Century Training with Type 1 Diabetes

This is a topic that I need some good advice on. I have Type 1 Diabetes and have been taking insulin for 20 years now. I have been cycling for almost 2 years and haven't had too many issues with my blood sugars. Until now. I am training to ride a century for a charity ride for no less than to find a cure for Diabetes. I have reached the point where I am really racking up the miles and am having trouble keeping my blood sugars stable. Even when I am not riding, they keep dropping out on me. My doctor is of no help, I have no insurance and the stupid clinic people really don't know what they are talking about. I have tried to slowly reduce my basal insulin as I increase my miles. This helps a little, but still have the surprise drop in blood sugar a couple of times a week. Is there anybody out there who has experienced this and has come up with a good diet plan/medication percentage reduction that has helped? I know each individual is different, but I am just looking for a base model to work with. Also, if there are any books on the subject. I have searched, but have found zero.

 

I hope you can find a reliable source. There is a lot of hope since there Team Type 1 dedicated to those competing with diabetes. Maybe you can fine an avenue through their website. If anyone would have good advice it would be them.

Team Type 1

 

Not sure if anyone has mentioned this to you but there's a pro cycling team called Team Type 1. They competed in Tour of Flaunders and will compete in Tour of California, Tour de Suise, USA Procycling challenge, Leadville trail 100 and dozens of other races (they're not in the Tour de France, Vaulta, or Giro...yet). But they're in some of the top races in Europe. Five of their riders have type 1.

This if from their website: The 23-man squad includes world-class veterans Laszlo Bodrogi, Rubens Bertogliati and Alexander Efimkin, sprinter Aldo Ino Ilesic, stage specialists Javier Megias Leal and Alessandro Bazzana, climbers Will Dugan and Kiel Reijnen. Five of the riders have Type 1 diabetes: Fabio Calabria, Joe Eldridge, Alex Bowden, Martijn Verschoor and Javier Megias Leal.

http://www.teamtype1.org/

If these five riders can do the training volume needed and compete as well as they do, there is a way. I've also met someone who put up a good time during an Ironman with type 1. A time that ANYONE would be VERY proud to have.

If all else fails, find out how these five riders do it, and keep reaching out and sooner or later you will make the right connection.

The reason why I choose to respond to this thread isn't because I have type 1, but because, after a 16 years of competitive running and triathlons, I developed a medical problem that cut into my ability to train, recover, and therefore, compete. I spent one year going to 3 primary care docs, 2 endocrinologists, 2 urologists, 2 neurologists and got NO WHERE. I am lucky enough to have insurance but still had to pay about $400 out of pocket. They couldn't even figure out what was wrong with me 12 months later.

Not only did they not understand athletes but they didn't understand how to figure out what is wrong with someone who has something outside of the what they normally see (I'll spare you the details). I finally connected with a naturopathic doc and acupuncturist and one month after, I'm 50% better, understand the problem and am getting back to my old self again. At the rate I'm going, I will have to spend $400 to the ND and acupuncturist because my crappy insurance doesn't believe anything beyond pills will work so that sucks and I understand your limitations being uninsured.

I work in health care at a hospital and my take on Western medicine is they're good at dealing with trauma or people who are "broken" but have common problems (Ex: have type 2 and don't want to to lose their feet), but if you want to not merely manage your type 1 symptoms but excel at something, the vast majority of docs won't be able to help and it's obvious by your goals and dedication that you're not the average person you wants to merely survive. My advice: either go to a doctor who is an athlete him or herself AND an expert with type 1, or find an ND who works with athletes.

I hope this helps.

