type 1 diabetic sportive nutrition help

carrock

Any type 1 diabetics care to comment??

I am 46, type 1 diabetic. I completed my first sportive yesterday ( Caldbeck killa, 64 miles and 4200 ft of climbing )and think I got my nutrition all wrong.

What I did was this:-

ate muesli for breakfast 2 hours before the start, with a small shot of insulin, and stabilised my BS at around 10mmol

I didn't take any more short acting insulin as I didn't want to hypo during the sportive, but I had jelly babies, gels and cereal bars with me in case of hypo.

I nibbled a few jelly babies, had a gel and a banana during the 5 hour ride, and my BS was fairly stable throughout, although my performance tailed off after the first 30 miles or so and I felt quite heavy legged.

My non diabetic wife, on the other hand, had 3 gels and about 200g of jelly babies, and a banana, and flew round the course.

Would I have been better taking on a lot more carbs during the ride, and taking insulin to force the glucose into the muscles? I felt as though in hindsight I cycled round on an empty tank for fear of suffering a hypo....

thanks

owenlars

They say that your blood should be between 7 and 14 before you start. Have breakfast and about half your normal insulin. So I reckon you did that ok to make sure your muesli ended up in the right place.
I always take my measuring kit and insulin on a sportive and measure half way round at a feed stop, probably put in another half dose and take it from there. It is obviously important to eat but surely no more than anyone else. I reckon you didn't eat enough. The key is to balance the need for insulin against the level of exercise. Remember whatever you are doing you need the insulin to get the glucose from your blood to where you need it and the only place you can get it is from an injection. Incidentally I am on Novorapid/Levemir.

kendramutch

i'm also a Type 1 diabetic and have completed a fair number of sportives, competive races, multi day stage races and long distance rides 300kms +

You need to eat just as much as everybody else, gels, bannanas, muesli bars what ever takes your fancy, sounds like you definitley hunger flatted.

My normal programme for a 100km ride would be, breakfast, but less than normal insulin to cover it.
I run with a pump but the following changes can be made with MDI.
Reduce my basal rate, or if on MDI reduce your doseage, how much will depend on you and how hard your going and how long your out for.

i test reguarly and eat every 30-40minutes like most of my riding buddies.

Their are some really good sources for more detailed stuff for diabetics doing long distance/duration excercise

A book called 'The diabetic athlete'
Team Type1, or now they are Novo NordisK a Pro continental team in the US they have some good info on their webage
Connected In Motion, a Canadian Outdoors group
HypoActive, An Australia group that does a lot of excerise related stuff and studies that go with in.

My Jersey Has a Big sign that says ' Insulin Injected Engine' only a few people notice

markhewitt1978

carrock wrote:

I nibbled a few jelly babies, had a gel and a banana during the 5 hour ride, and my BS was fairly stable throughout, although my performance tailed off after the first 30 miles or so and I felt quite heavy legged.

That happens to me sometimes too and I'm not diabetic!

team47b

carrock wrote:

I nibbled a few jelly babies, had a gel and a banana during the 5 hour ride, and my BS was fairly stable throughout, although my performance tailed off after the first 30 miles or so and I felt quite heavy legged.

owenlars wrote:

The key is to balance the need for insulin against the level of exercise

...and amount of carbs ingested has to be part of this balance.

You should be eating more during than this in a 5 hour period even if not exercising, and eating all simple/fast acting/high GI carbs is not helping, need to add in some slow release carbs into the mix.

legendary27

A couple of things that spring to mind when reading your post: as has been mentioned, it definitely sounds like you could have done with eating more. To be honest though, if you have a decent breakfast, I would not expect to take massive amounts of food on a 100k ride, but an energy bar or two would definitely help. The other thing is, depending on the QA insulin that you take, assuming that the insulin lasts somewhere between four and five hours, you would have ridden the last two(-ish) hours with only background insulin (assuming that you had taken some). This would impact you, as your muscles would have no (or very little) mechanism to get fuelled. I suffered something similar the first time I rode a 100 mile sportive. I took QA insulin with my breakfast, but did not take any during the ride - for exactly the same reasons you did - and found my legs extremely fatigued for the last thirty miles or so - much more than I would have reasonably expected.

