Training Variations & T1D Management

For the last couple of years my training has been very focused on Ironman and 70.3 triathlons with a couple of cycling and marathon events thrown in for something different. In training for these events I have learnt how to manage my diabetes and keep my BGLs very stable. Basal rates, when and what to eat and how my BGLs fluctuate depending on the intensity and duration of the session have all been figured out. My training sessions have generally been specific to a program including swimming, cycling, running, strength and recovery. In most cases the longest of these session was a 3hr cycling session but each different session, duration/intensity requires a specific plan for my diabetes. Although everyone manages their type 1 diabetes differently, I think that it is beneficial to look at the variations we all experience.

Below I have noted the way in which I have to manage me diabetes, nutrition and hydration for various cycling sessions. I have reviewed this recently as my training focus has changed to building endurance for my JDRF One Ride cycling fundraising and 1,000km ride from Melbourne to Adelaide coming up in May 2017.

Recovery (Zone 1)

  • Low heart rate, low power and high cadence
  • Aerobic nature of this exercise has a strong pull down on my BGLs
  • Require a lower basal rate to avoid a hypo (-20% for a morning session and -60% for an afternoon session
  • I use a drink with carbohydrates in it to assist maintaining BGLs and also good hydration, approx 30gr of carb for a 1 hour session

Aerobic (Zone 2-3)

  • Medium heart rate and power (as determined by FTP) and smooth pedal stroke/cadence with medium-long intervals
  • Aerobic nature of this exercise does pull down my BGLs but this does not occur until about 1.5hrs into the session
  • For morning session my basal rate remains the same as normal, but for afternoon sessions I need to reduce this rate by -60%
  • During these session I need to eat at the 1-1.5hr point of the session and then every 30 minutes after that. Depending on the session I need about 25gr of carb each time I eat and I eat a low-GI food for its slow release
  • I use a zero carb hydration formula for these session and try to consume 500ml per hour. I use a zero carb formula so that I can also drink without working about any carb intake.

Anaerobic (Zone 4-5)

  • High heart rate, high power and maintaining smooth pedal stroke with short-medium intervals
  • During these more “effort”session I need to increase my basal rate as the effort forces my body to release glycogen as I am pushing my threshold. I only do these sessions in the morning as I have been unable to maintain stable BGLs in the afternoon with this type of exercise
  • These sessions are usually around 1hr and with the rise in my BGLs I do not consume any carbs during the session. A post session meal is very important for recovery from these efforts.
  • I again use a zero sugar hydration formula and consume closer to 1L of fluid for the hour session

Like with anything to do with type 1 diabetes there are variations within variations which need to be managed as they occur. Always carrying high and low GI carbohydrates is critically important along with being willing to change your session if things don’t go to plan. If thing do run smoothly then my insulin and carb requirements run as per the chart below with insulin requirements dropping linearly and carb requirements increasing more exponentially as the length of the session increases. Being fat adapted I generally require lower carb intake early on in the session and then increase this intake as the time goes on. My basal rate drops to around 50% of normal around the 4hr mark but to maintain stable BGLs I do need to consume about 75gr carbs per hour, at this point through my body needs this to continue training.

graph

Chart shown the decrease in insulin requirements and increase in carbohydrates required over training session duration (note: active basal is 1.5-2hrs post the basal rate setting/time)

So the important things that I now work on (for my diabetes) to get through my cycling training sessions are:

Short Rides (1-3hrs)

  • Set adjusted basal rates 2hrs before starting including switching back to normal rate somewhere in the last 30 minutes of the ride
  • Carry  1 x gel (high GI) and 1-3 x bars (75-100gr of low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Know the turn-around points where I can assess how I am feeling and turn-around if things aren’t tracking well

Long Rides (3-6hrs)

  • Set adjusted basal rates 2hrs before starting and maintaining a lower basal rate for a couple of hours after the ride to avoid a delayed hypo
  • Carry  2 x gels (high GI) and 3-4 x bars (low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Have a route planned out and stick to it
  • Know stopping points where food and water will be available including at around 3 hours when some more solid food will be good to consume (bakery is a favourite for this stop)
  • Have a plan in place is things do not go to plan, this can include turn-around points, someone to come pick me up or public transport to get back home
  • These rides are safer to do with other people

Day Rides (6hrs+)

