Shredhead757

I think I prefer the word “remission” to “reversed, as reversed is assumed by many to mean cured. I am very heartened to hear that you have pulled it off, with your T2 diabetes now in remission. I will keep at it. I am still apprehensive about re-introducing carbs during cycling events. I guess that after a few weeks any stored sugars in my liver will be gone from my system. Thanks for your advice. Are you now able to conduct long distance low intensity rides, purely on Keto fat conversion and water? Do you consciously need to keep a certain amount of body fat and fat intake to make this work, or just keep on with a low-carb diet, which naturally has fat, protein and fibre?

Jughed

I fought the no carb during cycling fight for the better part of two years, so I understand your apprehensions.

Had good days and bad. The good outweighed the bad. But, say you were on a long ride and got smacked in the face with a stiff headwind - you would have to slow to a crawl to stay in the low intensity zone, or you would blow up. Or if you had to outrun bad weather, or needed to get somewhere in a hurry - just couldn't do it.

Nor could I ride anywhere hilly, or in the mountains.

You had to walk a fine line between easy and hard. And after 3-4 hours riding carb depleted - it was easy to blow up after even the shortest effort or hard pull.

I can do long rides with no carbs, or even food for that matter, but I'm completely limited to Zone 2 or lower.

Adding fat - never did it. I just eat whole foods.

Stored fat? Even the leanest athlete has 100's of thousands of stored fat calories. No need to add fat to the body...

The hardest part of the entire deal is teaching the body to become effective/efficient at burning fat. This takes a long time...

Carbs consumed during the ride will be burnt during the ride and even "keto" experts recommend targeted carbs for athletes. At least for me, these added carbs cause no harm or issues with the treatment of my T2.

PeteHski

Unless your body fat level is dangerously low, then rest-assured you will have enough fat reserves to ride for months. Whether or not you can utilise it is another question, but I wouldn’t worry about having enough stored fat available. Any fat you consume during a ride is not going to help fuel it.

PeteHski

It’s certainly not my field, but IIRC carbs burnt during hard exercise don’t require insulin for metabolism. That’s probably a massive over-simplification, but I do know that blood sugar spikes are much lower when consuming simple carbs on the bike vs on the sofa. I’ve tested that for myself with a blood sugar sensor. Note that I am not diabetic so I have a normal tolerance to carbs. But I do try to avoid simple carbs off the bike.

Jughed

Most T2's make insulin, plenty of insulin - they just don't process it very well. Insulin resistance is the issue at hand. (which diet and tons of exercise can fix/heal the body over time, reducing the IR and putting the T2 into remission)

When you are keto/low carb and your body is extremely low on stored glycogen - adding light to moderate carbs during exercise, carbs that will get burnt up, will not cause high blood glucose spikes or any ill effects on your A1C.

And short-term BG spikes are not optimal, but they are not what kills the T2 person. Repeated high spikes and constant high BG's that result in a high A1C and higher than normal levels of circulating insulin are the long-term culprits.

In short, eating some goo while on a 4 hour bike ride will not hurt the typical T2 person. The 4 hour bike ride is doing far more good for the person than the little bit of goo does bad...

Not to go too deep into this but... my A1C was 12 and average BG's were 3-400, all day, every day.
-Keto/low carb got those numbers slowly under control right out of the gate.
-Low and slow exercise coupled with weight/fat loss, over the period of 3+ years, helped heal the body and lower insulin resistance.
-Now I** can eat a carby meal and maintain completely normal BG levels. I don't do it often, but can do it... and carbs for exercise have zero ill effects.

**Not everyone can do this, every case is different. But the majority of T2 people can do this...

Clyde1820

In the long run, for "general" (as opposed to high-perf or racing) efforts, I've found that good ol' trail mix can work well. Each body is a bit different in terms of how efficiently it'll process things, but I've found a handful of such periodically over a hard run or ride helps. I've rarely done higher-carb type gels, bars and whatnot, even back when I was doing lots of performance-oriented trail running. The longer-lasting, higher-fat and -protein alternatives seemed to do well enough. Even nearly marathon distances (running) didn't often require much more than that.

