Cycling with diabetes

I’ve blogged about cycling and diabetes before. I’ve also said the hardest part of training for a century was the diabetes aspect. Conditioning is easy compared to diabetes. Figuring out what you need to eat, how much and how often during rides is tough. So is figuring out your basal rates before, during and after. Once you figure all that out, it usually changes because no two rides are ever the same. As long as you can come up with a general plan though, it’s easier to tweak.

The normal plan.

My snacks on rides include GoGo squeeZ apple sauce packs, LÄRABARs, Gu gel and Sport Beans. I also take Gatorade and glucose tabs along for lows. On average, I eat one of those options every 45 minutes. The apple sauce packs are 15 grams of carbs per pouch. LÄRABARs are 28 grams each, Gu gels are 25 grams and Sport Beans are 24 grams. When my blood sugars are higher, I eat one apple sauce. When my numbers are running more in range, I eat one of the others or two apple sauces. I tend to eat the Gu gels and Sport Beans on the front end of my rides because they’re geared more toward energizing athletes for longer activities. I have found eating 15-30 grams of carbs roughly every 45 minutes helps keep my blood sugars steady.If I see downward arrows, I start washing the snacks down with Gatorade instead of water. (I also minimally carb-load the night before and eat a protein-heavy breakfast before morning rides). Each of these snacks work with my metabolism. None spike me quickly, but rather a slow rise over time.

I usually don’t mess with my basal rate. The exception is Saturday morning rides. I have extreme spikes for a few hours after waking up, so my basal rate reflects those spikes. From 6-11 a.m., I have an increased basal rate. Other than the morning changes, my basal rate remains at 1 unit of Humalog an hour. On Saturday morning rides, I decrease my basal to whatever percentage puts me at 1 unit of insulin per hour. Beyond that, my basal rate ins’t touched when I’m on my bike. After a ride, I always see post-ride spikes. After much trial and error, I often give a bolus about an hour or two before I plan to finish riding so long as my blood sugars aren’t hovering around the 100 mg/dL mark. I often still spike, but if I continue to correct the highs, I end up crashing several hours later. On afternoon rides, that means I crash in the middle of the night. That’s another interesting facet I found while riding. It can affect me up to six hours after I’ve stopped riding.

Death Valley :: A different beast

I went to a training session at Death Valley focused on managing blood sugars while cycling. It was led my physicians, and they emphasized eating lots of sodium while in the desert and downing plenty of water and Gatorade (for electrolytes). They also recommended eating 30-60 grams of carbs every half hour while out riding. That’s far more than what I’m used to eating. Clearly, I don’t ride regularly in the desert, so the sodium thing I completely understood. But not the carb-loading or the half-hour increments. The physicians also reminded us everyone manages diabetes differently and not to change what worked for us. I did anyways. I was freaked out about falling into dehydration mode and not eating enough sodium.

I loaded up my Camelbak with water and drained it before every rest stop. I also ate a couple of salt packets along the route and forced multiple Clif bars down. (And there may or may not have been soy sauce shots at dinner). I lowered my basal rates because we started riding at 6:45 a.m. None of it mattered though. I was 153 when we started, which is great. I try to ride between 150-200. I drop fast when riding, but dropping from 150 is usually something I can catch. Within an hour of the ride, I was sitting at 150 with a down arrow. I chased that 150 all day long. At one point, I dropped to 108 mg/dL, which makes me a little more nervous. At 60 miles, I was 128 but with a downward arrow. I was tired. I was hot. And I puked up the last Clif bar I had eaten. I felt like a stuffed pig. I wish I had saved everything I’d eaten that day, but to the best of my knowledge, it included four apple sauce packs, four Clif bars, several Gu gels, a pack of Gu chews, four bottles of watered-down Gatorade, three packs of Sport Beans, about two whole bananas with peanut butter and some grapes. At 60 miles is when I took a SAG ride for nine miles. By the time I hopped back on my bike to finish the last 10 miles, I was sitting at 380 and climbing.

The misery came fast and lasted a long time. Knowing I had about an hour or hour and a half left, I went ahead and bolused two units before those 10 miles. About seven miles in, I finally started coming down and saw a 340 mg/dL staring back at me. I still felt the symptoms of being high, but I also felt relief. I knew I was high because I had stopped riding. It was an extreme post-ride spike. After the last 10 miles, I spiked back up to 400 mg/dL. I gave a normal correction hoping for the crash before bedtime. By the time I laid down, I was 220 with two arrows down. I went to sleep after eating a handful of glucose tablets and drinking some Gatorade. Knowing I had my CGM nearby helped me sleep a little more soundly. (Well, that and having just cycled 70 miles in the desert). It was a beautiful sleep. I set an alarm to wake myself up at 1 a.m. to double check my numbers. I was 101 mg/dL. I was exhausted and didn’t want to wake up anymore, so I ate four tabs and went back to sleep. I woke at 5 a.m. to a beautiful 128 mg/dL.

Lessons learned.

For starters, don’t get off your bike till you’re completely finished because riding high is hard. I also learned that riding in a diabetes-centric ride is pretty fantastic. It’s like having 315 moms hanging around. Everyone has food, and everyone asks “What’s your blood sugar?” No, seriously though. I loved this ride. I ate more than usual, but my blood sugars stayed lower than usual. I wouldn’t have done anything differently because what I did is what I always do. And riding in Alabama and Tennessee, my routine works beautifully for me. The desert? Yeah, the desert is the devil so all bets are off.

The thing is, diabetes isn’t hard for me. I know it can be for some, and I have moments like anyone. But as a whole, diabetes doesn’t bother me. I deal with it as second nature most days, and I prefer it that way. It rarely takes center stage and I don’t want to be defined by it. Ever. It can be used to describe me, but never define me. Cycling with diabetes is hard, and I refuse to ever let it keep me down. It will never keep me from cycling, and to be perfectly honest, it’s the only reason I continue cycling. I was told JDRF Ride to Cure Diabetes would change my life. It did. It made me want to keep cycling, to keep setting cycling goals and to encourage others to do the same. If I can do this, anyone can do this. I am so excited about Nashville next year, and I can’t wait to make new friends, reconnect with old friends and watch friends take their first-ever Ride to Cure.

Cycling with diabetes? Game on.