A Diabetes Exercise Success Story

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I write so many blog posts about my difficulties with diabetes and exercise that I feel the need to share an actual success story. Yesterday was a beautiful fall day in Pennsylvania, and my husband and I decided to take part in the annual Covered Bridges ride in Bucks County — a gorgeous, if hilly, 33 miles through fall foliage. 

Peter and a bridge

I’ve done a lot of biking with diabetes; in fact, I was diagnosed with Type 1 just three months before I was scheduled to take part in a cross-USA bike ride for Habitat for Humanity. I was likely still honeymooning, but biking 70-80 miles a day for 63 days with newly diagnosed diabetes was a challenge, to say the least (I’ll admit that I got pretty good about finding people who’d let me hitch-hike with my bike). The upside, though, was that exercising for eight to nine hours a day gave me tremendous leeway with what I could eat.

Suffice to say that the 13 ensuing years have not involved spending my workday biking, but I always think of that experience whenever I’m going to do a long period of exercise, and I take a couple of steps to try to get a good outcome. Namely: 

1. An hour (or ideally 1.5 hours) before I start, I set a temporary basal rate of 50 percent for the time I anticipate exercising, plus an hour or two afterwards. 

2. I test before I start and every hour or 45 minutes into the exercise (and I carry my CGM).

3. I eat more carbs than normal for breakfast and I under-bolus for them. I normally also eat several tablespoons of peanut butter, though I don’t know how much of that is a diabetes tactic and how much is a sign that I welcome excuses to eat peanut butter. 

4. I carry a variety of sugar sources with me — yesterday I had glucose tablets and weird Gatorade chew things (I also usually carry vanilla bean Gu), and I make sure to drink a lot of water. 

5. If I eat carbs at rest stops (which I recommend doing because I, at least, can definitely feel the energy boost when I start biking again!) I take a very, very, very small amount of insulin to cover it. Yesterday for example, I ate two Oreos, a random cookie, and half a banana at a rest stop (note: I do not normally eat cookies) and took 0.4 units for them, and was fine. 

6. I keep testing after I finish, and I continue to slightly underbolus for several hours afterwards. 

As always, this represents my personal experience and is not any sort of medical recommendation. But yesterday it actually worked perfectly. After slightly rising after my peanut butter and strawberry breakfast, my blood sugar remained between 70 and 110 mg/dl for the entire ride (my Dexcom thought I’d gone low at one point, but finger sticks showed it was incorrect). We went out to brunch with my parents afterwards, and I ate — wait for it — a piece of a bagel (!!!!). I mean, like not a whole one, but more bagel than I normally would consume (which would be 0 bagels). Blood sugar was totally fine. 

We finished our day by going to an orchard to pick apples (Stayman Winesaps are in season, which almost make winter worth it). It was a fantastic weekend, and such a relief to have diabetes behave itself. Now, if only the Covered Bridges ride were *every weekend*. . . . 

(Anyone else have suggestions for how to handle longer-than-normal exercise sessions?)

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Rob WoolfsonhmbalisonMatt M.Liz Recent comment authors
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Rob Woolfson

I am surprised that you feel the need to stop and do a BG test as often as every 45mins given you have the CGM. I test before I start a period of exercise and then again at the end.  For the duration I rely on my CGM with the exception on long rides if I am eating and injecting a bolus.  Unless I am racing then we always stop at least a couple of times on a group ride.  I will test then, if I am worried that my CGM is lying to me (invariably it isnt).  Its great… Read more »

hmbalison
hmbalison

Good for you. It sounds like a great day, and I like your exercise/diabetes strategies. 

 

Matt M.
Matt M.

This describes pretty much exactly what I do for longer bike rides — 7-8 hours. Except I typically don’t eat more carbs than usual in the morning, or any at all, really. I prefer to have maybe an egg or two, and/or some peanut butter. I find that my stomach is full and I have plenty of energy, and cutting out carbs at the start just removes another variable to think/wonder about. But I could see a different approach. Once I start riding, I do eat about 40g of carbs an hour, coming from bars and gels and fig newtons, etc.… Read more »

Liz
Liz

What a great day!  I have lots of challenges with my diabetes and exercise too.  Thanks for sharing your success.  I only have one question.  Why the peanut butter loading? It’s fat and protein.  What’s the advantage?

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