The nice thing about trail mix is that it's simple to make at home, in whichever combination a person finds works best. Nuts, seeds, dried fruits, granola, carob nibs. In the "right" combinations, occasional munching on a handful of such stuff can help a person last much longer than otherwise.

PeteHski

I suppose what the fat does in that scenario is help to damp down the blood glucose spike from the carb part of the mix. But it is still the carbs providing the fuel.

MoAlpha

True and I can provide a little more detail. During exercise (and for some period afterward), muscle uptake of glucose shifts predominantly to the Glut1 transporter which does not require insulin to work. This is in contrast to glucose uptake under anabolic conditions (i.e., on the couch), which is predominantly Glut4 transport dependent and requires insulin. Glut4 transport gets messed up in T2DM. Glucose spikes after eating are normal during exercise and rest, what's not normal is when glucose stays high longer than normal because of insulin insensitivity.

There is no point in consuming fat during exercise other than to satisfy hunger, since any healthy athlete has more than enough mobilizable fat stores to supply energy needs. Protein has no role in fueling, at least over cycling timescales, since converting it to energy substrate is energetically costly on its own and the body has more than enough protein stores to burn if it comes to that. That said, fat and protein are essential and one might as well eat them on bike under non-competitive conditions.

79pmooney

A small carb source but excellent ride drink is Vitalyte. Primarily a hydrolyte replacement drink, it contains glucose and fructose. (11 grams total per scoop. They pitch 2 scoops/pint. I've been using 2 scoops /WB forever. (Not really; just 50 years.) Edit: the point of this is that there is a good sport drink that goes a long ways in keeping faster lowish carb rides doable and the rider in good shape and uses much better sugars than the usual sucrose, dextrose and the recent inventions.

The stuff was formulated to be an excellent electrolyte replacement and to go down fast and stay down. I can drink 1/2 a WB in two slugs with no issues. (Fix gears in hills - drinking opportunities can be scarce. Doesn't happen out of the saddle or at 200 RPM.) Another place I drink it is when I have stomach bug. When I know whatever I swallow is coming back up. What does get absorbed is really good for sick people. What comes up taste decent. It's cheap. (Maybe 25 cents a scoop.)

The stuff was formulated by a biochemist marathon runner who got sick and failed to finish the very hot Olympic qualifier drinking Gatorade. Went about creating a better drink. 1970 or so. Got it right. Never made it big. Never sold out. '80s, '90s and big money sports drinks hit the scene. They gave up trying to compete for bike shop shelf space and focused on providing the stuff for third world relief workers who used it to help with severe dehydration from dysentery, cholera, etc. REI (and I) rediscovered it early '00s. REI goes on and off with it but the company is rock solid, on-line, quick, easy. The stuff has never changed and works as well as it did 50 years ago. I often bring the powder on supported rides and always do if I know it will be Gatorade. (Heed works OK for me but is a lot less pleasant to drink. Those "Fizzies" (I think that's what they are called), the tablets in foil envelopes are good and not very different from Vitalyte.

No, I am not a shill for Vitalyte. Just spreading the word because more demand means it will be easier for me to find. And I feel selfish knowing this and seeing so many using lesser drinks or spending far more. (And maybe the organized rides will go with it and improve my experience. Though probably not. I suspect ride electrolytes are given to the rides free as advertising. Something the much smaller Vitalyte probably will never do.)

Lucillle

Oatmeal with cream and blueberries is a relatively lower glycemic slow release fuel.

Calsun

Low carbs will result in your body scavanging muscle tissue which is not good. The way to lose weight is to balance your total calories (carbs, fat, and protein) taken in by the amount burned over time. Look up recomposition for more information.

I avoid ultra processed package snacks of any kind. All I consume is water and dried fruits and nuts while riding any distance and eat a high carb breakfast which is easy to digest a high carb diner for fuel the next day. I have been making my own carob brownies for the past 45 years and it is still a great recipe using carob powder, soy flour, rice polish, wheat germ,bone meal, brewer's yeast,dry skim milk powder, honey, and peanut butter. I like to know exactly what is in anything I put in my mouth.

Carb loading became popular for racers many years ago.

