rydaddy

I've done 5 double centuries this year and am a type 1 pumper. You need to fine tune your nutrition for yourself. I totally agree that you need to carry your BG meter to see where you're at (at least on long rides). I actually do bolus if my BG is too high early on in a ride. I eat a decent amount of carbs throughout a ride. Say 30-40 carbs per hour (depends on the effort too). The gels work great but I also like real food for fuel. Everyone is different though. In time you will know what your body is saying.

and +1 to seeing an endo and getting a pump (if possible). Also, carry glucose tabs during rides. I have bonked...

Sinn

Here are my stats from the 100 mile group spin ride yesterday.

All efforts below AT, mostly in my aerobic hr zone. Working on neuromuscular memory.

45 min before ride, 1 unit less of bolus. Normal breakfast. Glucose level, 130 mg/dl.

Start ride at 6:45 am.

1 hr 45 min in to ride. 8:30am. 2 bottles of sports drink down. 250 mg/dl. Ate one cliff bar duing 15 min break.

1 hr 45 min later. 10:15am. 2 more bottles of sports drink and one gu. 200 mg/dl. Ate one cliff bar.

2 hr 30 min later. 1:15pm. 2 more bottles of half strength sports drink and one gu. 120 mg/dl. Had lunch and took at nap!

All of this was done following what I outlined earlier. Pretty good results, I think.

If had took bolus to 'correct' the 250 reading at the first break, I would have obviously gone hypoglycemic before the end of the ride. It is always better just to correct with more insulin up front if your body doesn't have enough insulin to process the calories by your next meal.

bretthammy

Thanks everyone, a lot of this stuff helps give me info on what to be looking at, and once I can get a decent endo, talk to them about.

sstorkel

You can keep repeating useless facts from your organic chemistry textbook as often as you want, but it doesn't change reality: if I consume one "serving" of Gatorade without an insulin bolus, my blood sugar will spike to 250 mg/dL within 30 minutes no matter how hard I ride. In contrast, I can consume 2-3 servings of Hammer Gel without an insulin bolus and my blood sugar barely moves if I'm on the bike riding at my normal pace.

The only thing I can conclude from this real-world experience is that long-chain maltodextrin, which is the only significant source of carbohydrates in Hammer Gel and CarboRocket, ends up entering my blood stream at a significantly slower rate than the high-fructose corn syrup and sucrose syrup found in Gatorade. Other sports nutrition products which rely on "simple" carbs, as indicated by a large number next to the "Sugars" heading on the nutrition label, will produce similar results: a significant elevation in blood sugar over a very short period of time... unless accompanied by a significant insulin bolus.

DannoXYZ 

Note that those aren't text-books, but real-world studies. Personal experience and lack of objectiveness is why double-blind studies are de-rigeur for scientify studies. Without controlling all the numerous variables involved (pre-ride/pre-testing meals, air-conditions, ride type, etc), one cannot narrow it down MD versus other carbs as being the only difference contributing to the effects you've noticed. And your personal experience cannot dispel the results hundreds of thousands of others have achieved to the contrary.

UGASkiDawg

Once again you are missing the point...if you are a Type 1 diabetic the only thing that matters is N=1....studies on other people are irrelevant to ones own situation as each Type 1's blood sugars react differently (within a very general framework) to all kinds of different stimuli including but not limited to

What time you woke up
who pissed you off today
Did someone compliment or trash your haircut today
how much exercise did you get last night
what did you eat.. when did you eat it
what did you eat it with
Is the moon full
Are there clouds in the sky today
are your pants to tight

If you aren't a Type 1 or don't take care of a Type 1 on a daily (really minute by minute) basis then don't offer up your uninformed but well probably well meaning opinion on how some foods might or might no affect newly diagnosed Type 1's

Gordonm

I have been a type 1 for 35 years and the last 3 been on a pump. I can conclude also that what works for one person may or may not work for another. I have discussions all the time with my Doc and he just shakes his head on what works for me. My numbers are great and have been for the last 10 years so I must be doing something right. It is a trial and error with some coaching from the so called "experts" Until you have lived with it for years it is tough to give advice for 1 person. You can generalize but it may or may not work for the individual.

bretthammy

That's basically what I'm learning. Being diagnosed a few months ago, I originally did exactly what the doctor said. After a month or two realized all my doctor did was increase my insulin progressively until it seemed to keep my levels in a good range. Now instead of waiting for him to say use an extra unit here or there, I do it on my own when I see a trend and inform him at my appointments.

