wyd

So I just got back into riding since I'm diabetic and was wondering what every one does to keep there sugar from getting to low while riding or exercising in general. Do you guys eat something special or drink something special before or during your rides to keep the sugar levels from getting to low? I'm new to this diabetic thing and keeping the sugar up while biking/exercising. Sorry I should of posted that I'm Type II diabetic.

Barry2 

My Garmin estimates calories (just being alive) + calories (for the activity) = total calories.

I use prior activity calories to estimate what my intake should over the duration of an upcoming activity.

edit: Costco Fig bars are 200cal/pack & SIS gels are 90cal.
The Bars are slowish acting, the gels are (100% maltodextrin) like quick, 5-10min acting.

edit edit: I’m type II
Barry

Iride01 

Type I or Type II? Likely makes a difference in how you have to approach the issue. All the stuff I've ever casually read about it says to monitor your blood sugar more closely. There use to be or still is a pro cycling team that is comprised of diabetics. Which type I don't know.

google, bing or yahoo can be your friend for finding out more info. But probably should run some of what you read by your doctor before you go to far with it.

Fredo76

I'm type II, and I don't take any medicines that directly lower sugar, except long-acting insulin at night. I've never had hypoglycemia while riding, but my longest rides are only about 3 hours. I don't even carry any food items, usually, except for those longer ones, and then just a banana.

The meds you take and the timing of them might make your situation different.

Leisesturm

This will sound snarky but it isn't meant to be. Diabetes has an onset of 10 years. No one is ever 'new to it'. If you want to increase your activity level to burn additional calories that's a good thing. So burn away. You'd have to be on some kind of Century (100 miles) event to be in such a big calorie deficit to have to worry about blood sugar levels. So don't. This advice applies to people treating their Diabetes with diet and exercise. If you are on medication then you also have been given glucose tablets or have been advised to keep sugar candy close at hand. Follow doctors advice and you'll be fine.

elcruxio

Typically I try to not add any boluses a few hours before setting out. Right before I set out I eat or drink some quick carbs like a coke, skittles or non alcoholic beer etc. and put my pump on exercise mode.

During rides I'll monitor my sensor occasionally to see where my blood glucose is heading.

During short rides I'll have a few backup gels and some juice concentrate with me and use those if needed. It pays to make adjustments well in advance as the sensor has a delay.

for long rides I'll take bigger 100ml gels and a full bottle of juice and I'll eat / drink every 30min or so. Bolus when needed. Typically on longer rides some bolus insulin is required.

Before I had a sensor I learned to measure glucose while riding.

Type 1

Pratt

IIRC, there was a journal a few years ago by a cyclist with an insulin pump doing a transcontinental ride. Maybe the Bikepacking blog?
Also, some posters on CGOAB are diabetic, I don't know whether type I or II.
Bet a thread search here, there, and on Adventure cycling would turn up some useful leads.

Barry2 

I've not found this to be true.
I guess with Type 2 there is not a one size fits all.
I suspect it depends on your med's and your normal sugar levels (A1c)

Even some of my harder indoor rides have caused issues with low sugar.

Barry

Baldy1953

Been a diabetic for almost 25 years. I am a type 2 and have never had an incident of too low blood sugar while riding. Dehydration is a bigger problem for me. I check my blood sugar level after a ride and it seems to be higher than when I start. I have read it is the adrenalin that comes with the exercise.
I find it rather difficult to believe with you being "new" to diabetes, your doctor put you on insulin right away unless your glucose level is off the chart. Monitor your glucose level with your glucometer during several rides and keep a record of it to discuss with your doc. He should give some guidance on how to handle your glucose levels.

Jughed

T2 here

If you are not taking insulin or some other form of meds - lows are not an issue.

You may find that with diet and exercise that you can get by without any meds at all.

I've been a keto cyclist for that past 4 years now - I don't go high or low & don't need to test.

livedarklions

Definitely agree with getting medical advice from doctors.
I think this varies a lot by individual.
I am borderline Type 2 (no meds) and frequently ride over 100 miles. I just eat when I'm hungry on the ride and everything has always worked out fine. I have done 100 miles without eating and was ok, but it was a little unpleasant. Not even close to bonking, though.

One thing I figured out for me was don't eat a starchy breakfast before starting. There's some sort of rebound low that occurs a couple hours into the ride when I do that.

livedarklions

There's a subforum on bf dealing with health issues, but it's kind of buried. Seems to be a a good place to get other's perspectives on T2D: https://www.bikeforums.net/pills-ills/

RH Clark

Type 2 is completely reversable through diet. The last thing you need is something to raise sugar. You have to work on getting insulin sensitive again. Your body has had to make extra insulin so long because of frequent consumption of high glycemic foods that you have become insensitive to insulin. It takes more insulin now to properly lower your sugar and the excess can cause it to drop too low. You need to start stretching out the time between meals, no snacking, and eat very low glycemic foods.

