Diabetes Self-Management Blog

Hello, and thanks for reading my blog. And for those of you who are newly diagnosed, welcome to the diabetes team! My name is Joe Eldridge, and over the next couple of months I’ll be writing about my journey as someone with Type 1 diabetes who also happens to be a professional cyclist with Team Type 1.

Along with Phil Southerland, I’m one of the founders of Team Type 1. (You can go to www.teamtype1.org to get more information on who we are and everything we do.) I’ve also raced professionally for the past three years. In this post I’m going to share some challenges I’ve faced in the last three months while preparing myself for the upcoming cycling season.

The off-season is typically two to four weeks in October or November when racers take a break from the bike to catch up on life tasks that have been put off for the past 10 months. I had an exciting off-season this year — I got married!

Now, what does the off-season mean for a person with diabetes? Well in my case, it’s a very difficult time in my diabetes management. I go from training every day for 3–5 hours on the bike to doing nothing — absolutely nothing, if I can! However, during this downtime I’m tempted to eat like I do when I am training 3–5 hours daily. Needless to say, you can pack on a few extra pounds quickly this way.

My insulin requirements change after about three days of not riding. The change was drastic this year, maybe because I was in Costa Rica honeymooning, eating the best fresh fruit, fish, and rice known to man. I ended the racing season taking about 30 units of my long-acting daily insulin and with a 1:15 carbohydrate ratio on my rapid-acting insulin. The second day of my honeymoon, about a week after I stopped training, I was up to 45 units of long-acting insulin and had a 1:5–8 carbohydrate ratio on my rapid-acting! Fortunately, I was wearing my continuous glucose monitor (CGM), so the correct amounts were not too difficult to figure out, but without the CGM, I think my mind would have been spinning trying to find out how to manage my diabetes. I could have figured it out, but it would have required a lot of fingerstick monitoring. The CGM is a great tool.

Now fast-forward to the month of November, which is American Diabetes Month. For World Diabetes Day on November 14, those of us on Team Type 1 decided to compete in the Tour of Rwanda cycling race. As part of the trip, we also took much-needed supplies to Rwandan children to help them manage their diabetes. Thousands of strips and a year’s supply of insulin were donated by our many fans and people with diabetes around the world. It was great! We were able to give the Rwandan children enough supplies to last them for a year. In 2011 we plan to further this initiative and provide more supplies, as well as get the Rwandans the education they need to manage their diabetes. Very exciting stuff!

The Team Type 1 roster for the Tour of Rwanda was composed fully of cyclists with Type 1 diabetes. This was the first time in the history of professional cycling that a team comprised entirely of people with diabetes has competed in a professional race! I have to say, November was a great month for those of us with diabetes!

Now back to the present day. I’ve logged around 3,400 miles on the bike from December 1 to February 6 preparing for the season ahead. Additionally, I’ve had lots of diabetes changes along the way. For one thing, I’ve had to make huge reductions in my long-acting insulin, going from the 45 units a day I was taking in October to a mere 18–20 units a day on the big training weeks. I’ve also become much more sensitive to the rapid-acting insulin and my carbohydrate ratios have had to be adjusted many times. It’s amazing what a little bit (or a lot) of bike riding can do to your insulin requirements.

I’m off to my first race in India this week and will update you on the results and how I adjust to a 16-hour flight. I’ll also be providing you with more detail about a typical training day and its challenges in a future post.

Thanks for reading, and please feel free to leave questions or comments

Tailwinds,
Joe

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Comments
  1. I’ve had type 1 for 19 years now. I’ve been cycling regularly for about 6 years and have advanced to the top of the expert class in the local mountain bike scene. I’ve only dabbled in road racing. My problem is the infusion sites. Nothing is comfortable anymore. Any suggestions on sites for infusion and sites for CGM sensors? Have you found anything that works better for you? I can’t seem to find anyone local, doctors and educators included, that can make real world suggestions about this.

    Posted by Brian Parker |
  2. good luck in India!

    when I was recovering from an injury in 2009 I had to increase my basal rates on my pump when I went from lying down all day to sitting up for a few hours. It was pretty crazy.

    I look forward to hearing about how you manage D at the races.
    cheers

    Posted by Anne Findlay |
  3. Thanks for the insight on the changes in your insulin requirements. I have noticed significant changes if I go a third day without riding. On the pump which helps, and the cgm really helps but I can’t use as much as I believe is nessasary because of cost. Kevin

    Posted by KEVIN ORLANDO |
  4. Joe,
    Thanks so much for this post. Trying to navigate the numbers in my child athlete, is hard because I don’t get feedback on her end. When you share it gives me a a picture I can’t get from my kid.
    We too have had an “off season” and can see big changes in the first days.
    Do you also see a steeper drop in the early days of resuming training and then a leveling off.The first days of say, Basket ball, we can have about 48hrs of lows even after a pre basal lowering adjustment. Then she seems to get used to the activity level and we don’t have the wicked lows even if levels are left alone.
    Race strong. Your littlest, biggest fan is watching and cheer you on.
    Keep um Spinning AM

    Posted by Anne Marie |
  5. Interesting read! Nice to read about the challenges that are presented in times other than the race season. I know this phenomenon hits home for me as well when I even just take a rest week. Insulin ratios double for me after about 2-3 days off as well, with basal levels going up about 40%. The use of the CGM sounds like it really helps on those days where sensitivity is changing!

    Before I started cycling (my inspiration came completely from Team Type 1 :) I was running ratios of 5:15grams. Now, in an off week I’ll run around 2:15g, and while training about 1:15.

    Diabetes is a continuous game of balance and management and after 10 years it still amazes me by how much of an effect exercise (or lack there of) can have on insulin sensitivity and need.

    Posted by Sean M |
  6. I run 6 miles per day and I also have a schedule and more importantly the exercise keeps me regulated and in better control with my glucose normal levels. I do have to make sure my settling levels are Ok because if I don’t have orange juice it takes my glucose after running into the danger areas. Thanks for the reading.

    Posted by Bob |
  7. Hey, sorry on the delay everyone.

    Brian, try some new sites you might not have thought about before. When I am using the pump I use the sides of my lower back.

    Anne, yes I see drastic changes going both ways starting or stopping. The one thing that really makes the sugars stay down for the 48 hours is the intensity for me. High intensity = long recovery.

    Joe

    Posted by Joe |

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