So from this point I guess I just basically consult with him on what I am doing with my cycling routine and adjust as necessary (obviously cautiously, better to be a little high than low on a ride). Just wanted to see what info I could gain from others insight before attempting anything.

Thanks again guys.

KiuBWhy

Sorry had to.

RacerOne

Absolutley, my type 1 son got the flu last week (another scary matter altogether) and it was all we could do to keep his glucose levels up. Now for the last week we have been dealing with repeated lows (as low as 25 ) and have ended up cutting all of his insulin doses in half or more from what he was at just last week. This is just after we were congratulating ourselves for having an A1C of 6.8 at his last doctor visit. It's a terrible crazy disease that we do our best to plan for but more often than not end up reacting to what just happened instead. He's been diagnosed about 10 months and we're going in for a pump on Thursday. Hoping that goes well.

Praying for an artificial pancreas sooner than later!

rydaddy

Yeah, illness really throws me off. It's tough to nail down.

As for the artificial pancreas... well I know they are testing one now. It's sort of a CGMS-pump combo. I tried a CGMS once and can't stand them. But this would be great for children. There's also a trial going on for an actual cure for type 1 diabetes (search Dr. Denise Faustman). I know, people have heard this for years... but there is a promising trial going on. I've spent some time on the diabetes forums, and there is a lot of good info there.

Also, if you're new to type 1, "Think Like a Pancreas" is the book to read.

sstorkel

Hundreds of thousands?

A study with a mere 10 subjects, none of whom happen to be diabetic, doesn't seem very convincing given the discussion at hand. Neither does the one that looked at 25 runners... none of whom were diabetic. Got anything with real science in it? Say, hundreds of test subjects, a documented protocol, a control group and some actual Type 1 diabetics, perhaps?

DannoXYZ 

I'm talking about the athletes who use MD and why they use it. They certainly don't use it because it's a "slow digesting complex carb" that "doesn't raise blood-glucose levels". They're using because it delivers the largest amounts of glucose as fast as possible to the bloodstream; even faster than pure-glucose solutions in concentrations above 8%. And just because you've got Type1, which occurs in one stage of energy-delivery, doesn't change anything about thermodynamics or physiology. For example:

- 1 gram of CHO gives 4-Calories of energy
- digestion & gastric-emptying rates are based upon size of CHO (DE=1-200+), and molality of solution
- intestines absorb only glucose with an exchange of sodium ion (active transport), MD only exists in stomach
- each glucose molecule converts to 38 ATP via aerobic respiration or
- each glucose molecule convert to 2 ATP via anaerobic fermentation
- conversion efficiency of humans is 20-24%
- glucose has GI of 137 up to 8% solution, 100 over 8%
- maltodextrin has GI of 137 up to 20%
- to ride 50-miles, you're gonna burn off 1500-1800 Calories

Nothing in there is different just because you're Type-1, get over it. No human's gonna be able to ride 50-miles and burn less than 1000-calories or more than 3000 (maybe sitting fully upright, dragging a parachute at 25mph). Your main concern is how to transport the glucose from your bloodstream into your muscle-cells. It doesn't affect how the MD is digested or absorbed through your intestines.

And UGASkiDawg said it best:

You've mistakened maltodextrin's effects because you're not tracking all those other variables. It's dangerous to tell other Type1 people that MD is slow-digesting and doesn't raise blood-glucose. When in reality the only other thing that's faster is pure glucose-pills. Would you advise taking 50gm of glucose pills at once?

BTW - would you only go to a doctor for a heart-attack if he's had one? What about a bankruptcy advice from a CPA? Do you only pick one who's bankrupt? What about legal help for DUI? Perhaps ask the attourney who's in the drunk tank with you?

shuffles

Danno,

Thanks for your input, but if you're not a Type 1 diabetic (or the parent of one like I am) or an endocrinologist who deals with Type 1 diabetics, then you should gracefully back out of this conversation. I understand you want to prove your point regarding maltodextrin, but the point that you seem to be missing completely here is that Type I diabetics do not have an insulin response - they no longer create any insulin on their own and are thus completely dependent upon injection of insulin (whether MDI or pump) to enable their cells to utilize glucose of any kind.

