I'm a Type 1 diabetic waiting on an insulin pump. But until then, I suffer low blood sugar on almost every ride. To put it plainly, it really sucks. I'm tired of having to slow down to eat Skittles or walk the bike. It really bothers me. Are there any other diabetics into cycling? What do you do to prevent low blood sugar. I eat before I go, but I still go low. :(

Welcome to the forums!

Yeah, there are several diabetics that cycle and post here regularly. I am also a T1 diabetic and have been on the pump for 9 months. The risk of low BG is way higher if you are active (as we are), so ALWAYS be prepared (glucose tabs, ride with a partner, cell phone, Road ID/Medic Alert!!!).

In general though, your body becomes far more efficient metabolizing and lasts up to 48 hours after exercising. If you are becoming low while on the bike you need to reduce the insulin you consume several hours prior to riding to accomodate this greater efficiency. For example, when I ride I reduce my basal rate of insulin (insulin/hour) by ~50% a few hours before getting on the bike. Because I am on the pump this is a bit easier...

I was told by my nutritionist long ago that I should consume 15gC/30 min of activity prior to working out. That got me through soccer, but is dated advice. Depending upon how hard you ride, you should perhaps consume some carbs every 15-30 min or so while you are working out...gatorade, cookies, gel, gu etc...check your BG regularly to determine the formula that works for your needs. Also, it is very important to consult with your doctor/endocronologist to get a starting point, then work out the fine points yourself (doctors can't do that for us!)...

Good luck and keep posting!

Diabetics face the exact same issues as everyone else when exercising, reduced glycogen supply in the muscles. Which then absorbs glucose from your bloodstream. Additional insulin will just make it worse. So build up your blood glucose supply before and during the ride by lowering your basal rate and eating beforehand.

General rule of thumb on rides longer than 1.5-2.0 hours is to eat 200-250 calories of carbs per hour. This is about the maximum that can be digested by your stomach and absorbed by your intestines. The actual rate of absorption into your muscles, even with reduced insulin is much higher.

Even then an average workout at 500 cal/hr will ALWAYS burn off glycogen/glucose much faster than you can absorb and replace. So your blood-glucose will ALWAYS drop as you ride. Monitor it and time your food-intake and pump to keep the levels high enough to be safe. If it drops too low, STOP, rest and eat something!!!

You'll love your pump :D

I've been using one for 14 years. Wouldn't trade it for anything!! Oh wait, I'd trade it for a cure!

I too lower my basal to 50% a couple of hours ahead but only if I have time. Most of my rides are in the morning so I just lower it prior to breakfast then usaully start my ride within the hour. And after I finish regardless of the lenght I bolus 1-1.5 units. I'm also using full strenght gatorade, carb boom gel and sometimes cliffbar shot bloks.

Good luck with your pump and getting it dialed in. just remember test, test, test.



pmc

Because your using a pump with fast acting insulin the control will be much easyer. Right now your long acting insulin is droping the blood sugar and there is nothing you can do about it. I've been using a pump for 5 year now and have had type 1 for 40 years now. Don't know why I waited so long to use a pump but its great. Its nice to have some kind of control now.

What kind of pump are you getting?

rgl

bentnail, I have the Animas 2020 in my closet, but I still have a few more classes to attend before I can use it. I really can't wait to start using it.

bentnail, I have the Animas 2020 in my closet, but I still have a few more classes to attend before I can use it. I really can't wait to start using it.

OH! I didn't realize you were that close!

Man, you are going to love it...my control with the pump is more akin to "real control" than taking shots ever was--all my A1c's have been <7 (an improvement for me!).

Get ready for a new lifestyle (a better on, I mean!)...

Be sure to discuss your workouts with your educator at the training sessions. They will probably say the same thing you are reading here...

~mike

Animas is a great company. I have an Animas also.

I had my pump for about 2 months and was out racing sailboats one day. A line got caught under the pump and it came off my belt and went in the water. It was gone forever. It was my falt this happened and I couldn't aford another. I called Animas and they shipped me a new pump over night express mail at no charge. I told them I couldn't pay for another and they said the new pump was under warranty so it was no charge.

Did I say I love that company :-)

Anyway good luck

rgl

I use a pump and as previously stated, reduce the basal rate by 50% when I ride hard.

I have found the Nature Valley Fruit and Nut bars to be excellent for reducing low blood sugars on the bike. The complex carbos break down better than candy and the bars don't melt or get messy or crushed. I keep one in my jersey for fast access. I keep a second one along with my glucose meter and some glucose tablets in the wedge below my saddle.

This should help both before and after you get your pump.

Good luck.

I just thought I'd update, today I got hooked up to my pump and I love it already! My nurse suggested that I ride less over the 2 weeks that they try to pinpoint my basal rate, but in the end it's worth it.