Bearhawker

Too many of my relatives have died, or are suffering from T2D that i've made it a priority to never get it. My Mom's husband has lost a retina and absolutely refuses to stop eating carbs. Horrible to watch from afar but it is his life, his choice.

It's the number one 100% voluntary disease in the world. And the medical industry makes a fortune selling stuff to enable people to keep damaging themselves rather than address the root problem.

jaxgtr

My wife has been type 1 since she was 9 and keeping her glucose levels up can be a challenge. We always have gels, which she hates, for emergencies, but we do add carb mix into her bottles. It is far more problematic when the heat and humidity are high. She tends to run on the low side, so she will turn off or reduce her normal bolus on her pump during the ride, and can monitor the blood sugar on the phone, it is such a balancing act, but sometimes to have to have a little trial and error as you go to figure out what works and what doesn't. I remember once actually pushing her back to the parking lot over 8 miles and I told her to focus on steering. Once we got back, she was able to eat food and I was able to monitor while her blood sugar came back up.

livedarklions

Except when it isn't.

livedarklions

Let's leave the opinions on whether it's voluntary to a forum more appropriate to such questions. That isn't what OP asked, and I'm not going to get into why I disagree with that statement so vehemently. At this point, the science is that the causal arrow's direction is very unclear.

Barry2 

Not exactly on topic are we!
and thanks for your contribution.

Barry
(unsubscribed)

ricksessions

Check out Diabetes Training Camp. Avoiding exercise-induced hypoglycemia is part of what they teach, and they have a camp for Type 2s.

livedarklions

What does that cost? Their website only mentioned camp for adults wiih T1D, btw. Do you have a link to the Type 2?
Honest questions, I think people might be interested.

Your first post in 15 years? I gotta think you think this is pretty good!

Attilio

It depends on if you're on insulin or not.

Lifelong type 1 (the one that isn't my fault), super skinny, fit and active. I eat more before the ride and have an idea of what/how to eat for what kind of riding I plan to do and keep eating. I only ride in groups that are no drop and will allow me to stop. I used to be faster and climb better than everyone so I would race to the top to "earn" a moment to check my sugar waiting for the group to catch up then eat accordingly. I would have various bars or snack already opened and easy to eat in my frame bag and peppermint candy in my stem bag. It's trial and error, don't use CGM because it's not that accurate, bring my testing kit checking early and often.

For type 2 if you're not on insulin low sugar is the best thing you could possibly cause. You will never get truly "low" if you're not on insulin unless maybe you take a sulfonylurea. 90% of type 2's is because you eat too much and don't exercise enough, mostly eat too much so the movement and not eating and getting your sugar down and insulin down is the best thing you could possibly do. If you premedicate the ride with food (Assuming you're just on oral meds) you are spiking your insulin and undoing any benefit of the exercise. All bets are off if you're on insulin, if you're on insulin you want to get off but it's hard. You're going to need to lose a lot of weight to stop the juice. It starts with eating less (especially carbs) but do so very carefully because you'll be low at the same dose of insulin and insulin MAKES YOU HUNGRY AS HELL. You have to lower food and insulin at the same time. This will help you drop weight but anytime you change anything while on an insulin regimen its safest do contact YOUR healthcare team and make changes gradually and very gingerly checking your glucose early and often. It's all a fragile balance so check your sugar a lot, make gradual adjustments with your goal to do the least insulin possible, eat the least and exercise the most while still keeping your sugar around 100. It's not easy. Insulin sucks been on it 40 years.

Jughed

Yep - insulin sucks and can be difficult to manage.

For many, most even, T2's - you have a choice. A difficult diet or managing insulin and meds.

I'm in the diet camp, and I also fully believe that taking extra insulin to lower blood sugars - in a condition where the person probably already has high levels of insulin - only makes the disease worse/progressive. Or it speeds the progression. High levels of insulin are as detrimental, or more detrimental, to long term health than high BG's. High BG's along with high insulin levels - well those results are very predictable. I like my feet, kidneys, vision and being stroke free!!

That being said - and I say this to anyone that asks the question - if you are worried about lows and managing your BG's, try it with diet and exercise first. If the diet is too extreme and you can't manage, then you will have to worry about lows and BG management.

Simple as that right? But it's not simple or easy at all. And it won't work for everyone. Some people absolutely need insulin/meds to treat the disease. But the majority don't.

If you are worried about lows on the bike, or lows in general - do everything in your power to NOT be on meds that cause lows.

elcruxio

There seems to be a lot of misinformation about diabetes on this thread.