Bretthammy, it has certainly been our experience that many GPs really are not intimately familiar with or experienced in Type 1 treatment or diagnosis. Most have only read about it in Med School, at least that was the case for us. Also, many GPs continue to look a the needs of Type 1 and Type 2 diabetics as being the same, and they are dramatically different.

My 18 yo daughter is Type I and we have been on bike tours together. She is on a Minimed insulin pump with Novolog, though we are not using CGMS yet. Here's what we did:
- basal rate of 50% starting 90-120 minutes before the ride and thorugh the end of the ride
- get blood sugar up to about 180 before the start of the ride
- test every 30-60 minutes during the ride
- 15g of carbs every 30-45 minutes of riding
- bolus of only 50% for any meals during the ride (we had lunch and snack stops on these supported tours)
- if you are above 230-250 when you test, it would be a good idea to check for ketones. If you should have an infusion set problem (which would lead to ketones) then you would go into DKA very quickly with exercise and high BGs.

She did her first tour with a group of Type 1s and their endo from a diabetes camp in Cleveland, ** Mita Koda. This is the approach that they used for their groups. We just followed the same approach when we did the tour together later.

Make sure and take plenty of extra carbs with you, more than you think you'll need, and make sure you have a glucagon pen with you as well ans that your riding partner knows how to use it and when. You'll likely do just fine, but just in case ...

You can ride with Type 1 safely and successfully. +1 on checking out the Team Type 1 web site and blogs for their approaches, but keep in mind that they are sponsored by specific equipment, insulin, and glucose companies.

Now get out there and ride!

Gordonm

Interesting on why you would let it get up to 180 before the ride. I have gone out for long rides plenty of times with my BG in the 100 range with no problems. If I see it approaching 150, I wear a CGMS I may give myself a very small amount of insulin. Like maybe .2 to .4 units, obviously I'm on a pump. I try to maintain my BG between 80 to 120 throughout the ride. I'm certainly not saying this is wrong but it just seems like you are riding a little high throughout the ride. Better to be high than low for sure. I have only once been over 200 on a ride and that was because I was sick and was all over the place. Probably should not have been riding that day.

I just let the basal run at 100% and eat about 15 to 20gs of a gel or bar every 45 minutes to an hour. I also carry a bottle of carb drink that I am drinking throughout the ride. In a 3 hour ride I will consume an extra 100gs of carbs and never bolus for it. I have found this works for me but it was through a lot of trial and error. I won't mention the time I was 20 miles from home and had a Bg reading of 43. Ate everything I had and made it home safely but it was not a good experience.

RacerOne

Funny, we were talking about Type 1 diabetics and what they do to control their blood sugar while riding bicycles. Seriously, you are probably right when it comes to non diabetics, after all, that's why I use MD. I would not use it to quickly raise my son's glucose if he were to have a low, that's what juice, and pop are for.

sstorkel

Really? When are we going to hear about that? Because all I've seen are crap studies published in journals of dubious credibility. The one study that involved cyclists didn't seem to focus on long-chain maltodextrin, but rather fructose. And the protocol was so completely ridiculous (drinking 95oz of liquid over a 2-hour period while riding on a trainer at 50% of max power) that I'm surprised anyone would publish it, let alone have the balls to draw conclusions based on it...

The abstract of the study done on runners was interesting, since it seems to suggest that high concentrations of maltodextrin exit the stomach slower than lower concentrations or those that also include glucose or fructose. A bit difficult to draw any real conclusions without the complete text of the study, though.

shuffles

The guidance we've received from her endo for exercise indicates that she should start exercise at a somewhat elevated BG; I believe this is to prevent a low blood sugar early in the exercise due to the delay for either ingested carbs to get into the blood stream (min. 15 minutes) or the effect of the reduced basal. During exercise we want her to run 150-180 to give that buffer and provide safety. Being at that BG for that period of time is not damaging long term. With this method, we've been able to keep her right on target without lows or highs over 200.

I think you'll find that this is the same method used by Team Type 1 (whenever their site comes back up).

