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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The Physical Impact of Mental Stress

Mental health issues are frequently being addressed in the media and it has become evident that any mental health issue needs to be addressed with the same importance as any medical condition. I have always thought that I can the handle life’s mental stresses. I think that I have faced a few of them in my time and I have never really felt these stresses have affected me physically. Throughout my athletic career I have always had the ability to push myself mentally harder and further, and I believe that this has been a competitive edge which I have had. The tougher the event, the better I have performed. This being the case I have always focussed on getting physically 100% to compete at my best and just assumed that mentally I would be able to cope with whatever the event throws at me.

For the last 6 weeks I have been really struggling physically to get through training and even daily life. I have felt a real whole body fatigue. I have worked through all of the obvious triggers for this fatigue including; a lack of sleep, missing recovery sessions, poor nutrition and even dehydration. After ticking these off, a review with my doctor and a suite of blood tests, further results also revealed very little anomalies. Further assessment of my bike fit and running technique still left me questioning what had changed with me physically and why I was feeling so average for this prolonged period.

It was during breakfast with my girlfriend that I realised I may be suffering from the effects of cumulative mental stress which had built up over a prolonged period of time, likely since my broken collar bone 4 months ago. She asked me how I was feeling and I just looked at her sullenly and responded “average”. She then asked why and I first thought ‘stupid question’, but then reeled off everything that was on my mind; feeling fatigued, can’t train properly, goals slipping away, shoulder not 100% from surgery, lower body constantly sore, diabetes up and down, CGM not working properly, worried about what I’m eating, worried about my power to weight, trying to organise a new work car, trying to win contracts at work, dealing with local council re. neighbouring development, talking about future property investments, reassessing financial investments, reviewing home mortgage, bills-bills-bills, talking about starting a family, trying to support partners business and work, and trying to be a good boyfriend. Phew, “remember to breathe” she said.

Wow, that’s a lot of stuff to process and thinking about it more there were other indicators that showed my mental state may have been affecting me more than I realised. Some of these included having difficulty sleeping, losing concentration and focus on important tasks, lack of motivation for things that I normally love doing and generally being in a poor mood. I had dismissed these symptoms whenever they had occurred for any number of different reasons but when you put it all together there was a good possibility that my mental state was contributing to my poor physical condition. I was trying to sort out several things which will have significant influence on the rest of my life whilst also trying to train 15hrs per week, manage my diabetes and living my daily life may have been too much. I have been pushing my body to get back to 100% since breaking my collar bone in October and this was obviously at great physical stress. As the personal issues built up and I tried to assess and resolve these my mind was constantly working, even when I was trying to sleep. Thinking that I could just handle this I continued to train and continued to work through the various items at the expense of my physical and mental wellbeing all the time by myself without seeking any support. 6 weeks ago it all became too much and my body said ‘NO!’. I fell into a heap and was unable to push through any more.

Although it took me 6 weeks to figure this out, now completely stopping and taking a step back, I have immediately started feeling better. I have spoken openly with my girlfriend and just letting someone else in has made an amazing difference. I know now that I was physically wrecked and since stopping I actually haven’t wanted to do any training, I know that doing nothing is the best for my body and I am enjoying it. Mental, talking through the other issues has shown that these may not be as significant as they are in my head.

So what am I doing now? Stresses are part of life and they can all be managed with the support which I have. Being open and honest with myself and those closest to me has been a hugely rewarding first step. Things are certainly not as overwhelming as they may have seemed. In terms of my physical condition I am taking a couple of weeks off. No training at all, no thinking about training, just resting and enjoying time recuperating. Then I’m going to follow a really steady structured program to get my body right for racing which will include more functional strength work and then building for my races. I am also not going to put pressure on myself to be at a certain level too quickly, I have raced many times before being under done and I have performed really well in these instances.

Being in the middle of the season and at a very important time for my 2016 goals is not ideal but continuing the way that I was would have ended up in disaster both physically and mentally. I am amazed how great the physical impact has been from the mental stress. I have always focussed on the physical side of training but from this experience I understand that listening to your whole mind, body and immediate environment is vitally important to achieve your best.

**I am not a health professional and the comments made in this post are from my own personal experience only. Help can be found at Beyond Blue. See disclaimer.