Wayne00001

I was wondering how many people got to toss thier insulin once out on tour? Step down to metformin or do away with it all together?

I know when I can get in atleast 40 miles on the bike, I can drastically reduce or skip my shot of lantus at night.

Still working full time and helping my ageing dad cuts into my ride time. But I'm hopping to get out on the road next spring for a long term tour and looking ahead to what I will have to do.

Thanks in advance for any help or tips you can give.

Wayne

Bacciagalupe

Is that 40 miles in a single day, or have you observed similar results when on tour?

Keeping in mind that my comments in no way resemble medical advice it makes sense that your blood sugar levels will be low(er) after a few hours of sustained efforts. When you're engaged in an endurance sport, your body is burning through as much blood glucose as it can get.

I'd just make sure you stay in a normal blood sugar range; if it gets too low, you'll bonk. Apparently this can be more difficult for a diabetes patient, since your body/brain doesn't automatically regulate insulin production and can't compensate for low blood sugar.

A bit more info that may be helpful.... https://books.google.com/books?id=XMU...20bonk&f=false

BigBlueToe

I'm a type 2 diabetic. I reduce the amount of medicine I take on tour. It usually takes a couple days for things to stabilize. Even so, I have my test kit and food ready at all times, and I have to stop a lot to test and eat if my blood sugar is too low.

sstorkel

I'm a Type 1, insulin dependent, diabetic. When I rode from SF to LA last year, I found that I had to greatly reduce the amount of insulin my infusion pump was delivering; it wasn't quite off, but close. My continuous glucose monitoring system (CGMS) was a big help during the tour...

Wayne00001

Yes 40 miles in one day, pretty much non stop except for traffic and potty breaks. Should have said earlier, type 2 adult onset.

spinnaker

This is very interesting. What is it about riding that causes one to have to reduce insulin dosage?

Wayne00001

Exercise burns the sugar. I run out of time to go on longer rides dealing with dailey life. I usually manage 15 to 25 miles 5 times a week. It takes the longer effort for me to see a large difference. Don't get me wrong, any and all exercise helps. I'm just hoping to hear someone tell me that 50-100 miles a day for an extended period of time will let me throw away my meter.

Wayne

Bacciagalupe

Sorry, I don't think anyone will tell you that.

Check with your doctor, but the big risk here is hypoglycemia. When you're cycling for days in a row, you're burning up all that blood glucose. If you stop checking and your levels get too low, and if the efforts of cycling mask the early warning signs, you could be headed for some serious issues.

That said I'm sure any doc will tell you that exercise will significantly improve your condition. But you really should check your levels regularly if you're on tour.

jdom

I'm a type 1 diabetic also,I'll try to explain as best I can.

Think of your pancreas as a thermostat and the air in your house as blood sugar.
When the air gets too hot the thermostat tells the air conditioner to kick on and cool the house.
When the air has reached the desired temperature your pancreas shuts the insulin off.

In a type 1 diabetic the thermostat is broke,it doesn't work.
So we must try to do that job as best we can ourselves.

As metioned above excercise burns blood sugar,but to be more accurate your muscles burn glucose.Glucose is your blood sugar.

Bezalel

Since we're already discusing diabetes, how do those of you who are insulin dependent manage to keep it from getting too hot on long tours?

jdom

I don't worry too much about mine.I think this needing to keep insulin cool is for the older style insulins such as humalin and mixed insulins.I'm not sure about this though.

But that said I have not had any problems with my Novalog or Lantus insulins.They have a shelf life of 30 days and thats just about what I get out of them.However they do say to store in a cool place,but I never do and haven't noticed any loss of performance from them,for lack of a better word.

I do get insulin in three month supplies and I do keep the stuff I'm not useing in the refrigerater at home.

jdom

Don't throw away your meter,you need it.
However you can limit it's use if you can take it with you on your training rides.
If you use it alot on your training rides you will start to know what works for you and what doesn't.

But talk to your doctor first,cutting back on Lantis for a type 2 diabetic is differant than what I know about.
For me I take the normal amount of Lantis and cut back on the Novolog.Cutting back on the Lantis for me would drive my blood sugar over the roof ,over night.

eja_ bottecchia

JDOM, you are correct, during exercise muscle burn glucose. But there is a little bit more at work here. For Type-2 diabetics, exercises allows the body to better (and more efficiently) use the insulin that the pancreas produces. Insulin is a hormone that is produced in the pancreas. Insulin is central to regulating energy and glucose metabolism in the body. Insulin causes cells in the liver, muscles, and fat tissues to take up glucose from the blood. Exercise works as a key that "unlocks" muscle (and the liver) so that it can absorb glucose, thus reducing levels of blood glucose and making insulin work more efficiently. This "unlocking" effect lasts for up to 12 hours of intensive exercise. For Type-2 diabetics like myself, whose cells are insulin-resistant, exercise is a godsend.

On May 2010 my A1c was 13 and my doctor told me that unless I did something drastic, I was looking at certain blindness and loss of limb(s). On September 2010 my A1c had dropped to 6. An A1c of 13 is equal to a daily average blood glucose of over 300; an A1c of 6 is equal to a daily average of 126. In other words, I have managed to go from certain blindness, kidney damage and possible loss of limb(s) to relatively excellent health. I have gone from 140 daily units of insulin to 30 units a day.

