Mrs Poly is type 1 diabetic.

She has recently started doing some road riding. She is planning to work up to a 100 km ride at the end of May. She’s worried about eating – so looking for advice. She is also Coeliac so anything with wheat (etc) is not possible.

Any of you in a similar boat and able to suggest:

(i) convenient ways to check sugar level without stopping?
(jj) practical, edible, food for keeping sugar levels up over a long period (I’d guess 5hrs?) without the ‘shock’ of loads of sugar?
(iii) any gels etc which might be particularly appropriate?

team Type-1 might have some info. They are a diabetic road racing team.

T1 here and still go on big rides sometimes.

In answer to your questions

i) No – there is no way that anyone could get their tester out, get a test strip out, insert into meter, get finger pricker out, get lancet out, insert lancet into pricker, prick finger, put pricker down, squeeze blood out, get blood onto tester, press button, read, remove test strip & put it all away whilst riding!

ii) Eat (ideally something slow release) before setting off and go out with a higher blood sugar level than you would normally want to retain. Top up sugar levels with something easy to eat, say a jelly baby every so often. Everyone is a bit different, so a bit of trial & error needed, but it still does go wrong sometimes. I dipped to 2mmols late last year on a ride, but bizarrely felt fine!

iii) I tend to stay away from the gels, they can right stuff me up later in the day (and there are the inevitable gaseous consequences!

At the end of the day, she’ll need to experiment and see what works for her

We should form some sort of kick-ass diabetic-coeliac team.

How long has she been diabetic? To be honest I just don’t need to worry about it an awful lot, I’ve got enough awareness of blood levels while riding, and what the effort I’m putting in is doing to that, that it’s never been an issue. But failing that, just need to stop and test, doesn’t take long and she could get one of the more contained ones with a drum of sticks, rather than separate ones.

Otherwise it’s much like for everyone else- long-lasting carbs to fuel the ride rather than trying to deal with a shortfall with quick hits. Does she get on with oats OK? Tesco sell Hale & Hearty flapjack bars which work really well for me, they’re gluten-free oats but lots of coeliacs avoid avenin as well so might not be suitable.

I’ve never seen a gel that isn’t GF, though there might be some. And that’s the one place we’re ahead of the game- diabetics can’t insulin crash

I’ve done big rides and not had any problems (big for me is 50km). Jellybeans or similar are easy to eat and a good little boost if you feel low. Awareness and warning signs usually kick in. I did stop at a cafe once and do my blood sugar and I was 1.4 and felt fine.

Important to eat post ride as usually you can go low an hour or so after a session.

Thanks guys.

Mr Smith – I showed her the Novo Nordisk team site – she said they were a bit too serious but I’ll drop them a line and see if they have any views…

PDF – I know that she can actually test on the move at low speed on fireroads on a mountainbike – if she has a buddy to hand her the bits! But it would probably be quicker. She did have a continuous glucose monitor for a clinical trial that the hospital were running, they are stupidly expensive though and she wouldn’t need one normally.

Northwind – she’s been diabetic for about 15 yrs; coeliac for 4. Her control is excellent normally, and she usually gets good warning signs – BUT those signs are things which happen (to me atleast!) on a big ride anyway e.g. sweating, feeling wonky, getting cold; so I think she is worried that it will be too late before she spots it. From experience so far it can go from OK to bad quite quickly and if there is then half an hour waiting to get back to normal again it could be too much. But the flip side is too high is not good either.
She is OK with oats if specifically gluten free.

aphex – I may be wrong about this but, in my non-diabetic unfit world, the difference between riding 50km and 100 km is quite stark though. I’d quite happily set off for 50 km with nothing more than a banana and a bowl of cereal in me and perhaps a some suspicious white powder in my drink bottle. BUT to 100km would need some serious snacking / sweets etc on the way – or a nice coffee shop – but she is planning to do this as a sportif so no coffee!

50km off road, for me is a big enough ride to need a couple of decent flapjacks, drink and some emergency jellybeans. 100km for me would be a day out! That would be a decent breakfast, a stop off for lunch and nibbly snacks along the way. Every diabetic is different though, it’s a very individual illness. Good luck to your missus though, eh?

Have you had a look at runsweet.com. They have good advice on exercise, insulin adjustment and estimated carbs. Unfortunately can still be a bit of trial and error. She will also have to be careful for the 48 hrs after the event.

Team Novo Nordisk are ‘serious; – definite serious about winning road races but also appear to be very serious about raising awareness of diabetes, etc. within sport. Drop them a line, they are most likely able to put you in contact with others who can offer more usable advice to you (or your wife).

I was pretty good with my blood levels whilst riding but I apper ot have kncok-on issues due to a lazy_@rsed diet…I seem to have it sorted whilst I’m out on the bike most of the time now but I’m still doing some jigging about with the pump settings (been on it for about 8 months now and every month I get caught out once or twice with the exercise thing…but generally it is my unfitness that lets me down and the diabetes sails on through (but it is down to many years of ‘experience’ (I’m sure others would call it suffering but I don’t think having diabetes is that bad…it isn’t good but there are far worse things to have!).

I’d suggest she tries a few longer bike rides but plan them around a few potential stopping points so she can check her bloods (and maybe get some food if she hasn’t packed enough).

My current favoured ‘eat’ is a pack of Lee’s Tablet – I eat a half-piece every half hour…seems to keep me going. Saying that, if I actually got my diet improved I think it would be even easier/better, but just now I’m too ‘busy’ with other things to have a proper think and get myself sorted.

Is Mrs Poly on MDI’s or pump therapy? If pump therapy it is quite easy to lower basal rate to help control BS without needing lots of snacks.

Votchy – injections, not pump. I’ve lost track of how many (4 or 5?) and which ones (there’s a fast and a long acting – but there was at one point a mixture too – but I think that might have changed).

aphex – yes 50k off road would need considerably more (and probably need better contingencies for lack of shops etc) but also seems to lend itself better to stopping for a quick sugar check. On the road I can ride for 2-3 hours+ without stopping at all.

So some more questions:

– do you discipline yourself to eat something every e.g. 1/2 hour .
– do you force yourself to stop and do sugar level even if you don’t feel dodgy at certain periods?
– did anyone find that their specialist/nurse was actually any good with advice on this or are they too busy with the people with terrible control and complications to get interested in the “well who want to enjoy themselves” [thats not meant as a criticism].

I’ll point her to run sweet too…

– do you discipline yourself to eat something every e.g. 1/2 hour .
Yes, top up of a couple of jelly babies or similar stuffed in an easily accesible pocket every 30 mins or so

– do you force yourself to stop and do sugar level even if you don’t feel dodgy at certain periods?
If on a long ride then yes. As an example, did an extended London to Brighton offroad last September (95 miles on the MTB)and we stopped every couple of hours (ish) and I’d do a check. Most of the time it was OK, but I did nearly crash (in both senses!) just before the end – lots of Jellybabies soerted that out.

– did anyone find that their specialist/nurse was actually any good with advice on this or are they too busy with the people with terrible control and complications to get interested in the “well who want to enjoy themselves” [thats not meant as a criticism].
Mine were quite good. They did say that you could expect a 3mmol drop for every hour of moderately intense activity. Obviously depends on the individual, but it’s a good place to start. Riding road I don’t use up as much sugar as it;s less intense, especially when riding in a pack.

Team Diabetes UK have just formed.

https://www.facebook.com/TeamDiabetesUK

Ian Rees is behind it – UK Elite rider with Type 1. Have a look out for what they are doing and advising.