A Day in the Life of a Cyclist With Diabetes

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I decided for this blog post that I’ll share what goes into a normal training day as a racer for Team Type 1. First, though, I want to give everyone an update on my racing and recovery from illness.

After my last blog entry, I jumped on a plane to Singapore for a 70-minute race on the Singapore Formula One race track. I finished up my round of antibiotics the day before the race and was feeling much better. It was also nice to be in the warm weather again. (It seems I only make it home to enjoy the worst part of the Atlanta winter.)

My blood sugar levels were back to normal, but I was still using an increased insulin dose to keep them in normal range as a result of being on antibiotics.

The race was very fast from the start. Over 100 riders started, and after 25 minutes of racing the peloton (group) was whittled down to only 50 riders. This was due to the race being on a technical course consisting of nine turns and a road that was only 8 feet wide for 50% of the course. Needless to say this was a tough race!

I’d started the race with a blood glucose level of 189 mg/dl; after 15 minutes of racing I checked my continuous glucose monitor (CGM), and my blood sugar had already begun to drop. I quickly fixed this with an energy gel (25 grams of fast-acting carbohydrate). I was feeling great during the race. My blood sugar, legs, and nerves felt good. Everything was falling into place!

Unfortunately when the one-hour mark hit, my body shut down and went from a full tank of gas to running on fumes. I checked the CGM to find 179 flat. My blood sugar was not the problem, so what was it? Well, when you take antibiotics changes happen in your body. Your insulin may not work the same and your body doesn’t know how to process what’s going on when you have your heart rate at 170 beats per minute for an hour! This race made me feel OK about the direction my training and racing was going, but I still needed to recover from getting sick and taking antibiotics.

Fast-forward a few days and I’ve returned to Atlanta and am back to preparing for the next round of races. You may be wondering what all the training for the races entails. My next set of competitions are one-day races in Belgium that are 200 kilometers (roughly 120 miles) in distance and will be raced on flat, narrow, cobblestone roads. To get ready for this I will need intensity training and endurance training. The past three days I have put in 270 miles of training.

Here’s a quick rundown of one of the days (115 miles in 5 hours, 50 minutes):

7:00 AM: Blood glucose level: 79 mg/dl; long-acting insulin in the morning: normal amount

7:25 AM: Rapid-acting insulin dose: normal amount

7:30 AM: Breakfast: 120 grams of carbohydrate from steel-cut oats and two slices of whole-grain bread

10:00 AM: Start the training; blood glucose level: 127 mg/dl

10:00 AM to 11:00 AM: 70 grams of carbohydrate from a banana, energy bar, and carbohydrate drink mix

11:00 AM to 12:00 PM: 40 grams of carbohydrate from a granola bar and drink mix

12:00 PM: Blood glucose level: 185 mg/dl; injection of 1 unit of rapid-acting insulin followed by a bagel with 75 grams of carbohydrate (you have to have fuel for long training like this)

1:00 PM to 2:00 PM: 60 grams of carbohydrate from a granola bar, drink mix, and energy gel

2:00 PM to 3:00 PM: 20 grams of carbohydrate from an energy gel

3:00 PM: Blood glucose level at the finish: 186 mg/dl; injection of 4 units of rapid-acting insulin

4:15 PM: Lunch: 100 grams of carbohydrate — sandwich and a bowl of cereal

5:30 PM: Blood glucose level: 184 mg/dl; injection of 1 more unit of rapid-acting insulin

7:00 PM: Long-acting insulin with reduction of 1 unit due to low blood glucose the night before at 3 AM

7:30 PM: Blood glucose level: 135 mg/dl; dinner: 80 grams of carbohydrate; rapid-acting insulin: 50% of normal amount

9:30 PM: Blood glucose level: 106 mg/dl; small dessert: 40 grams of carbohydrate; no bolus

9:45 PM: Fell asleep mid-conversation on the couch! Hey, I rode 115 miles today — I’m tired!!

2:00 AM: Blood glucose level: 75 mg/dl; 20 grams of carbohydrate

6:30 AM: Blood glucose level: 79 mg/dl

What did I learn from my training and the two episodes of nocturnal hypoglycemia with a reduction in long-acting insulin? I think I will go back to my normal, pre-antibiotic dose tonight. Also, I think I need the day off. That was a lot of riding for three days!

One other thing that I have realized is that I have to keep notes on my training, blood glucose levels, and insulin use. You can’t remember everything that you did in a day and make a good decision in your diabetes management if you don’t. It’s one extra thing you can do each day that goes a long way toward being successful at exercising and having diabetes. You have to learn from your mistakes. (You also have to keep in mind that your body is always changing as you get in better shape.) I don’t want to go low tonight after exercising, so I need to review what I did the last two nights to make sure I adjust.

Thanks for the comments on the past entries! Make sure to check back as I continue to respond.

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