I just thought I'd update, today I got hooked up to my pump and I love it already! My nurse suggested that I ride less over the 2 weeks that they try to pinpoint my basal rate, but in the end it's worth it.

She is right. A good basel rate will be worth its weight in goldl. When its right you will know it because you don't have to eat if you don't want to and your blood sugar will stay close to the same. I always got so sick of eating. I have two basel rates. One for days I don't ride and one for days I do ride. I always had trouble at night when my basel was to high because I had riden

Hello All -
Tourezrick here, trike and two wheel recumbent rider for ten years, T2 for seventeen years. Does anyone notice difficulty with 'leg burn' from lactic acid due to taking Glucophage (Metformin)? How about difficulty in maintaining bg levels due to Byetta usage? Byetta slows emptying of the stomach, and therefore absorbtion of nutrients, but the attending weight loss (40 lbs since Jan. 07) is a blessing for this old man. I've been on a pump for five years, currently using a Minimed 722, Metformin for 10 years, Byetta for 7 months. I have discussed lowering my basal with my diabetes educator, but she has not suggested a 50 % reduction as mentioned. Then, again, they have little experience with riders that consider 100 - 200 mile weeks 'normal'.

Live to ride
Ride to eat
Eat to live

Hi,

T1, mdi, levemir/novolog A1C 5.5, will never go to pump (not that i don't trust them, but i can't wear watches or jewelry or anything..it freaks me out...and with a1c 5.5 I don't need to change anything anyway. shots do not hurt one bit...*)
---
I ride mtb and road and pretty hard, for hours and hours (4-5 usually)

I take 4 gluco tabs 10 mins before rollout, and drink gatorade and water through the entire ride. if I am hammering I will need to chow 10 extra gluco tabs at 40 miles, 60 miles, then eat something more substantial to go to 100 miles. so i always carry 2 tubes of gluco tabs and an extra if i know i will be out far.

I have a cupboard filled with huge cans of powdered gatorade. about 800 gallons worth. it is very effective
for any cyclist and super duper cheap, so when you get home and have to chuck what you didn't use
you don't feel like you are flushing 20's down the drain. I mix one scoop to a bottle, that is 1 hour.

some people stack up and hit the ride at bg 200 ! I never do that. I will jack up to 150 maybe with 4 gluco tabs but don't think I need to be 200 pre-ride.


skittles = BOGUS ! use gluco tabs . they go right in. candies have binders and waxes and other cruft which frankly, don't do a damn thing for ya. if you are riding and want to maintain...eat 4 tabs every so often(20 minutes)/or drink gatorade. if you are riding and you 'feel the bonk' (which for a T1 is the prelude to the bonk from hell), eat 10 at once (150 calories)...when you feel the bonk just nibbling 4 of them doesn't cut it, time to eat the stack. if you ride and do not feel the bonk then you are maintaining fine and don't need a lot at once.

test test test ! bring with you many many gluco tabs (50 of them, or one big bottle) and go for big rides and figure out a formula that works for you. bring the blood tester and test every 30 minutes till you can figure out how to ride and maintain close to 110-120 bg or under 150, and detect what makes you go low. test test test. then eventually you won't need to test, you will just know what to do.***if pumping you will always need to test...mdi you can get to a point where you can skip testing. a pump could kill you (1 chance in a bazillion but it still in theory could), mdi likely won't...so NEVER be strapped to a pump without a tester handy***


finally, as mentioned above, make sure (damn sure) you are not riding withing 3 hours of your last meal bolus...or make your last meal bolus 50% less than you compute. Because...even though bolus is supposed to be gone in 3 hours, riding hard makes it seem like you just took one. you will feel a huge bonk after 30 miles if you 'ride too close to a bolus'...so what i do is eat 4 hours before a ride, take the same shot, one maybe 1 u less, then just pop a few tabs pre-ride.


the key is make a schedule of test rides and burn up strips all day and get it dialed in to how you ride.

you will know you got things right when you get home and immediately test you can be (whatever) and then test 30 minutes later you should be 80 or so....then you have it nailed

I can't tell ya how good it is to stick with simple gluco tabs like dex 4 or walmart brand. I don't even go for a walk without a tube handy. but I am keeping my a1c 5.n my goal in life, so I'm always hovering at 70-90 and need to be ready


*99% of the time

Hello All -
Tourezrick here, trike and two wheel recumbent rider for ten years, T2 for seventeen years. Does anyone notice difficulty with 'leg burn' from lactic acid due to taking Glucophage (Metformin)? How about difficulty in maintaining bg levels due to Byetta usage? Byetta slows emptying of the stomach, and therefore absorbtion of nutrients, but the attending weight loss (40 lbs since Jan. 07) is a blessing for this old man. I've been on a pump for five years, currently using a Minimed 722, Metformin for 10 years, Byetta for 7 months. I have discussed lowering my basal with my diabetes educator, but she has not suggested a 50 % reduction as mentioned. Then, again, they have little experience with riders that consider 100 - 200 mile weeks 'normal'.

