Diabetic dilemma

[smoggy]

I wonder if any of you guys can give me some advice. I started cycling again the beginning of last year and I absolutely love it I’m slowly increasing the distances I ride which is unfortunately limited to once a week due to family commitments and this is where I have the dilemma. I’m an insulin dependant diabetic and am unable to find good information on how to properly “manage” my blood glucose level for say a ride of more than a couple of hours, of course I carry glucogel but have been eating something extra before going out which I feel is slightly defeating the weight loss I’m also trying to achieve. I have considered lessening my insulin with my previous meal but I’m not sure if this is the right thing to do can anyone advise? as at the moment I feel I’m playing “hypo roulette” BTW I look at a few forums but nothing compares to this one its the dogs cahoona's.

 

[byegad]

Your diabetes nurse should be able to advise.

 

[HelenD123]

There was a long thread on Crazyguyonabike about touring with diabetes. You might be able to pick up some tips.

 

[smoggy]

Many thanks Byegad, diabetic nurse referred me to dietician she referred me to GP he said experiment! and basically that's what I'm doing. The problem is a bad result from the experiment is me in a coma by the side of a remote cycle track? OK I like to think that wont happen but as fellow diabetics know a hypo can hit fairly quickly and sometimes without the warning symptoms. Thanks also HelenD I've quickly looked at the thread it seems to mainly assume your using a pump system, and at 61 the NHS wont invest in that sort of money for me I don't think I have enough contributions left in me. Ill read it more thoroughly tonight after work.

 

[slugonabike]

Can you take your testing kit with you on a couple of longer rides and see what is actually happening to your glucose during that time? Admittedly it would be a PITA on those occasions, but it might enable you learn how your body reacts to the exercise and how best to manage it.

 

[smoggy]

Thanks Slugonabike seems a bit obvious now but I've never thought of that! Although there are lots of variables it might help me establish some sort of base line as to sugar usage on different rides, it should help me estimate probable usage so I can balance/plan glucose before setting off.

 

[slugonabike]

Hopefully you will find that you soon get to understand what is happening to your blood sugars and manage things accordingly. Happy cycling!

 

[Fran143]

Hey Smoggy, It's not a good idea to reduce your insulin doses for earlier meals, always ensure you take the appropriate amount and eat more to compensate for the energy you will be burning whilst cycling. It does seem a bit like maintaining and equilebrium but if your going to continue cycling you need to manage your blood glucose levels. Always carry a fast acting sugar and a carbohydrate with you so that if you do feel signs of a hypo you are prepared....don't do borderline as you may not know until it is too late. Think Byegad's right tho a wee visit to your diabetic nurse who could provide you woth personalised advice is the best bet. Cutting back on food whilst exercising is one of the most common causes of hypos.

 

[smoggy]

Hi Fran143, I do run close to the mark with sugar levels my HbA1C is around 6 and I've found this has helped my peripheral neuropathy no end. The reason this has come about is I've been on a diet and combined with exercise managed to lose a stone. Unfortunately I have stalled / reached a plateau and for about 3 months my weight has barely budged, when examining my diet I think the intake of say a kit kat pre the ride or exercise is probably more calories than I'm expending. The diabetic nurse is in fact a "telephone triage system" manned 3hrs a day 4 days a week and very difficult to get through to, and although I have'nt used it for over a year as is being suggested I'll try again many thanks for your advice.

 

[Fran143]

Hey Smoggy, Well done on losing your 1st so far, your heading in the right direction. Shame to hear that you are not offered more support through your health centre, nurse triage is really no use for people like yourself who want to get tailored advice on improving your health and monitoring complications. This is such a vast problem that I can't understand why each health board to not provide adequate support. What about your local hospital....can you access a diabetic specialist through that? If you don't have any joy then pm me and I will try to get some info from a colleague who specialises in diabetes for you.

 

[Spin City]

Smoggy

I have Type 1 diabetes and I also cycle a fair bit. In the past I've done all day rides such as the Etape du Tour.

I always take a drink with me which is fairly sweet. For shorter rides I use this to keep my sugar levels up. My favourite is (not overly strong) Ribena.
However, there's lots of other drinks that have similar amounts of glucose. You wlll need to work out for yourself how much glucose
you require for a particular ride.

If you're going out for longer rides (probably over an hour or two) then it's likely you'll need to eat something to keep your energy levels up.
I prefer something like flapjack, tea bread, fruit cake, malt loaf etc.

Of course, you'll also have to take some emergency rations with you just in case. I take Dextrosol and some extra food.

Let me know if you're interested in taking insulin while you're out and I'll tell you what I do.

 

[smoggy]

Thanks Fran143, that's exactly the problem beyond basic guide lines there is no specific help, I've even asked one of the GPs at our practice who said "Id have to look it up, Ill get back to you" I'm going to see a consultant in March for a regular check up he's new I'll ask him.

Thanks also Spin city, I largely do what you suggest and always carry glucogel, and from all the comments above I now have some ideas on getting a better grip on what level to start. I am interested in how taking insulin during a ride would help I've heard of it and always wondered how it works?

 

[Spin City]

Smoggy

I tend not to reduce my insulin prior to a ride but if I was going out shortly after eating then I probably would.
However, when I go out running then I will reduce my dose prior to going out. The reason for this is a) running takes more energy and b) I only take water with me to drink (in a Camelbak waist bag).

If you're out cycling all day then you probably need to take a meal with you. A sandwich will fit nicely into a jersey back pocket or, if you've got a decent sized saddle bag, then you can fit all sorts of things in there. If you're doing a sportive event then there's usually food stops along the way and if you're into audax then there's usually a lunch stop. When I stop to eat (lunch) I will measure my blood glucose (so I need to take my monitoring kit out with me) and I will take a reduced insulin dose. The only problem with this regime is that sometimes, not always, you will have higher readings before you go to bed. I'm assuming you will also have a meal when you've finished cycling.

Let me know if you want me to be a bit more precise with what I do.

 

[smoggy]

Spin city,

That all makes sense, I suppose the theory is that if I run out of anything it'll be energy first. I'll certainly be giving I a try at the weekend maybe a 10% reduction at first as long as the current weather forecast holds true, many thanks.

 

[Spin City]

Smoggy

That seems a sensible approach to gradually make changes and review the outcome.

A couple of things:

1. I would make a mental note (or write it down if you need to) of things such as: size of meal prior to ride, BG level before going out, insulin dose, drink and food consumed, time out on your bike, BG level at end of ride, etc. I don't know if you count your carbohydrates but there are guidelines concerning how much you eat/drink and insulin doses. Personally I don't count carbohydrates but I do know approximately how much I'm eating and drinking. Keeping a note of these things will help you make adjustments when you're out next time or if you want to extend your rides.

2. If you're trying to lose weight then I would stay away from Kit-Kats etc as they contain a lot of fat. You can always give yourself a treat when you're say one hour from home and have some of your favourite chocolate. For a low fat food that's got plenty of carbohydrates tea bread is perfect as it's not made with any butter. For a good recipe see Tamasin Day-Lewis's one. If you want I can write a copy out for you. If you cycle after breakfast I can recommnend porridge as a good low fat meal with plenty of carbohydrates. My favourite at the moment is with a banana and some sultanas and sweetened with golden syrup.

Good luck out there.