jhnbssll

I didn't realise there was a third type of Diabetes until I was diagnosed about a year ago. It stems from damage to my pancreas from a serious illness around 8 years ago and means I cant produce as much insulin as I once could. It also means my remaining pancreas is a bit unreliable; some days it'll work fine, other days it will barely work at all and my blood sugar will go up and I'll struggle to bring it down. I cant control it with insulin until my pancreas gets significantly worse or gives up entirely, which is likely to happen at some point, but until then I have to control it with meds and diet. This makes fueling on rides a bit of a problem, because I'm told by my med team to avoid carbs wherever possible and that glucose drinks are out of the question... Wondering what I should really be fuelling with given these limitations as they werent able to tell me. Given the lack of alternatives I've kinda ignored their advice in the past and done my own thing, but on the last endurance ride I tracked my sugar and noticed later that it had been pretty high for the whole 18hour event which is obviously not sustainable.

Anyway, worth an ask - thanks in advance!

John

bbbean 

I'd be reluctant to stray to far from my doc's advice, but I would ask them to refer you to a dietician who specializes in diabetic athletes. You might also reach out to the Novo Nordisk cycling team - all their riders are diabetic, and they've obviously got a lot of experience with this issue.

I reversed my diabetes through diet and exercise, so I'm fairly familiar with the factors involved, but your situation could be dramatically different, given your pancreatic limitations. Are you using a CGM? Can you monitor your blood glucose during a ride and consume limited carbs as needed (per cgm) to maintain a healthy glucose level?

jhnbssll

Novo Nordisk is a great idea, I might pop them a message!

Well done for reversing your diabetes, I know it takes some doing but definitely worthwhile! Unfortunately Type3 is not reversible - I physically lost part of my pancreas and it ain't growing back, it'll only deteriorate from here unfortunately. I'm using a Libre 2 on longer rides to track my glucose, I've got it uploading to a cloud server and sending live data to my cycling computer so that's pretty handy but ultimately once it's high there's not a great deal I can do about it which is basically the problem. If my pancreas decides to have a wobble the only way of keeping it in range is by eating no carbs or sugar until it comes back down, which isn't really an option when you're out on a bike a long way from home.

I think I'm going to need to speak to a dietician as you say - not really sure how else to approach it.

bbbean 

Good luck. It does sound like you're on top of it if you're tracking with your CGM. Out of curiosity, what do you consider high? Does it stay high throughout your workout, or does it spike and drop?
It does seem like there would be some way to calculate your carbohydrate needs for a particular exercise and consume enough to fuel the effort, but that's what the MDs, PhDs, and RDs are for. Good luck.

Alan K

Hello John,
Please follow the advise of your doctor to keep your blood glucose in as good a control as possible rather than letting things go until the damage to your insulin cells is worse and you could use insulin injections.
Type 3c diabetes (given your reference to a previous disease involving your pancreas) is more complex to manage and until recently, it was often misdiagnosed in the beginning. But depending on the reason for its onset and the extent of damage to pancreas, it is manageable. In case of severe pancreatitis, auto transplant of islets (containing cells that make a number of key hormones: insulin, glucagon, somatostatin, amylin, pancreatic polypeptide to name a few) into liver can work quite well - unlike organ transplant from unrelated donors, in case of auto-transplant of islets, one doesn’t need immunosuppressive drugs. For close to optimum health, one needs to protect the remaining islets - talking insulin alone is not quite enough.
If you are not confident about your current doctor’s diagnosis or his/her abilities to manage your disease, it may ba good idea to see a good endocrinologist.
Best wishes,
Alan

Jughed

As a T2 with limited pancreas function and a prior high level of insulin resistance (now in complete remission minus the pancreas issues). Starting A1c was 12+, average blood sugars 400+/-.

Carbs raise blood sugars - all carbs - and insulin is required to control the BG levels.

Eliminate the carbs, and you essentially eliminate issues with high BG's and the need for (extra, added) insulin or the body spiking insulin. This goes for just about every human, regardless of diabetes. Some, like T1 or T3 may still require insulin - but they will need much less than someone on a standard diet.

I started cycling, very slowly with limited duration, while in ketosis. It took a long time to work out the bugs, had many bad days on the bike - but as I got deeper into ketosis, more fat adapted, I could essentially ride in Zone 2 (lower intensity) all day with no food.

Low intensity exercise runs on fat energy. The longer you train at these levels, the better you body adapts. The longer you eat a "keto" diet, the better your body adapts.

Zone 2 also repairs your body at the cellular level, allowing energy transfer in the muscular system - getting the glycogen out of your blood and into the muscles.

Higher intensity levels, above Zone 2, and the body begins to burn carbs. Without carbs added, you will bonk if you go higher more than once or twice on a ride.

4+ years now and I still eat a clean, whole foods low carb diet. I only have to supplement with small amounts of carbs to fuel high intensity training sessions. I typically consume about 1/3 the amount of carbs in the "training" guides say I should - and I can complete my intervals or hard rides without bonking. And I only eat these carbs before/during/right after intense or long sessions.

Doing this for 4 years put my T2 into complete remission - I can eat just about anything I want now and not have any high BG events. But I don't, because remission isn't forever...

As a T3 you have different concerns - but making the body more insulin sensitive, limiting carb intake, making your body more fat adapted - all good things for all diabetics.

bijosepke

Wow, I wasn’t aware of a type 3 diabetes until now! Thanks for sharing this information, @jhnbssll!

wilas

I haven't even heard about Type 3 diabetes, though I have several family members with Type 2. My grandmother was recently diagnosed with diabetes, and I want to understand more about it so that I can help her successfully. So far, she is doing fine, because we often consult with doctors and know that we have all the necessary meds that she needs. In addition, we read information about everything we need on the Canadian Pharmacy Partnership, so grandma feels ok and I can be more relaxed.
I understood you can't take insulin and need to manage the condition with diet and meds. But do other people usually use insulin for this tyle of diabetes? Is it similar to Type 2?

MoAlpha

Type 3 diabetes is a bad term with two totally different meanings. The term is most commonly used to refer (with questionable accuracy) to the disorder of brain energy metabolism which accompanies Alzheimer disease. The term as used by the OP refers to any kind of pancreatic damage, other than the immune process resulting in type 1 diabetes, that impairs insulin secretion. This disorder is treated in essentially the same way as type 1, with insulin.