Live to ride
Ride to eat
Eat to live

hey just an idea here. your goal as a type 2 is to lose as much weight as possible and get body fat % under 10. that is if you are serious. then drop all meds and only take insulin if you need it. whatever you need to do in life..change diet change habits whatever. you will feel a bazillion times better and perform huge athletic feats with ease and fun once you drop all those nasty meds. insulin is 'clean' way to treat high bg levels. meds wreck you

those meds mess with your body in many ways, all of them bad (yes they help blood sugar but they treat your liver and intestines like a punching bag, so how can you ride hard with your insides all whacked out on meds ???) trust me this is the way...I do a LOT OF RESEARCH. now of course i am not your endo....this all depends on your body and the state it is in, and the blood numbers and hormones and thyroid and everything else we cannot diagnose over the internet. but anyway, if you are not working 110% on your body in every aspect as a type 2 it is difficult to ride with ease.


enough about my nagging...metformin doesn't make leg burn...it is something else. metformin DOES interfere with glycogen supplies and takeup, and can result in starved muscles...but any burn from this is due to metformins effects not metformin directly...are you testing ketones and do you have any at all ? that will do it. make damn sure your ketones are undetectable. it is ok to have some but only in the few hours directly after hard efforts. any other time, that is likely your leg burn issue.

other than that, with zero ketones, then leg burn may be normal and you just gotta massage your legs before and after ride and before bedtime. normal cyclists with no health issues need to do this, so it may be normal.

edzo-Thanks for all the information! I've always had gluco tabs on hand, I just liked the candy better, but I think I'll have to start using them instead. Riding within 3 hours of your meal bolus really is a killer, I found that out yesterday. I called my nurse and reported my BG's and she told me I was good to excercise, I just had to remove my pump. So, I removed my pump and started excercising. I totally forgot about the bolus and I dropped way low. It's good to know that there are many other diabetics into the sport.

edzo-Thanks for all the information! I've always had gluco tabs on hand, I just liked the candy better, but I think I'll have to start using them instead. Riding within 3 hours of your meal bolus really is a killer, I found that out yesterday. I called my nurse and reported my BG's and she told me I was good to excercise, I just had to remove my pump. So, I removed my pump and started excercising. I totally forgot about the bolus and I dropped way low. It's good to know that there are many other diabetics into the sport.

well now here is the real kicker...if you do this, then that

this: eat right and dial in an A1c between 4.2 and 5.9

do all the things you know you must do. the point is with testing you can nail a perfect A1c

that: taking insulin properly gives you an advantage over someone who doesn't take insulin. it guarantees muscles will get fed after hard efforts. even non-diabetics could benefit from insulin post-workout to push fuel back into muscles***...it's just hazardous. it's hazardous for diabetics too, but we are educated on how to not kill ourselves. insulin is highly anabolic and a storage hormone in that it initiates cellular events that result in up-regulation of cellular nutrient content

basically it means you are in direct control of your recovery and can dial it in and maximize your time, so if you ride a lot, you can in some cases improve faster than if you weren't diabetic. you have to take it, so why not get super scientific on yourself and make it work for you.

it may not give a big advantage other than the guarantee that you will recover as best as possible, because you are controlling the most powerful hormone in the body. the one that regulates fuel.


just keep gluco tabs around everywhere, because maintaining the 5's a1c means cycling hard efforts will sometimes go into override and you will end up with the low feeling coming on later even after meals sometimes. for me it would be at night, after my normal meal and normal shot...it is rare but I am ready. glucose is cheap. 2 rolls in the car, 2 rolls with my insulin, 2 in the camelbak, big jar near my bed. I use maybe 10-15 tabs a week now...I am getting better at sticking to certain foods which have predictable decay rates. hint: a lot of flax and whole wheat pasta, and sprouted bread. I feel like a million bucks and am able to destroy myself on hill rides, and improve rapidly...like I am 20 all over again.

I am a fairly new type 1. thought the world would end at first. now, eh, I just take my shots and like it.


***don't try this at home. if your pancreas works don't screw with insulin...

One of the risks of taking Glucophage (metformin) is lactic acidosis. Most likely, if you are having trouble with lots of lactic acid build up, there is another problem in your body, ie liver, kidneys not functioning correctly, major systemic infection, severe dehydration.

I take Glucophage and have not had this experience when riding. However, Glucophage does make me want to puke all the time. Blech.

basically it means you are in direct control of your recovery and can dial it in and maximize your time, so if you ride a lot, you can in some cases improve faster than if you weren't diabetic. you have to take it, so why not get super scientific on yourself and make it work for you.


Can you elaborate on what you are doing to control your recovery. I am also type-1.

