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Diet controlled diabetes & cycling

Old 06-11-19, 10:29 AM
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medic75
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Diet controlled diabetes & cycling

I am hoping there is a similar person here who can offer their experience.

I was diagnosed with diabetes years ago, but nothing serious. The doctor prescribed metformin & I took it, continuing to eat a very unhealthy diet. Finally my body gave up and my blood sugar went through the roof. For those who know what it means, my A1C was 11.8. This scared the crap out of me and forced me to change my eating habits. A much healthier diet & 75 lbs later, I am off of half of my medications, my cholesterol levels are great, and my blood pressure is a step away from being completely off that medication. The more important part is that my A1C was 5.4 at my last MD visit.

Now, on to my problem. I changed my diet on my own. My doctor had all but given up on me and admitted he had planned on putting me on insulin at the 3 month visit following the A1C level of 11.8. My diet change is what prevented that from coming to fruition. The doctor was astonished when I returned after 90 days and his exact words were "I don't know what you're doing. I don't want to know what your doing. Just keep doing it because it is working." What I was doing consisted of completely cutting out simple carbs. I eat almost nothing with added sugar. I do not eat bread. My meals consist of vegetables & meat with some high fiber / low net carb flat breads mixed in. I do eat some occasional popcorn because I have convinced myself that it is whole grain

When cycling, I can go for hours at a slow & controlled pace. If I climb a hill or start to push myself at all, my legs begin to burn and I can only go so far before I have to stop for a break. After a couple of minutes I am good to continue for a short period until the same thing happens. This is common until I get back to flat ground or begin to ride at a more leisurely pace. I am wondering if this is due to my lack of carbs. Can diet controlled diabetics consume small amounts of simple carbs (30 grams per hour) during rides without any ill effects? Is it possible that I am just weak?
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Old 06-11-19, 01:52 PM
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I don't have any information to add, but congratulations on controlling it on your own!
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Old 06-11-19, 02:14 PM
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FWIW, I lowered my A1c from 9.something to 4.9 through diet and exercise, and have been there consistently since 2013. **What works for me** is a moderately low carb diet off the bike (25-30% carbs), and a normal diet before and/or during rides (40-60% carbs). On race day, I carb load like anyone else (lots of yogurt, fruit, gels, etc), but return to my regular diet after I've had a good recovery snack/meal.

I also dropped a lot of weight in the process, which contributed to my ability to maintain normal blood chemistry.

Assuming you are within your doctor's guidelines, there is a lot of trial and error to figuring out what works for your body and your exercise regimen. Be assured, however, that it is possible to reverse diabetes and get the on bike performance you would like. It'll just take some work.

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Old 06-11-19, 04:12 PM
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It's my understanding that simple carbs you take in during sustained exercise are burned off immediately, and don't effect the stuff you care about because of it.

But I'm just some idiot on the internet. This really seems like a conversation to include your doctor in.
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Old 06-11-19, 04:18 PM
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Originally Posted by Seattle Forrest View Post
It's my understanding that simple carbs you take in during sustained exercise are burned off immediately, and don't effect the stuff you care about because of it.

But I'm just some idiot on the internet. This really seems like a conversation to include your doctor in.
Initially, you can learn A LOT by testing yourself before, during, and after exercise as well as meals. That was my primary way of figuring out which foods spiked my blood sugar and which ones just gave me available energy.

Sounds like the OP is talking to his doctor, so the advice here is just from others who've been there.
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Old 06-11-19, 05:06 PM
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Originally Posted by Seattle Forrest View Post
It's my understanding that simple carbs you take in during sustained exercise are burned off immediately, and don't effect the stuff you care about because of it.

But I'm just some idiot on the internet. This really seems like a conversation to include your doctor in.
Yes generally there is not an insulin spike after glucose ingestion during evercise for a normal healthy human being, or at least the spike is very small and short. With type 2 diabetes things get a bit trickier because of the insulin resistance the patient has developed, so yes a discussion with a doctor is key. Also if your goal is to use exercise to reduce insulin resistance then avoiding carbs even during exercise and simply keeping intensity down is a better strategy long term until you've cured your T2D
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Old 06-11-19, 07:42 PM
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Thanks for the help.