RH Clark

It is my understanding that some muscle could be lost after extended fasts, but the body will not simply choose to burn its own muscle rather than the fat it stored for the purpose of having fuel. Why would the body even store fat if it couldn't use it as fuel?

What causes muscle loss is sudden reduction of calories combined with reduction in muscle activation. The body will reduce muscle mass when it is viewed as unnecessary in this situation. Loss of muscle mass can be greatly avoided by continuing to work all those muscle groups.

MoAlpha

As long as caloric requirements are being met with fat and/or protein, carb restriction won’t cause muscle loss. If they’re not, then what happens to muscle is a function of the depth of the energy deficit, protein intake, muscle growth stimulation (e.g. resistance exercise) and other factors.

RH Clark

I don't disagree with that statement, but muscle doesn't necessarily have to be lost to reduce body fat, although it often is.

MoAlpha

Of course this is possible, but not when the energy deficit is deep enough.

Polaris OBark

Ethanol.

(I got in trouble in high school gym class for pointing this out, but it is right, not that it is advisable.)

Shredhead757

My main concern is that because of the ineffectiveness of the conversion of sugars into the blood cells, due to insulin resistance, will there still be excess sugars building up in the bloodstream, which the the body will be unable to covert and also sugars getting stored in the liver for later? I guess there’s only one way to find out. I know that I struggle (unsuccessfully) to keep my blood sugars in spec on my smart trainer if I am using carbs as fuel, no matter how hard I ride. Admittedly I do not do 100 miles plus events on my smart trainer, just too boring and to painful on the backside. In real life you are in and out of the saddle all the time.

PeteHski

Post #33 might be applicable to this. I guess the thing to check is your blood glucose a couple of hours after exercising to see if it remains high. Is that the problem you get using carbs on your trainer?

RH Clark

What happens if you simply choose not to consume carbs? Do you get so weak you can't perform? Does your blood sugar get low? In your situation I would be more concerned about reversing insulin insensitivity than logging a few more miles on the bike. Think of insulin insensitivity as an addiction.

When anyone is addicted to a drug, they develop a tolerance over time, and it takes more and more to have the same effect. When blood sugars are raised often and high from high glycemic foods the body has to use more insulin more often than what is healthy. The body develops a tolerance to insulin. The cure is to gradually decrease the need for insulin by eating lower glycemic foods and prolonging the duration between consumption.

The difficult part is that because you need more insulin than necessary, the massive insulin dump drops your blood sugar lower than healthy causing weakness and hunger. Blood sugar can become a roller coaster of extreme highs and lows. IM fasting combined with lower glysemic foods will reverse the condition over time, but it takes a while.

Shredhead757

QUOTE=RH Clark;23174497]What happens if you simply choose not to consume carbs? Do you get so weak you can't perform? Does your blood sugar get low? In your situation I would be more concerned about reversing insulin insensitivity than logging a few more miles on the bike. Think of insulin insensitivity as an addiction.

When anyone is addicted to a drug, they develop a tolerance over time, and it takes more and more to have the same effect. When blood sugars are raised often and high from high glycemic foods the body has to use more insulin more often than what is healthy. The body develops a tolerance to insulin. The cure is to gradually decrease the need for insulin by eating lower glycemic foods and prolonging the duration between consumption.

The difficult part is that because you need more insulin than necessary, the massive insulin dump drops your blood sugar lower than healthy causing weakness and hunger. Blood sugar can become a roller coaster of extreme highs and lows. IM fasting combined with lower glysemic foods will reverse the condition over time, but it takes a while.[/QUOTE]

Thanks for your advice. I am a serving member of the armed forces, therefore my fitness and my BMI, and my mental health are factors that I also need to take into consideration. My main concern is of course to be able to bring my T2 Doabetes into back into remission. Some 7 years ago, I embarked upon a lifestyle change that managed to maintain my blood sugars in the normal band for some 5 years, through diet and exercise. However, over a period of 2 years of a less controlled dietary regime and not having the opportunity to exercise, while dealing with some fairly serious life events, I unwittingly allowed myself to fall foul of T2 diabetes again and ended up in a viscous cycle of reliance upon diabetes medication that in the long run, just wasn’t really working for me.