  • Set adjusted basal rates 2hrs before starting; it is very important to understand how long I will be riding for and lowering my basal rate accordingly
  • Carry  4 x gels (high GI) and 4-6 x bars (low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Depending on the ride I sometimes use a small backpack to carry all of the supplies which may be required for a long day in the saddle
  • Have the route planned out which you’ve checked thoroughly and let someone know where you are going
  • Maintain communication with someone during the day so that they know you are alright
  • Know stopping points where food and water will be available which should include places to get more substantial food (service stations don’t count)
  • Have a plan in place is things do not go to plan, this can include turn-around points, someone to come pick me up or public transport to get back home
  • These rides should be done with other people
jdrf-ride-3

Long days in the saddle are much easier and safer with a group

There are a lot of things noted above and they certainly don’t cover all of the ways that diabetes and BGLs can vary. Overall I find that longer rides are easier for my diabetes management as any fluctuations in my BGLs can be adjusted  more smoothly over the longer time. I also take the opportunity to consume a few extra calories (and treats) which on a normal day I wouldn’t be able to for fear of wild BGL swings. Most importantly, preparation/planning is key, regularly checking your BGLs is critical and then making adjustments (insulin, crabs, route, etc.) well before you get into trouble will ensure the safest and most enjoyable time on the road!

I am cycling to raise money for JDRF and type 1 diabetes research. I am riding 1,000’s of kilometres every month and will be riding from Melbourne to Adelaide in May 2017 to raise awareness of type 1 diabetes and show people that although living with type 1 diabetes is challenging, anything is achievable! Please donate to make a difference Donate Here!

All information provided in this piece is from the authors own experience and does not represent medical advice. See Disclaimer

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Evening Training Highs & Hypos

I have always had a lot of trouble maintaining my BGLs when I am training in the afternoon. No matter how much I lower my basal insulin or how many carbs I consume, I always seem to end up having a sharp BGL drop during the session and if not that, then I end up with stomach issues from eating too much before/during the session. The combination of consuming carbs before/during a 1-1.5hr session and also reducing basal insulin, ultimately leads to a spike in BGLs after the session. Adding all of this up it’s 4hrs of worrying about BGLs every afternoon as I prepare, train and then recover.

20160823_175453_resized

Getting levels stable can be very challenging, trying to balance; insulin, carbs and session duration is all important. Sometimes I do manage to get it close enough right though!

Especially with triathlon training where you need to squeeze in swim, ride and run sessions along with strength and recovery, you need to utilise all available sessions which including afternoons/evenings. With my challenges training in the afternoon I try to plan my sessions to get the most important ones in the morning (run and bike) and do other sessions in the evening (strength, swim plus lighter runs/rides). It takes some effort to get my planning right needing to consider; diabetes (am/pm), session requirements (hard/easy/length), pool availability, recovery time between sessions, weather and other personal commitments. Even so, but with a little stress, I manage to get 15 hours of training in most weeks.

So even though it’s a real challenge, I prepare myself most afternoons to head out and complete a training session know full well that there’s a high chance I’ll have a hypo. Recently I have had some success, my BGLs have been fairly stable and I’ve been able to complete some really good afternoon running sessions. The things which I am doing at the moment to give myself the best chance to complete these sessions include:

  • Reduce basal insulin 2 hours before training session and maintain reduced basal for first half of session. I need to reduce my basal rate by 70% for swimming and running session, and 50% for bike sessions in the afternoon. I do not require a reduction for strength sessions.
  • I do not start my session until after 2 hours post reducing my basal insulin rate to ensure that insulin levels in my system are reduced.
  • I try to start my sessions with BGLs around 10.0 mmol/l knowing that they will drop within the first 15 minutes
  • Consume between 20 and 40 grams of carbs about 30 minutes before the start of the session. This will usually be a supplement like Endura Optimizer or Hammer Recoverite mixed with water. I find that I respond well to these carb sources and they do no upset my stomach.
  • During a 1 hour session I will consume 25 grams of carbs at around the 30 minutes and this is usually a sports gel. It is important that whatever I consume does not upset my stomach and I also need to be able to carry it when running. When swimming or riding liquid carb sources are also an option.
  • I check my levels every 15 minutes during the session to make sure my levels are tracking OK and I can adjust things if needed. This does seem like a lot of testing but my levels are drop very quickly and when  you are covering a kilometre in around 4 minutes it can be a long walk home if you’ve missed a hypo!
  • I plan my sessions so that if something does go wrong, most likely a hypo and needing to walk back to the start, I am not too far away. A 20 minute loop is a good option and also provide for keeping provisions in your car for easy access.

