type 1 diabetes riders

Anonymous

Hi

I am a rider with type 1 diabetes so I am insulin dependent, I just wondered if anyone would like to share any tips or what they do for their rides and manage injections.

I have been diagnosed and on injections for around 6 years and Doc says I am still in the honeymoon stage so only inject small amounts of insulin.

Normally I use 24 hour slow releasing glargine in the mornings 4 units & nova rapid with meals 3 ish units depending on the meal or what exercise I am doing.

If say I was going on a typical 65 mile ride with my club I would only inject my 4 units of glargine in the morning and eat some porridge or muesli and not use my nova rapid until I have finished my ride and having my main meal.

I tend to take home made flapjacks out with me and a few gels if I drop really low and tend to eat what I want at the cafe stop.

I just wondered how others manage their diabetes while on rides?

Cheers
Simon

rick_chasey

Can't remotely help you since I don't have it, but there is a bike team that I believe was in a few of Flanders' finest:

http://www.teamtype1.org/

There was also an article in pro-cycling about them.

I'd imagine they'd be happy to share their tips.

Anonymous

Thanks Rick, I had looked at this site a while back and forgot about it, I will take a look again.

Cheers

Simon

n1ckster

Hi Simon.

I too am T1, but unlike yourself I am new back to road riding after a long time out of the saddle (during which time I was diagnosed) and am having similar thoughts re. my insulin regime during rides.

Last September I attended a DAFNE course, organised by my health care professionals, which taught us a new method of managing your insulin dosages based on the carbohydrate content of the food you eat, as opposed to a fixed regime of x units at each meal. One of the most beneficial sections of the DAFNE course was around exercise and the rules to apply based on the activity and the duration of the exercise. This was really useful for me as I play a lot of cricket in the summer, five aside football, skiing in the winter and now I plan on returning to road riding.

I am not at all familiar with your regime, but I will say that it sounds totally different to mine. For example, at breakfast I have calculated that I consume 6 'carbohydrate portions' (based on the nutritional values printed on the packet of cereal plus milk + juice etc) which equates to 9 units of quick acting insulin (when using a 1.5:1 ratio - all explained in the DAFNE course). If I were exercising after breakfast I may choose to lower the insulin by 10 or 20 % depending on the length and intensity of the exercise. This would be repeated at each meal time (ie 3 times a day), plus I'll take a long acting background insulin at night, and again, this can be reduced after exercise.

If this all sounds complicated, it is probably because I am struggling to explain it succinctly. Your best bet may be to speak to your HCP's or GP, or to google DAFNE and see if this is something that would be of benefit. Speaking from a purely personal perspective, my long term HBA1c has reduced and my overall control has improved. Also, and this is the best bit, I can now literally eat what I want, pretty much when I want, and can administer the correct amount of insulin for any given meal/food. Apologies if this comes across as a bit 'evangelical'; I was seriously sceptical when my GP suggested the course, but I can now say that I am 'believer'.

I am glad you have asked this question on the forum and I look forward to following the thread and sharing experiences etc.

Kind regards, Nick

Anonymous

Hi Nick

Thanks for the info, it looks like you do similair to myself, I tend to change my fast acting depending on what I eat and exercise also but I have not yet done the DAFNE course. I think as I only inject such small amounts at the moment there is not as much room for error right now but I think things may change in the future.

This also suits myself well as like you I can eat say a sweet pudding it just means that I inject more...

If I was to do quite a lot of long rides over a weekend I would even look at reducing my 24 hour injection as I find that I get quite low if I am not careful.

Good luck with getting back on your bike!

Si

Teuchter

I know this is an old topic but I was looking for tips on longer rides with type 1 diabetes and came across it.

I've been type 1 for 20 years and have been cycling (mainly for commuting 20 miles a day) for over 4 years now. I recently got a decent new road bike so am planning to do more long rides at weekends.

I did DAFNE a couple of years ago and can totally recommend it to any type 1 diabetic. To me it totally redefined my approach to diabetes to the extent that now I wonder how I coped doing things the old, rigid way. Now I can eat (or choose not to eat) when and as much or little as I like. It takes a bit more effort but it really is worth it.

As Nick said, part of the course also covered modifying things for exercise. I'm on Levemir (long acting) and Novorapid (short acting) and find that on days when I cycle I reduce long acting by about 20% in the morning beforehand and drop 10% off short acting. It took some trial and error to arrive at this and the DAFNE course doesn't really give you these exact answers... it does however give you the knowledge to find your own best solution.