 

Hello,

I am on Team Type 1 and think I can offer you some guidance. I will send you a PM with email.
Tom

 

I am Type 1, diagnosed 2.5 years ago, and a pretty keen cyclist. this area you mentioned is just not on the doctors radars, you need to consult other type 1 diabetics, all care no responsibility though. I rode in The Jayco Herald Sun tour charity ride last year in Victoria, Australia for Hypoactive to raise funds for kids with type 1 and education in sport. It was 700 km in 4 days, with loads of climbing, the best advice I had was from a couple cyclists who were pretty serious in general, and a couple of guys from Team Type 1 were invaluable. Monique Hanley who rode for TT1 in Race Across America summed it up pre event, you are your own personal science experiment. If you are doing multi day riding basal needs adjusting as the days go on, I dropped mine by 50% on the final day, and quick acting by 70 % on some sections depending on the course, you need to experiment. There are some formulas , but it's trial and error. Over summer time here I was riding 600 km per week and basal dropped by 25 to 30 %, but daily fast acting depended on flats versus hills. In general I would drop my fast acting by 50% for a meal pre ride, and don't be afraid to take a few units post ride, if you are high, just need some food approx 20 minutes from then. If you post email address I will send you a great article. Good luck, it's trial and error. Stewart.

 

Sorry for barging in on an old thread.

I am fairly new to cycling and have been Type 1 for over 15 years. I need to get into shape and I want to start training for a half century. I am just concerned about my sugars and getting the right balance down. Do you ride without the pump, lower basals, I am kind of lost. For the most part my sugars are okay but I know once I get going things may get out of whack.

 

Unfortunately, I can't afford to use my pump without insurance so I am stuck with injections. Since I first posted this, I have learned a lot. I completed the century without any problems and I am less than 2 weeks away from my second. I am actually blogging about my training methods and the dosings and how I adjust for specific days. Look up Adam McCoin on Google+ and my blog is called Sports Training with Diabetes.

I have warned people to not use the exact dosages I do, but talk to your doctor about it. I am showing people how much by percent I have decreased my insulin while training. I usually take a basal of 22 units of Lantus, but when I am training its down to 18 units. And on long distance days of 50 or more miles its down to 16 units. I have also decreased my bolus.

I just started this blog, but I invite you to read it and ask me any questions you may have. It is totally possible. I felt so amazing crossing the finish of my first century at the Tour de Cure for Diabetes, I cried. Now that I know its possible, I am working on losing the weight to start racing next year. I have 30 pounds to go and 5 months to get there.

Let me say, don't worry how long it will take you. Just finish first, then you can work on getting better. My first half century took me 3 hours and 28 minutes. Keep me informed on how you are doing. I would love to hear it when you make it.

 

If you use Google just a little bit, there are several websites and blogs about training, cycling, and even racing with Type I and Type II diabetes, put together by experienced cyclists. For your century, besides getting advice on insulin dose adjustments from your doc, you should do some long rides before the century to test your dosing. No matter what else you do, I'd advise you to carry a glucometer with you on the ride. There are small glucometers out there that take up little space in a cycling jersey pocket (like the OneTouch Ultra Mini). Also, if the ride is warm to hot, you should be sure to bring small cold packs to keep any insulin you need to carry cold. Insulins like Humalog don't survive well in heat. The old saw about being sure to stay hydrated applies even more to diabetics (who can be prone to dehydration when serum glucose levels are high). I can't over-emphasize the need to take longer rides to test insulin testing and also so that you can become familiar with your body's signals over the course of a long ride. As for the century itself, as a first timer it's likely best that you set your goal as just completing the ride, not setting it as finishing in a certain time. It's also likely advisable to stop at regular intervals (or more frequently if you're feeling funky) to check your serum glucose levels. Talk to your doc.

 

Alienator has all good advice. That is all how I prepared for my first century. After you figure out how your own body reacts, the next time makes it so much easier to focus on getting faster.

 

• Advice to coaches on training diabetics for cycling
• TeamWILD's website, with their suggest training plan for diabetics riding centuries
• A look at cycling with diabetes
• A look at cycling with an insulin pump that includes some useful info for diabetics in general
• A slideshow on a training program for cyclists with diabetes

That's a start, anyway.

 

It really depends on what you want to know. I have seen all these sites and none of it was any help at all. The truth is no research has been done on diabetes within athletes. Sad but true. We aren't just people being active with Diabetes, we are elite athletes doing unnatural things.

 

There's nothing unnatural about cycling and centuries. Certainly completing a century does not make anyone an "elite athlete." Not in the slightest. Those sites are starting points. Research that has or hasn't been doesn't mean anything. Those sites offer suggestions as based on the experience of more experienced people. That no research hasn't been done is a fact not in evidence.