Unfortunately, I haven't really involved my doctor in many of my decisions. I switched doctors a couple of years ago when my original doctor moved out of the area. I currently see a nurse practitioner who I used to work with. As a rule, I meet with her twice a year to get my meds refilled & get blood work ordered. I tell her what I am doing and what I have changed and she agrees with my decision. I will admit that I have never told her that I want to re-introduce simple carbs into my diet and I don't know how she would respond to that idea. I did steal a few Jolly Ranchers from my son before tonight's ride. It was a 17 mile loop with 1,200 ft of elevation change and 800 of that climb was in the first 3.5 miles. I think the sugar may have helped, but I can't be sure. I will pick up some gels from my LBS next time I stop by.
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Old 06-11-19, 09:36 PM
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I am convinced that most doctors only have a general knowledge of diabetes treatment. I would suggest you locate a person who has elected to focus their career, in part or full, on diabetes. I would also suggest you share all your information about your health
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Old 06-12-19, 09:01 AM
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Originally Posted by debade View Post
I am convinced that most doctors only have a general knowledge of diabetes treatment. I would suggest you locate a person who has elected to focus their career, in part or full, on diabetes. I would also suggest you share all your information about your health
This. Look, doctor's are smart but there simply is too much information about the human body for any one person to be an expert at everything. Fueling strategies in a long endurance activity, and how the relates to diabetes, isn't exactly common knowledge. Your typical general practitioner isn't going to encounter this very often. Go see a specialist if possible.
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Old 06-12-19, 03:41 PM
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OP needs to talk to a registered dietician or a nutritionist who has experience in sports nutrition and diabetes.
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Old 06-12-19, 04:03 PM
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See an endocrinologist. Plus... my partner, who is type 1.5 (yes that is a thing, think a really slow onset type 1 in adulthood) needs something like porridge in the morning when we tour. High carb but low GI so slower release, then regular snacks, sometimes I have to make her eat, because she doesn't feel hungry.
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Old 06-14-19, 04:42 PM
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You've seen these cyclist??.............. https://www.teamnovonordisk.com/spor...s/racing-tips/
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Old 06-14-19, 05:25 PM
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Originally Posted by Iride01 View Post
You've seen these cyclist??.............. https://www.teamnovonordisk.com/spor...s/racing-tips/
Those athletes have type 1 which is not what the OP has, with proper insulin dosing an athlete with type 1 can eat as much sugar as they can handle because they do not have insulin resistance
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Old 06-14-19, 05:32 PM
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Originally Posted by redlude97 View Post
Those athletes have type 1 which is not what the OP has, with proper insulin dosing an athlete with type 1 can eat as much sugar as they can handle because they do not have insulin resistance
So absolutely nothing about dealing with type I diabetes and cycling applies to type II?? I'm just curious because all my life people have told me I was a candidate for type II later in life. 60 plus years so far and it's not come true yet. However I casually try to take some interest in such discussion.
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Old 06-14-19, 05:38 PM
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Originally Posted by Iride01 View Post
So absolutely nothing about dealing with type I diabetes and cycling applies to type II?? I'm just curious because all my life people have told me I was a candidate for type II later in life. 60 plus years so far and it's not come true yet. However I casually try to take some interest in such discussion.
There is very little overlap, and they really shouldn't have been given the same name at all. Type 1 is a autoimmune disease that comes about from destruction of your insulin producing beta cells but the rest of your cells are fully functional and respond well to insulin, type 2 you have a mostly functional pancreas that produces normal ranges of insulin but the rest of your cells have become resistant to it, so you can't just give more insulin which has genetic components to risk but is mostly due to poor diet. Type 2 is also curable in most cases with extreme limitation of carbs/sugars so the cells lose their resistance.
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Old 06-14-19, 05:45 PM
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Originally Posted by redlude97 View Post
There is very little overlap, and they really shouldn't have been given the same name at all. Type 1 is a autoimmune disease that comes about from destruction of your insulin producing beta cells but the rest of your cells are fully functional and respond well to insulin, type 2 you have a mostly functional pancreas that produces normal ranges of insulin but the rest of your cells have become resistant to it, so you can't just give more insulin which has genetic components to risk but is mostly due to poor diet. Type 2 is also curable in most cases with extreme limitation of carbs/sugars so the cells lose their resistance.
Interesting... I'll certainly quit pointing at them for Type II dealings.
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Old 06-14-19, 11:26 PM
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Another way of dealing with insulin resistance besides starving (literally) is an increase in lean muscle mass. New muscle tissue takes years to become insulin resistant. I don't know that once resistant, that cells can ever lose that resistance. Until they die. That takes years, with or without any change in diet. A muscle cell has a lifetime of 15 years. I am not saying that a low carb diet is the wrong strategy but I don't believe one can 'cure' diabetes this way. Only control it. But if one were committed enough and moved enough heavy iron in the gym to make a physically noticeable difference in their body size and mass and they kept their intake of simple sugars and complex carbs relatively low it would be purely semantics as to whether or not the person was 'cured'. To the o.p. ... I don't know ... when I read "If I climb a hill or start to push myself at all, my legs begin to burn and I can only go so far before I have to stop for a break." I don't automatically think that this has anything to do with your diabetes. All muscles do this when they go anerobic and lactic acid builds up in the muscle fibers. I am not convinced that adding in carbs will fix this problem. But if you want to try it. Try it. It's all well and good the well meant concern expressed here by others but ... ... just saying ... 11.9 A1C ... that didn't kill him. I doubt some experimenting with carb intake on long rides is going to do him any harm. It just may not do any good. More training on the hills (and weight training in general) will increase the legs ability to work longer before fatigue sets in.
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Old 06-15-19, 01:40 AM
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Originally Posted by Leisesturm View Post
Another way of dealing with insulin resistance besides starving (literally) is an increase in lean muscle mass. New muscle tissue takes years to become insulin resistant. I don't know that once resistant, that cells can ever lose that resistance. Until they die. That takes years, with or without any change in diet. A muscle cell has a lifetime of 15 years. I am not saying that a low carb diet is the wrong strategy but I don't believe one can 'cure' diabetes this way. Only control it. But if one were committed enough and moved enough heavy iron in the gym to make a physically noticeable difference in their body size and mass and they kept their intake of simple sugars and complex carbs relatively low it would be purely semantics as to whether or not the person was 'cured'. To the o.p. ... I don't know ... when I read "If I climb a hill or start to push myself at all, my legs begin to burn and I can only go so far before I have to stop for a break." I don't automatically think that this has anything to do with your diabetes. All muscles do this when they go anerobic and lactic acid builds up in the muscle fibers. I am not convinced that adding in carbs will fix this problem. But if you want to try it. Try it. It's all well and good the well meant concern expressed here by others but ... ... just saying ... 11.9 A1C ... that didn't kill him. I doubt some experimenting with carb intake on long rides is going to do him any harm. It just may not do any good. More training on the hills (and weight training in general) will increase the legs ability to work longer before fatigue sets in.
https://academic.oup.com/jcem/articl...5/1596/3070517
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Old 06-15-19, 02:07 PM
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Seriously, who is going to read all that?! What is the TL;DR? Does it matter? I notice, right from the first line, they say "remission". What is the definition of "remission"? I stand by my earlier remarks.
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Old 06-15-19, 02:53 PM
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466941/
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Old 06-15-19, 08:09 PM
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Originally Posted by medic75 View Post
Is it possible that I am just weak?
It looks like this may be at least a portion of the issue. I am not a racer, so I do not necessarily need to go full on with a high carb diet prior to rides or during rides. It just seems to me that I am running out of steam pretty consistently regardless of what I do when it comes to climbing on longer rides. This is a very short term issue - as I can be back in the saddle & climbing again after 2-3 minutes. This just got me to thinking that I am literally running out of energy and that few minutes allowed my body to catch up by breaking down some body fat. A little experimentation can't hurt as long as I don't do too much.