Pete.

Anonymous

Thanks for the info Pete, I recently spoke to a dia nurse and she said I should think about doing a DAFNE course, but as I I still only inject small amounts of insulin I might not be fully ready for it yet.

I allready alter my jabs depending on exercise/food I eat but it sounds like DAFNE would be a more scientific approach rather than my guess work.

I will see how things go and maybe try to get on a DAFNE course soon, they seem rather long a week? I am self employed so will take a big chunk out of my work but sounds like it might be worth t.

Thanks again.

Simon

rockmonkeysc

Hi, I too am a Type 1 Insulin dependant Diabetic and have been for 25 years. I have a similar set up as you...Glargine (long lasting back ground insulin at night) and during the day taking small amounts of Novorapid at meal times.

I am now getting back into mountain biking (love off road stuff) so am also trying to find what is best....my Diabetic specialist told me to reduce my insulin or if my sugars are below 6/7 then do not take any insulin as that way I do not have to go eating carbs to get my sugars back up. I am at the moment finding this very helpful as I find my sugars drop quite a lot when out biking. I have a couple of times just had a very small amount of insulin (couple of units with a meal) before going out biking and also have not taking insulin at all and still had a meal before biking and both has worked quite well for me.
It is a bit of trial and error just always make sure you have your test kit with you and an emergency supply (lucozade or something).

I am looking to do the winter challenge in December so am a bit nervous about that - as will be a big ride for me. People keep telling me to put these energy powders in my water bottle but this concerns me a little as yes they are for energy so I'm sure have lots of sugar in them as well as other things but is it enough and suitable for a diabetic I wonder....I suppose something like this I need to try before hand and also ask my specialist.

Good luck

Anonymous

Thanks for the info rock monk, I used the energy powder drinks all the time when riding tend to keep my levels about right so worth a try & see how your levels are, I guess it all depends on each individual and what you are doing....

Simon

Novomix30

As an NHS Consultant diabetologist, may I also pass on this useful website to you all with regards to any form of exercise whilst you have diabetes. It is a wonderful resource if you spend a little time with it.

http://www.runsweet.com/DiabetesAndSport.html

The advice you have exchanged between yourself is appropriate. DAFNE / Carb Counting is the key.

I would add that on longer rides you will need slow release fuel, don't just rely on energy drinks, certainly after 2-3hrs depending on your insulin use, starting sugars and degree of exertion.

Don't forget insulin with post exercise carbs either.

Hope the website helps.

legendary27

I am also a type I diabetic - of eight years, operating a similar Lantus/Novorapid regime and would wholeheartedly endorse the already-stated comments about attending the DAFNE course if possible.

The biggest observation I would offer is that cycling for prolonged periods makes me significantly more sensitive to insulin, or perhaps more accurately, makes my body much more efficient at using the insulin I inject. I commute 40 miles a day, five days a week. I take 50% less background insulin when commuting by bike than I do when I am not cycling and my insulin:carbo-unit ratio typically reduces from 1:1 to 0.5:1 as well (for the DAFNE'ers)

One observation that I would make is that when cycling sportives, or other long-distance rides is that I find it useful to take a VERY small dose of insulin when taking on large amounts of carbs - at a lunch stop for instance. I do this as I am taking in significant volumes of carbs and insulin is required to transport the glucose to the muscles, keeping them fuelled during the event. It is EXTREMELY important to note that this works for me specifically, and may not work for you - I have adopted this approach after a period of experimentation - mainly after finding my legs are extremely fatigued after 80+ miles when doing these sort of distances with no quick-acting insulin at all for the duration.

I suspect that every diabetic that posts here will have a slightly (or greatly) different solution to the same problem and that the important thing is coming up with a solution that works for you. I would reiterate the need to take your testing kit and some high-GI carbs with you and would also suggest not cycling on your own if trying a new insulin regime !

The most important thing by far though, is that there is no need to change your cycling habits - just how you manage your carb/insulin intake around them ! :P

Regards,
Gordon

evans6854

I ride for Team Type 1 - the US based racing team - all of the women on the women's team are type 1. If you have any specific questions feel free to message me and I'll be more than happy to help.

I've just returned from Rwanda where we - the women's team - went to support the men's team during The Tour of Rwanda.

Kate

Anonymous

Thanks for the info all, I have only just noticed the replys so sorry for the delay. I think I will look at doing a DAFNE course in the new year!

Simon