What I tend to do now is eat something like a jam sandwich an hour or so before the start, along with a minimal amount of insulin - one unit usually - and then stop to eat something at the main (or middle) stop and take another unit of insulin. I usually nibble on an energy bar or two during the ride. This seems to be enough for me, though it is worth mentioning that I am using a pump. I have the basal rate on my pump turned down to -90% for the duration of the ride as well. I have stopped using carbohydrate drinks after a bad experience with very high BC levels and find it easier to regulate my carb intake with bars.

Whilst this process seems to work quite well for me, it has been formulated over a number of sportives over a number of years. I would suggest riding as many as you reasonably can and come up with something that suits you. As long as you take more carbohydrate sources than you will need, and do not ride on your own (until such time as you are comfortable) you will be okay. More to the point, well done for getting out there and doing it. It is always good to here other diabetics getting out there and getting on with it !

Regards,
Gordon

carrock

Folks, all the above has been massively helpful. I think my fear of going hypo has caused me to overlook the basics- which are

eat enough to fuel the ride ( perhaps 60g of carbs per hour )
take enough insulin during the ride to force the glycogen into the muscles

All I succeeded in doing was balancing my blood sugar levels at the detriment of performance.

will get it right in 2 weeks at the Jennings River ride. And with 8000ft of climbing it will need to be right

Thanks to all

carrock

owenlars wrote:

They say that your blood should be between 7 and 14 before you start. Have breakfast and about half your normal insulin. So I reckon you did that ok to make sure your muesli ended up in the right place.
I always take my measuring kit and insulin on a sportive and measure half way round at a feed stop, probably put in another half dose and take it from there. It is obviously important to eat but surely no more than anyone else. I reckon you didn't eat enough. The key is to balance the need for insulin against the level of exercise. Remember whatever you are doing you need the insulin to get the glucose from your blood to where you need it and the only place you can get it is from an injection. Incidentally I am on Novorapid/Levemir.

I am also on Novorapid/levemir. It sounds as though I need to eat more during the event and take on insulin during the event to push the carbs through

carrock

I have just googled and read the following article which is very helpful

http://spectrum.diabetesjournals.org/co ... l.pdf+html

redvee

I did the Great Weston Ride a few weeks back which was 56 miles and the food prep started the night before with a serving of spag bol. and lots of pasta, my insulin dose with it was normal and I ate normally through the evening till supper when I had more than usual and less LA insulin. Breakfast was an hour before I left home, 1.5 before the ride started and I ate more, cereal, toast and banana, and cut the SA insulin back to 50% and no LA insulin.
I did take my blood test kit with me and tested at each of the three stops. I had malt loaf and bags of haribo plus a couple of bananas and had to buy a snickers on the way too, in my bottles I had squash with a bit of energy drink mixture and the other bottle was the same but with Lucozade.
When my BS were low 4-7 I wasn't that fast but over the last 10 miles when I had been drinking the lucozade squash I was flying. If you know the symptons your body shows when your BS is low then you can react accordingly, be wary of eating too much in the final miles as you'll end up with a high BS reading after the ride.

carrock

OK so having read through the very helpful replies, this is my plan for the next sportive

Breakast (muesli/porridge ) at 6am as usual with insulin to cover aiming to stabilise around 10mmol

aim to start the ride at 8am, take another small dose (15 units ) of short acting novorapid immediately prior to start which should cover me for the 5 hours of the ride

start fuelling from about 20 mins into the ride with a mix of cereal bars, gels and jelly babies every 15 mins or as required

test bs at feed stops ( every 90 mins approx. )