I really work hard to get the most out of all of my training sessions and I do get upset when things don’t go to plan. I try to not let these incidents get to me but when you are trying your best and things still go wrong it is challenging to remain positive. Nevertheless, after many many incidents I continue to train and continue to work to get my diabetes management as close to perfect as possible. I know from experience that this will never be possible but the most important thing is to continue to strive to be better and in the end be healthy. Two afternoon run sessions week, one successful and one included a 20 minute walk back to the car in the rain, luckily I’m running first thing in the morning tomorrow!

The Diabetic Athlete

I was lucky to catch up with one of the fastest marathoners in the Australia yesterday, Shawn Forrest, who is also a Type 1 Diabetic. Shawn’s been running all of his life and as a professional athlete has a wealth of experience and knowledge about competing at the highest level which I just love learning about. He’s only been a T1D since 2014 so I might have also been able to provide the same to him with my lifetime of diabetes experience.

I get so much from speaking with similarly experienced and focused people with T1D and I walk away from these meetings feeling enthused with new knowledge and with a little weight lifted off my shoulders knowing that someone else is going through the exact same experiences and feelings as I am.We are not along!

One of the topics which we spoke about was an athletes mindset and how having T1D can change this. I told Shawn about my experiences through the end of 2015 and early 2016 where I suffered from crashes, injuries, fatigue and ultimately depression. During that time I was so focused on the results that I stopped enjoying what I was doing, didn’t celebrate any achievements and had such a poor mindset that my performances suffered. Once I was able to acknowledge and reconcile this everything including my performances improved. The results are certainly important,  but so is the journey and also the bigger picture and enjoyment. On a much bigger stage Shawn had been working to qualify for the Olympic Games for a number of years in the marathon and there were untold pressures on him to achieve this, and then he was also diagnose with T1D. Listening to him I had so much respect for how he continued to push through and achieved some great results through some very challenging times.

The thing that we both agreed on was that having T1D allowed us to have a really positive impact every single day and in every single race through the diabetes community and this often something that we overlooked. There will always be personal goals, but working to promote T1D and inspire other T1Ds to be active, take on challenges and achieve their own goals is super rewarding in itself. This fact alone is great motivation to continue pushing our own limits and finding new challenges. As another T1D positive this is something which many athletes and people generally do not have the benefit of.

I’m looking forward to spending some more time with Shawn and getting my legs run off with a few training sessions with him.

If you don’t know about Shawn he’s a real inspiration for T1Ds and has competed at the top of long distance running around the world for many years. You can follow him on Twitter: @runforrestT1run

T&D June 19 – Time Off

A week of rest and recovery after Ironman 70.3 Cairns which included many hours in a deck chair, in the pool and at the dining table, it’s been a really different week for me. With no training on the cards for the time being I am reflecting on some of the big lessons I’ve learnt recently and allowing my mind and body to rejuvenate after a long 12 months. These things that I have learnt are all critically import to achieving my nest performances and they will form important checks for me next season so that all of my performances as good and better then my recent races.

  1. Mental: I believe that this has the biggest impact on my performance, both diabetes and athletic performance. I cannot believe how greater my BGL/diabetes stability is when I have a positive mindset. This positive mindset also yields the best training and racing performances along with rest (sleeping) and recovery.
  2. Physical: Although I am good a pushing my body to the limit, I am not so good at adapting my training program when my body is not 100%. Taking days off, sleeping in or doing those small recovery and rehab things are as important as getting the kilometres in.
  3. Diabetes: It’s obvious but the control of my diabetes (BGLs) has a direct influence on my athletic performance (and the rest of my life). This is the most important part of my life which I must remain focused on. This is not something to be upset by, it should be used to provide the planning and structure which will help me be the best possible athlete.
  4. Nutrition: Closely linked with all other aspects I have a tendency to be really strict with my diet which does not always provide for the best overall outcomes. There is no point beating yourself up for eating a treat and enjoying the experience. With a more relaxed approach over the last 3 months where I have allowed myself to indulge a little more, my performance has not suffered and have actually ended up physically and mentally stronger.
  5. Racing: During the last 12 months I got to a place where I was only focused on the result and forgot to enjoy the journey. It sounds simple but I was training hard and racing well but would constantly focus on the negatives. Recently with the help of my girlfriend and my training partner (constantly reminding me of all of the positives) it finally sunk in and this really transformed me. When racing, you’ve got to enjoy it and not take everything to seriously; you’ve done the training, your’re ready to race and the performance will be what you deserve.
Bike Rack Photo

With loads of winter training miles on the cards I can share the love around to all of my bikes; which one have I taken out this morning?