There is a local dietitian who also cycles regularly (and can run circles around me). I may consult with her if I don't start seeing some minor changes.
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Old 06-18-19, 08:15 AM
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Originally Posted by redlude97 View Post
Those athletes have type 1 which is not what the OP has, with proper insulin dosing an athlete with type 1 can eat as much sugar as they can handle because they do not have insulin resistance
There's also type 2 divisions of athletes in the TNN and TT1 organizatons. I'm still sure they'd be willing to point people in a helpful direction.

https://www.teamnovonordisk.com/teams/type-2

Worth a shot if you're a diabetic in the cycling world to reach out to either the TT1 or TNN organizations whatever type of diabetes you may have.
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Old 06-18-19, 11:56 AM
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Originally Posted by medic75 View Post
... This just got me to thinking that I am literally running out of energy and that few minutes allowed my body to catch up by breaking down some body fat. A little experimentation can't hurt as long as I don't do too much.
...
You never told us your diet that is controlling your diabetes, is it low or no carb?

I'm not a doctor or a dietician, but if you are in ketosis - nutritional ketosis, NOT diabetic ketoacidosis - then you are burning fat and making ketones for fuel. Once you are adapted to exercise on ketones you should be ok for normal riding (or so the ketosis guys claim).

If you are eating carbs, over a very minimal level, you are not in nutritional ketosis. Instead of running on ketones, your body is using the minimal amount of carbs on board for fuel, and then running low on fuel for hills.

If you are eating carbs, I can't advise you to go to ketosis since I'm not your doctor. But some diabetics have used that diet with success. Do your research and talk to your doctor.

Personally, I eat low carb when I'm not riding, but eat carbs on days I ride, including some Gatorade and gels during a ride. I know I'm not in ketosis since I bonk (lose energy) if I don't fuel with carbs on a hard ride.
Recently I'm trying to cut down on carbs and sugar, and I plan to try a corn starch and maltodextrin mix in my water bottles for fuel instead of the Gatorade and gels
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Old 06-18-19, 11:59 AM
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Originally Posted by burnthesheep View Post
There's also type 2 divisions of athletes in the TNN and TT1 organizatons. I'm still sure they'd be willing to point people in a helpful direction.

https://www.teamnovonordisk.com/teams/type-2

Worth a shot if you're a diabetic in the cycling world to reach out to either the TT1 or TNN organizations whatever type of diabetes you may have.
didn't realize that, only followed the pro team for a bit since I do research on type 1. That is a great resource
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Old 06-18-19, 12:39 PM
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Originally Posted by redlude97 View Post
didn't realize that, only followed the pro team for a bit since I do research on type 1. That is a great resource
I've no idea how up to date they keep those websites and respond, but at our corporate website I see stuff scroll across all the time of some Type 1 or Type 2 patient or employee around the world in a bike kit doing something inspiring. Sometimes I see triathletes or cross country skiers also shown.

I'm not diabetic, but it's how I got into riding bikes. I have nothing to do with TNN or TT1, but I wear the kit around to show support or promote conversation if someone notices.

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