I owe it to better diet and riding my bike. I ride an average of 15-20 miles 3 times a week during the weekdays. On the weekends I ride both Saturday and Sunday. My weekend rides go from 50 miles on flat roads to 30 or so miles on hills.

I know that I will never, ever be able to get rid of my blood glucose meter. and I know that I iwll probably have to continue to take insulin, albeit in reduced amounts, for the rest of my life. As long as I keep exercising (biking), however, I know that my A1c numbers will remain low and my health will continue to improve.

This is my ode to bike riding!

sstorkel

Just keep it out of the sun. I'm not a doctor, but the need to refrigerate insulin is vastly overblown, as far as I can tell. I haven't refrigerated a single bottle of insulin in the last 20 years and it's never been a problem...

jdom

Wow great success story,congratulations.

Thanks for elaborating on my comments as it seems to contribute more to the OP's situation.
Type 1 and type 2 diabetes are two slightly different diseases it seems.Although I never really thought a type 2 diabetic needed so much insulin if any.

eja_ bottecchia

Hi Jdom, with type-2 diabetics the body's cells become increasingly resistant to insulin. As a reaction to the body's increased resistance, the pancreas produces more and more insulin. But no matter how much insulin the pancreas produces, blood glucose levels continue to rise. After years of increased insulin production, the pancreas finally gives up and stops producing insulin altogether.

As a type-1 diabetic, your body is not insulin resistant like mine is. You need insulin because your pancreas does not make any (or makes very little, I am not sure on this point.)

My pancreas, on the other hand, makes insulin; my body just refuses to use the insulin I make to metabolize glucose. For some reason (and I am not sure that doctors quite know the reason) the cells in the bodies of type-2 diabetics become more and more insulin resistant. That is why I needed increased doses of insulin.

Exercise, especially aerobic exercise, has the ability to "unlock" certain cell receptors so that insulin can "get in" and glucose may be metabolized. For me, riding my bike (and a better diet) has enabled me to drastically lower my A1c numbers and to reduce the amount of insulin that I need to take.

I am fortunate to have a very good doctor who stayed with me even during my "denial" stage. If anyone is interested, PM (or email) me and I will give you her name.

BTW, as the days become shorter I will not be able to ride as many miles. Consequently, I will need to start doing more indoor training. If anyone has a recommendation for a good trainer (especially a fluid one) that will not break the bank, I would to hear from you.

Regards...

Jiffyjam

Type II using a Mini Med Paradigm pump. I'm fairly resistant but have found I can completely suspend while doing 20 mile rides and that includes a 44gm snk along the way. ( I have to eat or go low ) Anyway, I would feel confident touring with my pump along doing maybe 30-40 miles a day. Base what you do according to your BS checks, which you should do fairly often as you go along until you get a feel for how your body reacts during different times of the day. I go high during the morning hours and then drop rapidly between 1pm to about 4pm, then I tend to go up again. Be careful and ride safe.
( If your ever faced with having to use a pump don't hesitate. They can free you up tremendously, and only 1 stick every 3 days. )

cyccommute 

I'd go further and say that type 1 and type 2 diabetes are two different...probably very different...diseases. They present the same symptoms so they get the same label but they aren't really the same. Type 1 (insulin dependent) diabetics don't have the cells to produce insulin. Those cells were destroyed when their body's immune system attacked and destroyed them. Without treatment, the patient will die, usually in a matter of days.

Type 2 diabetics still have the cells to produce insulin but those cells may not be producing enough or the insulin may be 'capped' by substances in the blood that render it unusable or the mechanism for utilizing it may be compromised. Type 2 diabetics may, and do, live for years with this condition untreated. Their health will probably be compromised but they won't die immediately.

As for reduced insulin usage, my wife (a long term type 1 diabetic) sees the same effect while bicycle riding. She has to set her basal rate on her pump to nearly zero. She actually saw the same effect when she was pregnant. I would suspect that the reason for this (not a doctor but...) is that cycling mobilizes glycogen within the muscles to fuel them. Insulin is involved in the making of glycogen but, once made, other mechanisms take over to utilize it. While exercising, you don't make a lot of glycogen (a fairly slow process) so insulin demand is lowered.

The storage issue...however slight now...is a nonissue if you use a Camelbak. We pack ours with ice at the beginning of each day, when possible. My wife stores her insulin in the main pocket of the Camelbak so that it's up against the cold bladder. If there's no ice available, she still store it there because the bags are insulated and even without ice the bladder will maintain a constant temperature which is usually lower than the surrounding air.

jcbryan

I used a FRIO pack thing, just put my pump in it. Had another to keep the opened bottles in. Quite expensive I might add.

jcbryan

I too, basically stop my basal rate, check when I get done, and most of the time have to wait an hour or so and a snack ot two, to get my sugar into a workable range. Oh, Type 1 on a Cozmo.

ayceejay

As an experiment I tested my sugar before going for a ride. I planned the ride so with extra carbs my meter read 11.3. I rode steady for 45mins and tested again, it was 7.5. Perhaps if you did the same it would give you some reference point.