This is the first time that I have had a real break for the last couple of years and it’s certainly a new experience which I am going to have to adapt to. I’ve had to make changes to my diabetes management including increasing my insulin doses (around +20%) to account for the lack of exercise I am doing. My diet has also changed and although it is still very healthy I am not eating as much and I am enjoying a few extra indulgences. If I am thinking about doing anything to strenuous I just remind myself that I am actually getting real benefits from this break and by doing nothing it will actually improve my training when I return. It’s also a great time to pay back my family for all of their support and putting up with a diabetic triathlete (thank you).

Without training to blog about I have a couple of pieces which I have been thinking about for sometime which I want to post over the coming weeks. Mental health, diabetes performance and stress and use of continuous monitors. T&D will be taking a break until training returns in July but plenty of diabetes stuff will be posted. Looking forward to all the things to come!

 

Diabetes Race Plan Preparation

After the weeks and months of training hard for an event and then battling through a week or two of taper the final piece to the preparation puzzle is figuring out my diabetes plan for the race. Since late 2014 I have used a similar formula for all of the races which is based on a basal program to deliver sufficient insulin throughout the event to allow me to maintain stable BGLs within a good range whilst consuming necessary carbohydrates and thus performing at my best. If you have been following my blog over this time you will have seen that this does not always work out, usually running high with a bolus correction dose required. With the various physiological and mental influences on you BGLs it is certainly a challenge to get things exactly right.

To prepare my plan I start with the race times (travel, prep, start, swim, bike, run and finish) and then work our what my BGL will be to start, what carbohydrates I’ll consume and when, what the exercise BGL pull-down will be and finally what basal rate I need over the race hours to keep my BGLs within a good range.

Race Plan

Excel is an excellent tool to develop an insulin plan; setup, make changes and review.

Critically important elements to the plan are if/when a pre-race meal will be consumed and allow enough time/amount of insulin so that you are OK to start the race and not hypo (during the swim). As I predominately train in the morning without eating before starting I don’t eat prior to a race and will only consume some protein in the hours before and then a small amount of liquid carbohydrates within 30 minutes of the start. This allows my BGLs to rise prior to the start and then stabilise once the race has started.

For me, I prefer to be cautious with regards to a hypo as having a bad hypo will almost certainly be the end of your race. It’s obviously a balancing act though as you don’t want to run too high either. My best advice is to trial an insulin plan during you longer training sessions and this will give you the best understanding of what is required. For Ironman events this will involve a swim followed by a ride or a ride followed by a swim. Be sure that the duration of these is long enough to reflect the event which you are competing in. Luckily most events start first thing in the morning so it’s easy to train for this.

When a diabetes plan does work perfectly it is an amazing feeling of relief which usually also results in amazing performance. My Ironman Melbourne in March 2015 was such an event and one of my proudest achievements.

IM Melb BSL

CGM graph from IM Melb 2015. Arrows point to start and finish and BGLs stayed with 5-10mmol/L for the entire 9.5hr race. Note that a bit of a high due to celebrations is OK but I could have managed this beter

 

The Importance of Self-Awareness

One of the biggest things that I have learnt this year is the importance of having and acting on good self-awareness, both physical and mental. The mind and body gives us many signals both positive and negative and I have found that the more I listen to these the healthier I am and the better I perform. This is by no means a soft and fluffy approach to my health or training, but more a means to understand how my body is reacting to things; treatments, training, nutrition, etc. By having this understanding I can then make better decisions which result in better performances (diabetes, sport and just general well-being).

So what do I mean by self-awareness? It’s the sensations, feelings and thoughts you have many times a day about how you are feeling and performing. For me these are generally around fatigue and training performance (physical), blood glucose levels (diabetes), gut health (nutrition) and mindset (mental health). I’ll label myself a “competitive male” and as such I have generally taken the approach to push through with the mentality that the harder I push the better the result will be. This is certainly not the case and coincidently generally results in worse results for me. My most recent 70.3 race at Port Macquarie was a good example of this; a very good performance and leading into the race I made a concious effort to listen to what my body were telling me and adjust what I was doing accordingly (rest, recover, eat, etc.). I can attest from this that acting on this self awareness really helped my performance.

