. 40 miles later I'll be on the verge of dropping below 4 and I'll usually have done half a bottle of lucozade by then. this usually gets me to the first cake stop though ! This is just how it works for me. It's the longer runs that need careful attention. It's a pain in the arse but it's managable.

Der Kaiser

I've just been diagnosed with Type 2 Diabetes which explains an awful lot of my dips in energy in several sportives this year.

Just been out for my first ride on medication. I did 16 miles at just over 12 miles an hour and I feel pretty good. I could have done more but for the fading light.

I was reluctant to tell people within my club about my condition but I realised that it is very important that they know in case I go hypo during a club run. Hopefully the combination of Metformin, exercise and improved diet will help me to shift the weight.