Firstly, the categorization of type 1, type 2, MODY, and LADA is still misleading. As we're finding more information about diabetes, it turns out there are way more types and originating factors than autoimmune and too much of the carb.

A pancreas can just give out. Sometimes organs do that. That's type 2 that isn't induced by bad habits.
Type 2 is also more hereditary than type 1, even though type 1 if often considered to be the hereditary type.
Type 2 can actually be a variation of MODY but diagnosed as type 2.
Type 2 also isn't really reversible. Once you have it, you're not getting rid of it no matter how well you control the symptoms. You might think you got rid of it, but you probably didn't.

What I'm saying is that it's complicated. Calling type 2 self inflicted is both false and unhelpful. While lifestyle choices can play a role in the onset of type 2 diabetes, they also may not.

Also, too much insulin doesn't cause health issues other than hypoglycemia. I don't understand where this myth that high insulin levels or insulin spikes cause harmful effects has come from. If you have high BG's and can't manage them without insulin, it is infintely better to lower them with supplemental insulin (alongside with other treatment options) than to try to tough it out until you get your insulin sensitivity back. Getting your insulin sensitivity back can take years but high BG's are causing damage NOW! So first, get your BG's to acceptable levels and if you need supplemental insulin, start working on lowerin that after your BG's are ok.

Insulin resistance is complicated. Stating it's caused by too much insulin is too simplified and false. Too much insulin plays a role, but high BG's cause insulin resistance as well both directly and also via secondary effects. Mainly low level infection, damage to the body and weakening of the immune system.
There are other things that can directly cause insulin resistance and the solution isn't just "get thin, exercise and eat less carbs".
Some alternative tips for getting insuling resistance in check.
1) Brush your teeth twice a day, floss regularly and get your teeth checked out and treated for any issues.
2) Get rid of any muscle spasms, tight shoulders, etc. Massage won't cut it. If you have chronically tight shoulders etc. you'll need to exercise those areas. Physio is good for that.
3) Try to verify you do not have any underlying chronic infections such as yeast infections, long term localized skin issues and that sort of thing.

Infections and various types of overloading of the body can cause insulin resistance. HIIT and other high intensity exercise can put your body on a rollercoaster ride of insulin resistance as those work by effectively overloading the body. It's a good idea to do them when able (verify that you're able) but don't be surprised if you have trouble managing blood glucose for up to a week after.

Even type 2's may need to refuel during exercise. Type 2's have glycogen stores just like everyone else. If they run out, they're going to bonk just as hard as anyone else. If you're type 2 and are going for a ride that's 2+ or 3+ hours long (and are not on keto or some other restrictive diet), it's a good idea to carry some carbs or have a rest stop planned as a backup plan in case you bonk or want to prevent a bonk.

wyd

Thank you. I'm type II. I'm on insulin a long term and a short term before I eat. I been on insulin since December of 2022 but since that time I have changed my diet completely and lost 78 pounds and down to 231 from 309. With the big weight loss I been able to take less insulin overall and I plan to keep working on my weight loss as I would like to eventually lose another 30lbs but I do feel much better already with the weight loss I have had but will keep working on. I do monitor my glucose a lot and hope as I continue to lose weight and with my diet I will be able to keep taking less and less insulin and so far it's working. Not sure if it will ever get that I take no insulin but I will just just keep working hard and see where it leads me.

Jughed

Not sure its a myth. I'm not digging to deep into it, but you can research it yourself. Quick quote:

"Because of the largely unrestricted insulin signaling, hyperinsulinemia increases the risk of obesity, type 2 diabetes, and cardiovascular disease and decreases health span and life expectancy. In epidemiological studies, high-dose insulin therapy is associated with an increased risk of cardiovascular disease".

High levels of insulin are associated with all of the metabolic conditions and weight gain/fat storage.

My take (not an all-encompassing statement, I know everyone/situation is different) -
-In The years building up to a T2 diagnosis, the body is making more and more insulin to cover higher BG's due to insulin resistance. It produces more insulin until the point where it can't overcome the bodys resistance & high BG's are now a symptom of the problem.
-These high levels of insulin are contributing to high blood pressure, cholesterol issues, fat storage in all the wrong places, higher levels of insulin resistance - and possibly contributing to dementia and even Altheimer's

The vast majority of T2's still make insulin at the time of DX. Rather than adding more insulin to a system that is already overloaded with insulin just flat makes no sense to me. Get a meter, test 1 hour before, 1 and 2 hours after - learn what foods cause spikes in BG's - don't eat that food anymore.

Many T2 diabetics are learning this now - and it flat out works for a ton of people, not everyone - I understand... but docs will not tell you this, their first line of defense is meds/insulin vs lifestyle and diet changes. And I don't think this does anything positive for the patient to address long term care, treatment and even remission of the disease.