PMChart

I’ve found a good correlation between my self awareness, performance and what my Training Peaks data is telling me – best thing to do is listen.

How I apply this self awareness to my daily life is pretty simple, the difficult part is actually being aware of and interpreting what you mind and body are telling you. I have been calibrating how I am feeling with my data on Training Peaks and they align pretty well. When my body is telling me to rest and recovery, training peaks shows high fatigue and low form. It will be individual how you read your mind and body and it will take time for you to understand how best to react. Below I have listed some of the straight forward but very important signals and actions which I take.

Area

Signals

Actions

Fatigue

–    Tired during the day, falling asleep early at night

–    Feeling lethargic

–    Eyes hurting

–    Not alert or switched on during day

–    Allow body to rest, this can be for multiple days in a row to fully re-energise

–    Focus on diet and hydration (drink plenty of water)

–    Do nothing as oppose to active recovery

–    Get a minimum 8hrs sleep per night for several nights in a row (10hrs if possible is even better).

Performance –    Can’t hit session training targets (HR, Power, pace, etc.)

–    Feeling weak during training

–    Prolonged muscle soreness and not recovering as quickly as normal

–    Reduce training volume and stop intensity (try active recovery)

–    Takes a couple of days off completely

–    Get a massage and get on the foam roller/stretch every day

–    Ensure nutrition and hydration are adequate

Gut Health –    Uncomfortable stomach/pain

–    Bloated

–    Irregular trips to the toilet

–    Simplify diet and focus on foods which assist with digestion

–    Don’t over eat

–    Avoid foods which agitate your stomach including high fat, too higher protein, sugary and processed foods

–    Water, water and more water

BGLs –    Individual hypo or High symptoms –    Stay calm and go back to basics, count carbs and test your BGL regularly

–    I focus on being positive and doing things which assist BGL stability including walking, not stressing and eating sensible

Mental Health –    Lost motivation

–    No enjoyment

–    Procrastination

–    Negative mindset (can’t look at the positives)

–    Irritable and rude

–    Stop everything and speak to someone about how you are feeling

–    Assess what you may be stressing about

–    Work on things you can control and influence

–    Don’t worry about things which are not in your control

–    Do activities which energise you, for me this is exercising, relaxing with my girlfriend and walking the dog

–    Focus on single tasks, complete them and then move on

–    Review how you are going, continue to speak with someone and acknowledge when you achieve/do something well

Managing your mental condition is the most challenging of these for a number of reasons and it also may have the greatest performance implications. From recent personal experience this is an area which I have taken a special interest in and I will be writing a piece soon about how I have overcome the mental challenges and depression which I have faced.

It seems straight forward that we should listen to our bodies but it is surprising how difficult this actually is and how often we ignore the signals, ending up in a worse situation. The best performances comes when we are feeling at our best, both physically and mental. Feeling physically fit and strong, healthy and nourished and with a positive mindset shouldn’t be that hard to achieve. Use your mind and body as a guide and you will be able to achieve your goals.

Getting Through Race Week

The week (or weeks) leading up to a race can be the most difficult of a training program to get right. All of the hard work has been done in the months leading up to this point and no further fitness can be gained this close to an event. The focus now shifts to tapering so that you are in the best possible physical and mental condition for the race. But with nothing to be gained there is much to lost to the detriment of your race day performance. For further information on tampering see advice from Training Peaks.

Getting your taper right is hard enough as you fight your emotions and constantly question if you’ve done enough; will an extra session help, am I losing fitness? Having type 1 diabetes makes these weeks even more challenging as you try to keep your BGLs stable whilst changing pretty much everything that has worked for you during the previous months of training. I find that stable BGLs are the most important factor for me to perform at my best and this is particularly the case leading into and during a race. Some of the major challenges for a T1D during a tapering period can include:

  • Reducing training volume and intensity changes insulin requirements (Basal and Bolus)
  • Carb-loading would require an increase in Bolus insulin doses
  • Changes in activity and sleep patterns can change Basal insulin requirements
  • Physiological adaptations often change insulin requirements
  • Mental and emotional states including stress may introduce unexpected rises and falls in BGLs

Essentially during a taper we are changing what are bodies have been used to (training and eating) and we are stressing about many things (BGLs, race performance, tapering/training, etc.), and this is a high risk cocktail for a T1D trying to maintain stable BGLs.