Of course, her target for non-exercise times is 80-120, and our motto for her is ABT (Always Be Testing). While we'd love to have the CGMS, interstitial BG is 15 minutes behind what a fingerstick will read, so I might think it would be good to see where one is trending, but not for the reading 'right now'.

Gordonm

Yes the CGMS is a 15 to 20 minutes behind but it does show if you are on your way up or down or level. I shoot for a nice even line. Not always easy to do. I have found it to be helpful but not replace the finger sticks. It has reduced the number of finger sticks and it is costly and a lot of insurance does not cover it. I had to fight for a year before insurance covered it at 80%.

I do find if I am running in the 80 range while riding it is almost impossible to get it higher while riding. Your body just cannot absorb it quick enough so yes it is better to run a little high than low.

What we have today is a quite far from what I started with 35 years ago. The level of control and knowing where your BG is at vs the urine testing of years ago that could give results from as long as 6 to 8 hours ago. It is still a daily challenge though.

AndrewP

I have been type 1 diabetic for over 55 yrs. Everyone's metabolism works differently, so learn how yours works by keeping a close watch on your blood sugar while you are practicing your long rides. Stop frequently and measure. I drink 70/30 water/fruit juice mix. When I was young my blood sugar dropped while I was exercising but now it is sometimes delayed by 12 hrs, after riding all day I set the alarm to wake me in the middle of the night and check the blood sugar. Good luck!

Gordonm

That is encouraging.

gcedillo

Hey Andy, I have been with type 2 for 3 years and with all due respect you inspire me to keep taking good care of myself.
God bless you

ecoovert

I have been a type one diabetic from the age of two. I also am an avid cyclist who has raced some in France as a diabetic. There is no reason to think you can't do great things as a diabetic. As to your question on avoiding bonking I always check my blood sugar before going on a ride. I also carb up at least 2 hours before I go on a ride and make sure I include protein in order to keep my blood sugars as stable as I can. I often ride over 100 mile rides including cat 1 and beyond cat climbs. In order to keep my blood sugar stable I always drink a high calorie energy drink or use a gel. What I try to do is if my blood sugar is say 100 before I leave on a ride I take 2 swigs of an energy dring that comes to 400 calories per 16 oz every 10 minutes along with 4 swigs of water. My water bottles contain the energy drinks and for water I use a Camel Pack. On the longer rides I always bring gel packs. With this system I rarely bonk. If on the other hand I start my ride with my blood sugar at say 200 I will wait about 30 minutes before I start taking the energy drink but still drink the 4 swigs every 10 minutes of water. This works for me but depending on how hard you push and your body weight... you may have to adjust this to fit you.

I mostly ride alone as I have trouble finding other cyclists that can keep up with me on long rides. On my solo rides even with hard climbs I usually average 20 mph. This I hope will encourage you and I hope the info. helps.

I would be more than happy to give you more pointers if you wish.

Eric

Biker395 

You guys are all amazing.

ecoovert

I also have been a type 1 diabetic from the age of two. Having had diabetes for over 45 years I have learned a thing or two about how to manage my diabetes. When I ride I fill my water bottles with high calorie energy drinks and for water I fill my 3 liter Camelpack. I always check my blood sugar just before a ride and assuming it's in the normal range I drink 2 squirts of my energy drink every 10 minutes during the ride followed by 2 to 4 squirts of water. Drinking more than that can cause your bladder to fill and make you need to make more pit stops. At this rate the two bottles will only last you about 2.5 hours so on my rides I also bring hammer gel packs for when I run out of energy drink. When using gel packs it's more important to drink as they contain little water. I weigh 140 lbs. and usually ride at a 20 mph. average on solo rides so depending on your weight and pace you may have to change this to fit your needs. If you are riding with a group you may also need to lower your caloric intake. The kind of ride you are on also will change how you need to adjust your caloric intake. On flat terrain you may need less than on rolling or mountain terrain. At first if I were you I would rather err on the side of caution. That is to say until you find out what works best for you in each situation you may want to take more energy drink or gel and tune your caloric intake as you gain experience. It took me a while to figure this out but it was well worth the time.

Hope this helps,

Eric

P.S.

As you gain fitness you will go through the calories faster so keep checking your blood sugars at the end of your rides as well.