bigmat

Interesting reading the above. I have a habit of focusing on blood glucose levels and thinking that if they look OK then I'm fine, forgetting that I actually need to take on food even if my bllod glucose is healthy. Sportives aren'ttoo bad as you can stop and test whenever you need to. I also find that with that kind of long steady endurance effort my blood glucose stay fairly constant - as long as it is within range at the start, I can pretty much keep shovelling cake / bars etc down my gullet without any massive spikes, although there's usually a kick after the finish. Racing is a lot harder - something about intense efforts forces blood glucose up, and I have found that if I take on enough food during a race my blood sugars rocket - the energy doesn't reach my muscles so I end up fatigue and hyper. I have experimented with taking an extra shot of long acting insulin (Levemir for me ) immediately before the race and then seems to help stabilise things - it just isn't viable to test / inject during a race (for me anyway) so this seems like the best solution, so long as you don't forget to eat!

carrock

BigMat wrote:

Interesting reading the above. I have a habit of focusing on blood glucose levels and thinking that if they look OK then I'm fine, forgetting that I actually need to take on food even if my bllod glucose is healthy. Sportives aren'ttoo bad as you can stop and test whenever you need to. I also find that with that kind of long steady endurance effort my blood glucose stay fairly constant - as long as it is within range at the start, I can pretty much keep shovelling cake / bars etc down my gullet without any massive spikes, although there's usually a kick after the finish. Racing is a lot harder - something about intense efforts forces blood glucose up, and I have found that if I take on enough food during a race my blood sugars rocket - the energy doesn't reach my muscles so I end up fatigue and hyper. I have experimented with taking an extra shot of long acting insulin (Levemir for me ) immediately before the race and then seems to help stabilise things - it just isn't viable to test / inject during a race (for me anyway) so this seems like the best solution, so long as you don't forget to eat!

I too thought about the Levemir but it remains in the system for 18 to 26 hours with a peak 8 hours after ingestion, so better to take at midnight the night before rather than immediately before the sportive.......

team47b

BigMat wrote:

although there's usually a kick after the finish. Racing is a lot harder - something about intense efforts forces blood glucose up

sprint finishes encourage adrenalin to be released into your system and as with any stimulant will increase blood glucose without consuming carbs.

bigmat

team47b wrote:

BigMat wrote:

although there's usually a kick after the finish. Racing is a lot harder - something about intense efforts forces blood glucose up

sprint finishes encourage adrenalin to be released into your system and as with any stimulant will increase blood glucose without consuming carbs.

Not just a sprint finish, basically any intense effort that puts me beyond threshold which is unfortunately a very regular occurrence when racing!

Useful info re the Levemir and makes sense. Still think its a decent idea in principle but I probably need to refine the timing.

carrock

Finally completed the rearranged Jennings ride- 55 miles with 8000 ft of climbing

Got my nutrition and insulin spot on.

what i did was this

Got up a 430am, had a huge bowl of porridge, plus 25 units of short acting insulin to cover

went back to bed

got up at 7am and took 50 units of long acting levemir. this would give me cover until mid afternoon and provide insulin release without causing hyps

then i simply fuelled constantly on the bike- around 50 grams of carbs per hour inthe form of cereal bars, plus a full bottle of juice every hour and gels etc as required.

Never ate and drank as much on the bike before, but still fresh legs at the end.

Secret I thing is having sufficient basal long acting insulin working in the background to shuttlle the glycogen to the muscles throughout the ride

redvee

carrock wrote:

Got up a 430am, had a huge bowl of porridge, plus 25 units of short acting insulin to cover

went back to bed

got up at 7am and took 50 units of long acting levemir. this would give me cover until mid afternoon and provide insulin release without causing hypo

Given that I'm using 3ml cartridges which hold 300 units that seem a huge amount of insulin. That amount of inusulin is approx 4 days insulin for me.

carrock

everybody is different in how they react to insulin. i often take 25 units before meals and 30 odd units at night.

I calculated that as i would be eating small amounts of food regularly whilst on the bike if i didnt take a big whack of long acting it would just push my blood sugar through the roof whilst starving my muscles of fuel.

obviously in your case you need lower dosage, and thats an individual thing