Trek Speed Concept

I love getting my bike ready for race day, a good opportunity to focus on the details to go fast

So for one of the most important weeks in my training program, that is also one of the most challenging and stressful, what do I do to keep things on track:

  • I don’t have an extended taper prior to a race and keep this to Monday to race day (Sunday) generally (one week).
  • Maintain a similar training schedule; I continue with my morning training sessions as these seem to have the biggest impact on my daily diabetes requirements and drop/alter may afternoon sessions.
  • As with a normal taper I keep some intensity in all of my sessions to remain sharp (neuromuscular) but also to keep BGLs similarly stable to previous weeks with the session excursion.
  • When focusing on recovery I like to complete active recovery sessions which also help stabilise BGLs (through the exercise).
  • I really focus on my diet and try to consume the highest quality nutrient dense foods so that I do not need to increase my carbohydrate intake too much and I still get the full benefits of tampering. By not changing my diet too much it minimises the risk of changes to my insulin requirements and possible hypos/high BGLs.
  • If I do consume more carbs then I monitor this closely and increase my bolus insulin accordingly. In most cases I find it easier to add small amounts of extra carbs throughout the day rather than load up during main meals.
  • Keep track of your BGLs; as important as ever, I keep track of my BGLs constantly throughout the week so that I know exactly where they are at.

Finally, two really important things which I always work on are; control the things that I can, and don’t stress. Things out of my control will happen but if I am on top of everything which I can be then these uncontrollable events will be much easier to manage – control the controllable. It is difficult not to stress during taper week but remember that you have gotten this far, have controlled your diabetes to this point and you are ready to race. I try to stay calm and work through any issues knowing that this will result in the best outcome for me.

basal work

Keeping track of BGLs and planning for race day (BGL, Basal rate and Carbs)

Managing diabetes is never simple but by really focussing on yourself and your control during the taper week you can get great results from it and feel fantastic on race day.

There are big events on in Port Macquarie and Busselton this coming weekend so good luck to everyone who is racing and I hope that any T1D’s are tracking well for their events and I wish them all the best for race day.

T&D April 3

It’s been a busy and tiring week! Thank goodness for the free hour this morning from daylight savings change. I’ve upped the training volume this week and have continued with my strength training, this has left me feeling great both physically and mentally. Apart from some minor discomfort from last weekends rolled ankle I am really looking forward to the next four weeks building towards Port Macquarie Ironman 70.3. Being refreshed physically, mentally and with my diabetes management going really well the positive results of my break are continuing. Upon reflection this week a few basics have been reaffirmed this week and I’ve picked up a disappointing trend on social media.

Strength training, stretching and recovery. Following my adjusted program I have really put a focus on my alternate sessions including strength training, stretching and recovery. After only a couple of weeks I am already noticing an overall improvement in my on-the-track sessions and also my recovery. These often over looked components of any athletes program are just so important and should always be made a priority.

T&D April 3 Image

Solid week of Z2 training including new strength sessions

The importance of exercise in diabetes management. Now that I am back into training I have noticed how much exercise assists in achieving stable BGLs. I find that I have a greater sensitivity to insulin and require lower total daily doses when I am training. Additionally I am able to consume a few extra treats which I would usually avoid and this provides both a boost to my diabetes management and also my mental well-being.

Don’t fight your T1D. I have seen several posts on social media this week from other T1D’s who seem to be trying to beat their T1D into submission. I believe that you need to work with your diabetes to get the best out of yourself and essentially live unaffected. Having had T1D for 20 years I have developed most of my passions and interested with T1D and I have gained so much strength and success from having T1D (see my recent post).

Daylight savings is over so there’ll be a little more sunlight in the morning and there’s no better way to start the day than training with the sun rising on you back.

Carrying Diabetes Equipment When Training

I am often asked how I deal with all of the diabetes paraphernalia when I am training and racing. With the risks associated with exercising and maintain BGLs I have learnt the importance of having all of my diabetes equipment with me at all times. These items can now include; insulin pump, CGM or blood testing kit, snacks for hypos/energy, mobile phone for emergencies and some money.  To carry all of these items can make things difficult but I have been able to find ways to do so and not hinder my training sessions or races. I have looked to carry everything so that when swimming, running or riding my technique and comfort is not affected.

