This past Sunday I rode with the Freedom Machine team in their annual Around the Bay ride supporting Zagame Motors. The Zagame group was huge (over 200 people) and the weather conditions were terrible (50km/hr+ winds) but the ride was a great success.
Details of the Ride
- Distance: 150km including getting to the start
- Time: 5:30am to 12pm including waiting at the start and mid-ride stop
- BGL Checks: 20
- BGL Range: 4.5 to 12.5mmol/L
- Bolus doses required: none, adjusted basal program provided enough insulin
- Carbs Consumed: approx. 150gr during ride (7am to 12pm) based on my BGLs and how I was feeling energy wise
- Issues: ‘pump not primed’ warning which require a stop and re-prime
The evening before an event is very important, apart from organising all of my cycling kit I also figure out my diabetes plan which includes insulin (basal rate) and the food I’ll consume. For a ride like this I’ll usually take enough real food, sports bars and gels to provide up to 50gr of carbs for the first couple of hours after which I would restock. For hydration I prefer a no-carb mix as I can then always consume it no matter where my BGL’s are at (a carb loaded drink could not be consumed if BGL’s run high). With my basal rate I need to consider that although I was getting up at 5am to get to the start, the event wouldn’t actually start until 6:45am. I needed to increase basal a little for when I got up and then a little more for when the ride started. I obviously wanted to avoid a high or low whilst I was waiting for the event to start. In the end I set my basal to increase at 3am and 5am and then reduce at 8am and 10am to cover the ride duration. All in all, it’s a good hour to get things organised the night before an event.
On Sunday my alarm went off at 5am and I immediately checked my BGL’s which were running at 6.5mmol/l. A good start to the day! I usually try to get up and be training within 30 minutes so having to ride to the start of the event and then wait for around 1hr meant that I have to take extra care to maintain stable BGLs. Due to this I consumed a low carb protein bar whilst waiting at the start and I checked my BGLs every 15 minutes to ensure things remained stable, which they did. Setting off for the ride my BGLs were at 8.5mmol/L which was a good level with my increased basal rate and the cycling soon to kick in.
When cycling I usually check my levels every 30mins over the first hour, then every 20 minutes for the next couple of hours and for longer rides like this one I end up checking every 15 minutes as the risk of rapid BGL changes increases the longer I am riding for. With a strong tail wind, the first half of the ride was really fast and we were at the breakfast turn-around within 2hrs. I had consumed a muesli bar on the way down and my BGLs were dropping when we arrive. This was actually planned and I didn’t eat any carbs as we got close to the midway point know that there was food available there. I had a coffee, ate a banana and half a vegetable wrap at the stop which equated around 50gr of carb. For the 20 minute stop I would have checked my levels 4 times so that I ensure I did not go too high or low. The stop was only for 20 minutes so I did not give myself a bolus dose with any BGL increase to be limited when I started riding again. We ended up stopping for over 30 mins which meant that my BGL rose more than I would have liked to 12.5mmol/L. I decided not to give myself a bolus dose and after we started the ride back (into a 50km/hr+ headwind) I check my BGL every 15 minutes to make sure that this re-stabilised.
Riding back into such a strong and gusty headwind was really challenging. Obviously I was getting blown all over the road, the effort was high and the speed was slow, and in situations like this you can forget to check your BGLs and it’s easy to forget to eat. We were also responsible for getting the group to the finish line safely which meant constantly checking on how the group was going (not an easy task given the conditions). I was checking my BGLs consistently on the way back ate a sports bar and snickers bar (my treat on long rides) as well as mixing some Gatorade in my drink bottle for some extra carbs. I was able to keep my BGL’s stable on the way back and finished with a reading of 6.5mmol/L. After a quick shower I was able to have a good lunch with carbs (50gr), protein (omelette with extra egg white) and plenty of salad.
Overall the ride was not overly tough even though the wind made the return journey twice as long. From a diabetes point of view, it was a challenging ride having to manage a delayed start, riding with a group, at their pace, and generally not being in control of my own ride. Also having to monitor the group, provide assistance and battle the weather added to extra things to think about. I was able to manage my diabetes without an issue and to achieve this I made a point of doing what I needed to do, when I needed to do it (check BGL, eat and even re-prime my pump).
So some important things which helped me get through this ride:
- Good organisation the night before the ride including setting insulin plan (basal) and laying out all the food I needed including calculating the nutrition/carb content and having some low carb options
- Regularly checking BGLs throughout the event including every 15 minutes during critical times and later in the ride when insulin sensitivity increases
- Making sure that I ate when I needed to which was not necessarily when the group stopped and eating only what I could best estimate the carb content of (no egg, bacon and relish rolls)
- Letting people know when I needed to stop to re-prime my pump, confirming things were alright and then chasing back on to the group
Even with type 1 diabetes every event is achievable and all that is required is a little extra planning and following the process to maintain stable BGLs and performance.