 

I consider riding a bike 100 miles unnatural, otherwise more people would be doing it. Natural is everyday activity. I have spoken personally to Joe from Team Type 1 as well as 2 others. What we do as cyclists is much more than the normal guy who goes to work and then sits at home watching TV.

The research I was referring to is that nobody can tell me what percentages I could expect to reduce my insulin. At the Tour de Cure, only 3 of us who rode the century were Diabetic. I have read on Team Type 1 website that they have begun actual research on athletes in endurance sports who have Diabetes. Hopefully soon there will be more information that gives a more broad idea of how to adjust insulin when one's own doctor can't tell them anything.

I just want to see more information out there. Everything I have seen this far was the same stuff they tell us to do daily. It really hasn't helped much. Sorry if I come off sounding short, this is something I am passionate about since I have been a Type 1 Diabetic from the age of 13. It is a personal battle to prove that we Diabetics can do the same things as those without with the right dedication and information available.

 

So? I was an insulin dependent diabetic for 27 years. I complete centuries and longer rides in that time, doing a perfectly natural activity, i.e. cycling, as non-elite athlete. It is absolutely wrong to consider that just because the majority of people don't do something means that something is unnatural. Most people don't exercise or exercise enough. By your reasoning that means that exercise must be an unnatural activity, which is, of course, absolutely wrong. Moreover, more people ride bicycles than you think. According to the League of American Bicyclists (apparently the latest data they have 27.3% of the population over the age of 16 rode a bicycle at least once during the summer of 2002. It's fair to assume the actual is higher if you include children and information from the latest year (number of cyclists has increased since 2002). Just because no one has told you by what percentages to change your insulin dose for cycling (or long distance cycling) doesn't mean anything. First, given the variability of human metabolic rate, insulin sensitivity, immune response, percentage of adipose tissue, and etc, it's highly unlikely that anyone will ever be able to say with any precision how much your insulin dose should be changed for cycling. Christ, there's nothing exact about defining insulin dosing for inactive people or just regular Joes and Josettes going through their daily lives. Dosing is titrated through observation of the results of different dosing. Maybe once in a while someone is given an initial dosing level that is perfect for them, but that is very likely the unusual case. Sure cycling is more than the average person does. So what? That's obvious, and anyone who's watched the news, read a paper, or got their news online knows that. Golfing is more than the average person does. Walking is more than what several million people do. It's only cycling we're talking about. It's not like we're discussing climbing K2 solo without oxygen on a new route. Cycling is an activity that is well accessible for a great portion of the population.

 

You know, you have a way of making someone's accomplishments sound meaningless. You obviously have no idea what I am saying. There is no iformation out there that answered my questions. It has been a long and experimental road.

 

Welcome to the club. Someone should have pointed out explicitly that there weren't any exact answers. I wasn't addressing your accomplishments but rather the idea that riding a bike is unnatural and doing so for some extended distance makes us elite athletes. To me, that's wrong-headed and completely distances some from the important idea that cycling is perfectly accessible by a great portion of society, and that portion of society should and does include insulin dependent and non-insulin dependent diabetics. After all regular exercise is fantastic for regulating the life and health of diabetics. I've done El Tour de Tucson (109 -111 miles, depending on the route in a given year) several times. One thing driven home by finishing that distance just like 3-4000 other people each year is that a lot of people can do it. Also such a ride with so many people has reinforced the golden, olden chestnut that no matter how bad someone's got it, there are likely a lot more who have it worse. You read to much into things if you think anyone has, to date, made your accomplishments seem "meaningless".

 

I didn't say cycling was unnatural. I said riding 100 miles was, just like running a marathon. If it wasn't, there would be countless others doing it all the time. Tons of people can gonout and ride a bike right now, but only a small percent can go out and ride 100 miles or run 26.2 miles right now. It takes someone at a higher level of physical fitness to do that. Those of us that do it often don't think much of it, but I am sure there was a day for all of us that we said, "100 miles? Yeah right...lol." Now I know I can do it and encourage others who thought like i did realize how possible it is. I try to help those in the same boat I was and have the same questions.