Can you elaborate on what you are doing to control your recovery. I am also type-1.

nothing special, except that my postprandial 2 hour bg level...I strive for it to be 100 or less. ada allows 180 ! DCCT allows 140 or lower. I do a bit more insulin. here is what I mean:

normal person: call him N
and a type 1: called 1

N does a huge monster effort, and is knackered and gets home and chows down. he is dehydrated and muscles sore and in fact all his organs and systems are tired. so he drinks and eats and does what normal athletes do...recover. but his insulin response and nutrient uptake in the cells is going to be a little less than
if he was fresh and not beat from a huge effort. his blood sugar goes up, and comes down as anyones would after eating...and everything is fine. but does his insulin production exactly match what his muscles need at the right time and right amount ? don't really know and you cannot control it


Now take 1...does the same effort and recovery, but also takes a shot of insulin to match whatever carbs 1 is eating. a solid guarantee that the right amount of insulin is available at the right time. and takes enough insulin to hit bg 100 or less after 2 hours. this packs fuel back into muscle faster than someone who doesn't take insulin. N's natural response may be similar, but doubtful. 1 can control this action with the artificial insulin. it is also risky. so 1 knows to keep tabs handy later on if 1 gets the sweats... 1 wants to remain in the 80's afterward.


so what I mean is if you take insulin you really guarantee them thar tired muscles will get packed ASAP to speed recovery. that fast and reliable guarantee means no matter how knackered and tired your endocrine system is from being on the bike all day, at least the insulin response is that of a rest day (compared to N when N's pancreas is loaded and ready to dump all the insulin N needs). and of course in 1 he doesn't have his own insulin.

so...if you have to shoot up to live, and insulin is totally UCI legal if you need it to live, strive for very close to 100 postprandial 2 hour numbers (which results in excellent a1c which is key for longevity) and you know you got the best recovery you can possibly achieve. force feed the muscles basically.



so my formula is: maintain your diabetes better than the ADA recommends. better than the DCCT.
and this means test a LOT so you don't fade !!!!!

ADA sez 180 or less is ok 2 hour...I say BOGUS !
DCCT sez 140 or less is OK. I say good idea, but I can do better. normal people are usually 140 or lower, and they
never really go higher...as they can dump insulin in sustained amounts

ADA says a1c target 7. I say BULL ! that is way too high and can lead to problems
DCCT says under 7 for a1c...which it still too high in my book.

normal a1c is 4.2-6.4 so i say anything in the 5's should be fine

I am getting 5.5 and i am happy. I tried to go into the 4's a1c but i was going low too often,
so I found something that works for me.



put it this way. for anything I eat, I am happy with a postprandial 2 hour '86 to 110'. if it is above that for any reason i will adjust something the next time I eat the exact same meal, so it goes to 100 at the 2 hour. sometimes of course I will eat something strange and hit 150 or higher. or get those weird times when the insulin doesn't even seem to work and it is even higher. so i check 30 minutes later and it usually starts going down....this just means it is one of those weird shots that absorbs a little different. I always use my abdomen for shots because it is the most predicable area.


every second your blood glucose is above 100, you are aging faster. high blood glucose after eating is a fact for everyone. but the faster that comes back down to 100 or less, the faster you stop the accelerated aging and effects of high bg. that is what the endocrine system does with insulin. it keeps the fires from burning too hot and burning you out. keep fuel regulated and keep the system on a slow, even burn when eating carbs. letting bg stay above 100 past the 2 hour point you are letting the fires burn a little hotter and a little longer than they need.


note: all of the above may not work for everyone. the pancreas does 4 other digestive functions besides insulin, and if you have other endocrine issues, digestive problems, liver problems, are too fat....this may be really hard to do. I have no other apparent problems other than lack of insulin. all my other hormones and blood numbers are perfect. I radically changed everything diet related to take care of my type 1. I don't think about the food i don't eat anymore...I don't jones for ice cream or cookies. this is about living as long as possible. it was too easy to give up all the bad foods and start eating the best foods, because I wanna be a model type 1 and not someone who needs to talk to diabetes educators and have my endo make recommendations. Every endo I talk to or educator say 'Gee we wish everyone took diabetes are seriously as you do...we'd have far less complications and people would be healthy.' I say 'yeah ?' They say 'Yes, you are in the top 1% excellent a1c, excellent blood numbers...keep doing what you are doing'...so that is all I know about it


oh by the way I never mentioned this...My FBS: was 74 this morning and i did a big hill ride last night. last night at 2am I was sweating a tiny bit, so I popped 2 tabs and went back to sleep. on days i don't go big, my FBS is usually 82-86. having an FBS every stinking day between 70-90 is critical to the overall program!!!!!!! I use 1 shot of levemir at 10pm, and then during the day 3 - 5 (depends on how i eat) shots novolog. 31g needles do not hurt one bit