Swimming

  • I just tuck the pump into my bathers. I have stitched a little pouch into the back of my bathers in the past but this is not necessary.
  • When swimming in a wetsuit I generally just do the same but you just have to be careful when putting on and taking off the wetsuit as you can knock the pump or push buttons which can cancel a temp basal or deliver an insulin dose accidentally.
  • When swimming in the pool I always have my testing kit on the pool deck in a waterproof bag and a small towel to dry my hands prior to doing a test during the session.
  • Remember to always rinse your pump off after swimming a salt or chlorine aren’t the friendliest to the pump.

Cycling

  • Cycling jerseys are great for carrying all the things that we need in the back pockets. Generally three pockets for my pump, blood test kit, food and mobile phone.
  • I always have my pump connected when I train and to keep it safely in my back pocket I cut a small hole in the back of the jersey and then run the pump tube through the jersey, under my cycling shorts and then connect to the cannula. This works a treat and also allows easy access to the pump whilst riding.
Run Pump Image

Pump tube (circled) with pump safely in the back pocket of my triathlon singlet

Running

  • Running is the most tedious of my sessions as carrying extra items can really impact your running technique and you can feel weighed down.
  • I wear a triathlon singlet-top which has two pockets in the back which I can place my items in. These tops are available from many brands and they usually have at least two pockets on the back.
  • I wear a pretty tight singlet so that the items do not bounce around too much. I can squeeze in my pump, test kit and food without issue.

Gym

  • Doing a session in the gym can be difficult as you are moving around a lot and the pump can easily get in the way or the tube can get caught on something.
  • I wear training shorts which have a small pocket on the inside at the front or side where I can safely keep my pump and have the tube tucked into my shorts. Safe, secure and out of the way.

The most important thing is that you carry all of the necessary items. It can be a pain at first but when you get caught out without your test kit, food or money it can quickly get serious. Lessons learnt here from experience, always carry you diabetes items.

T&D Mar 6

Another full week off training and although my body has really enjoyed the recovery my mind has been itching to get back into it. Unfortunately I picked up a bug late last week and struggled to get over it but this just added further importance to my resting.

Without a focus on training my diabetes challenges have been a little different this week. Trying to maintain stable BGLs whilst sick is always difficult and days spent in bed or on the couch change things significantly. I also attended a friend’s wedding over the weekend and this type of event always needs some careful thought to keep my BGLs in check. Having got through the week relatively unscathed I’m happy to provide some tips on how I did it.

Tips for managing diabetes and illness

  • Test your BGL more frequently when sick so that you can catch highs and low earlier and react quicker with smaller insulin adjustments.
  • Allow your BGLs to run a little higher when you’re sick as this is much safer than battling a hypo; I usually aim for 6.0mmol/L when healthy but am happy to sit up to 8.0mmol/L when sick and I don’t stress about it.
  • Get on the vitamins as soon as you feel sick, my favourites are vitamin C or a cold/flu blends from my local health store. An increase in fresh fruits and vegetables is also important.
  • Rest, rest and more rest. You’ve got to let our body put all its energy into recovering and remember that fluctuating BGLs will make it harder for your body to do this.
  • Remember to eat, your body needs energy to fight the illness so don’t skimp on meals in a effort to keep BGL’s in check.

Tips of managing diabetes at functions

  • Organise a proper meal and try to eat it at your regular meal time. The wedding I attended had a grazing menu spread over 4 hours which is not ideal for insulin dosing. We asked for a plate of food at around dinner time and this allowed me to eat and give a single insulin dose.
  • Remember that beer and wines have carbohydrates in them, a single beer or glass of wine can have between 10-15 grams of carbohydrate which can quickly add up over an evening. Having several drinks will require some insulin to cover these carbohydrates.
  • Remember that there’s always an extravagant desert and wedding cake so if you’re going to indulge then allow for this in you insulin plan, it can be a really good or really bad way to end the night!

I’m back into training this week and I super excited! I’m still a little nervous about pushing my body too hard so I am going to take a very cautious approach to my training over the next 6-8 weeks. A strength and condition component will form a big part of my upcoming training block with my swim/bike/run session around this. For each of these my swim session will focus on feel in the water, bike sessions to build cardio and endurance and my run sessions will be focussed on technique all in an effort to support a strong base for me to sustain.

**Consult your diabetes physician before making any changes to your diabetes management. Refer disclaimer.