I am now very much back on the wagon. I very much enjoy the feeling on a Keto diet of being back in control of my blood sugars, and not experiencing the constant carb-cravings. I now have a fairly low appetite and almost have to force myself to eat. However, I really do need to lose a substantial amount of weight, which I know will also help reduce my insulin resistance, which cycling and hill walking will help me achieve.

I tend to be very target oriented and therefore taking part in cycling sportives and military adventurous training events give me a training goal to aim for. I also very much enjoy these activities. I also find that without regular exercise I am prone to depression. I do not want to have to be dependent on anti-depressants either. So, it is not just a case of logging a few extra miles cycling, it is all part of an holistic approach to keeping myself mentally and physically fit and hopefully staying well enough to see my children grow up.

I went on this forum to try and help me understand when or if I can get away with adding carbs, and how much, ie during sportives, training rides, etc and when I cannot. I would very much like to able to take part in sportives and long distance social rides, but obviously not at the expense of my health. I do not want to be achieving record times, but I do want to be able to complete 100 mile plus events before the sweeper vans are sent round to clear up the stragglers. Perhaps I need to have some patience and understanding that my return to leading this kind of lifestyle may be a longer process this time around, perhaps because I am older now, and that some of the damage that may have happened to my cardiovascular system due to diabetes may be permanent.

RH Clark

I would prioritize losing the fat, over higher performance on the bike at present. Stay away from processed foods as most are very quickly absorbed raising blood sugar fast. Concerning damage being permanent, it doesn't have to be. Here is a good video. The whole thing is very informative but advance to about 1:20 mark and you will see images of arterial damage reversed.

MoAlpha

You might consider working with an internist (preferably an endocrinologist) who understands athletes and/or a sports nutritionist who's comfortable with T2DM and CGM data. Given the current state of military medicine, I realize this may impossible. It was bad enough back when we had it.

Here's my partially informed take: Glucose spikes (up to, say, 200) immediately after consuming carbs are okay. However, glucose should go down rapidly during exercise. If you're getting lasting high levels, remember glucose stuck in the circulation isn't fueling anything, so you should be able to back off on the carbs without hurting performance.

Jughed here seems to have the carb management thing down, at least for themself.

Jughed

That's my partially informed take as well.

The occasional spike, which otherwise healthy people are also subject to, is not a concern to overall health and longevity.

For T2DM people, its a combo of cronic high BG and insulin levels. It's a long slow process of attacking the body with, years if not decades of progressing damage. T2DM is a slow moving wrecking ball.

IMHO - exercise and properly fueling for said exercise, along with a good diet for the rest of the time, causes more good than harm. Even with the occasional carb intake.

Many of us, not all, can drastically improve our insulin sensitivity and overall health to the point of being able to eat small and even moderate amounts of carbs without negative effects.

This process took me 5 years. 5 years of strict low carb whole foods and mass amounts of low and slow exercise. Extreme weight loss came with the territory. I'm lucky that I have some pancreas function, that coupled with the all out attack I waged against the T2 - now I have some breathing room.

In the beginning, one scoop of mashed potatoes would send me into the 400's and I would have high numbers for days. Now I can fully carb up for a century ride and never go above 130.

I understand Shred's reluctance/worry about the issue. I was there for the better part of 4 years.

Now my cycling goals have surpassed what low carb can fuel - so I have to supplement, tactically supplement.

canklecat

While not quite no-carb, white potatoes are high glycemic index without resorting to sugary snacks. A bag of chips at the convenience store is a reasonable alternative to donuts, etc., if you're tired of sweet stuff.

Two or three years ago GCN did a long distance test (100 miles, I think) with Hank eating normally while riding, with Conor fasting while riding with a glucose monitor. Toward the end of the ride Conor finally tested a few snacks and they discovered a packet of chips (or crisps?) restored his blood sugar as quickly as a typical sugary snack or sports-specific snack (gel, etc).

If memory serves, sweet potatoes/yams have a lower glycemic index than white potatoes, despite being "sweeter."

RH Clark

There's plenty of research detailing how ultra processed foods damage our good gut bacteria and induce the kinds of bacteria we don't want. Food is more than just replenishing blood sugar. Protect the liver and feed the gut bacteria is a good way to look at the situation. Whole foods is the answer.