 

Simply put, you're dead wrong. It is not "unnatural" to ride 100 miles. You must be using some really screwed up definition of what "unnatural" is. You really need to get out more and see what other people around the world are doing. Cycling 100 miles or so is apparently so unnatural that between now and the 22nd, there will be 13 centuries and 3 multi day rides over 350 miles. That's just from one list, and that's just covers one summer weekend. Yes, it must be totally unnatural because so many of such events are happening just this weekend. Yep. Heck, by your definition, it must be unnatural to be a physicist since so few people get such degrees. "Unnatural" ≠ "A challenge for some". A challenge for some is what a century is.

 

Given that this years Death Ride - 125 miles, 15,000ft of climbing over 5 high Sierra passes - had 3,000 riders, one could say that whilst a 'regular' century is a good goal there are 3,000 folks that sign up within hours of the entry opening six months prior to the event itself that would beg to differ at your verdict of 'unnatural'.

The Furnace Creek 508 - that shit is unnatural... 508 miles, 35,000ft of climbing across 10 passes going from near LA, across to Death Valley (and below sea level) back up over 5,000ft and back towards LA. Nuts. Stupid hard. Unnatural, bordering on just plain wrong. That you need two support crews for each rider to monitor the riders progress over the day and a bit of riding (no sleep) during Death Valley heat and wind gives this ride an A+ on the 'unnatural' ranking. It's almost the Badwater marathon of cycling. (both events are held in and around Death Valley)

Maybe our definitions are different but I see unnatural as an event that really fit riders are pushed to their limits. Events that aspire kids to dream and pin posters on their walls of, events that even good club cyclist will initially think "screw that" - those are the unnatural events.

Even an event like the Death Ride, whilst being a hard day out on the bike for even the fast lads, can, with careful pacing on the hard sections, be completed by a regular club cyclist and therein lies the difference...


I reckon if you do lose a bit of weight and keep the triple on you too could complete an event like this next year, should you so chose.

Take the above rides big evil brother - the Alta Alpina Challenge:



Long? Yes. Hilly? Hell yeah. Challenging? Damn right. Unnatural and beyond the realms of a fairly fit guy? No. Pacing, feeding, sticking to "the plan."

Once you do 100 miles and can finish in good condition, you've reached the point where you've figured out a working pacing/feeding strategy. If you hadn't figured that out then you wouldn't finish 100 miles in reasonable condition. From there it's mostly a mental thing. Can your head deal with 200 miles? 300 miles? If it can then you'll most likely finish the ride - tens of thousands of Brevet and Audax riders prove that each year as they do events of 600km in distance. Many thousands do 1200km rides - that's almost 800 miles with minimal rest. Some of the guys that I rode a recent 600km with are far from what you'd call "fit", myself included. I'm basically a 140something pound guy with 30+ pounds of beer ballast around the waist but give me a course profile and the time limits required and I'll figure out a pacing strategy and make it happen. If the required pacing strategy says you gotta go faster than what you deem comfortable with then you show up and do what you can based upon pacing that'll get you through the 'hardest' cutoff point on the route. Even if you don't make it it's not a complete failure. If you rode to a schedule you then have some data to go off for the following year.

Just across to a point of contention from your other thread. Gearing. I think that you're dead wrong on your thoughts on gearing and would be well served by keeping your triple, using the small ring when required and dealing with the negligible weight difference. You'd be far better off keeping your current cranks and taking your better half out to a really nice restaurant instead. You never hear of riders complaining they never used their bottom gear - but that third climb on the Death Ride, the first climb up Ebbetts pass, you'll see those that mashed a 34x27 up the bottom of the first climb of Monitor pass at speed, zig zagging across the road and sitting in the shade on the steeper section - you'll hear riders complaining that they don't have a low enough gear. Pacing and gearing... pacing and gearing...

Go out, have fun, ride... You know how to do a century - you've done it before. Apply what you learned of the first one and take that bit of confidence with you and make the second ride a success too.

 

So, where in nature can I find a bicycle? Do those grow on trees or a bush?