One of my stepsons has recently been diagnosed with type 1 diabetes.

With the warm weather here he's anxious to get to get out on his bike and explore.

Obviously, we're not going far without blood testing kits, a supply of fast acting glucose and long lasting carbs but I'd appreciate some words of wisdom from anyone out there who is either diabetic themselves or is caring for someone with type 1.

I'm type 1, lucky in some ways that I was diagnosed when I was 7 so I don't know life without it. And the secret is- don't let it make a big difference, don't be a diabetic cyclist, be a cyclist who happens to have diabetes. They'll probably have already done this but diabetes never stopped Steve Redgrave.

Yes, carry a bm kit, because he'll need to do a lot of testing til he gets a handle on how exercise affects him. Carry dextrose tablets or gels, to recover any drops. Doesn't have to be very intrusive at all, after a while he'll get a better feel for his own reaction, everyone is different so it's just got to be learned. ABSOLUTELY carry ID though, one of the real dangers to diabetics is misdiagnosis of a hypo, you can seem just dehydrated or concussed, or drunk, or high…

The other thing is not going too high! And also not avoiding insulin. It's very tempting to say "Don't want to go hypo, I'll cut my insulin" but you need it to get the energy into the muscles, exercise with an insulin shortfall is just murderous. And likewise, a lot of the things we do as riders- gels, constantly eating haribos- can drive you up. Unexpectedly I had to increase my dosage for 10UTB, despite riding as hard as I ever do, because I was consuming so many carbs as well. I'll happily run a high BM for a short time when it's appropriate but it's not a habit to get into.

The hospital should be able to give good support, diabetic care in general in the UK is very good apparently, I know my own outpatients (Edinburgh Royal) are fantastic but I gather they're nothing out of the ordinary. Often the dieticians and diabetic nurses are of more use than the doctors btw. Do make sure they understand he's active, diabetic care can be a wee bit skewed towards the less physically fit.

I don't have any great advice or great secrets, but if you have any questions you're always welcome to ask, it can be a bugger of a thing to live with but done right it doesn't have to be- and it's weird, because dysfunctional lazy diabetics are the ones that have all the problems, whereas the ones that put in the effort will always have a better time of it and suffer less disruption. The lazy option is good control 😉

I think most people I know and ride with sooner or later see me do a test or an injection but it can be very low key and unintrusive.

Another Type 1 here. Agree with all Northwind has said, especially the bit about trying to exercise without insulin.

Treat him to some form of ID from Road ID in the US – only takes a week or so to arrive. I've got some day tags that I wear whenever I'm out on the bike.

How old is he? I know that there's three Type 1 pupils at the secondary school at which I teach; two of them do 'rebel' against being diabetic/different – I had to get one sent home just the other day after I tested her blood sugar level for her and it was in the late 20's. Goodness knows how long it had been like that; I do know that girls will use ketoacidosis (running a high level) as a way to lose weight.

Try and instil in him a sense of him taking charge of it – not the other way around.

My daughter is Type 1 and I cycle with her a fair bit. Although I agree with the above about not wanting to ride without insulin, I do find that she needs to cut back a bit when going for any length of cycle.

If your stepson is just diagnosed he may well be in the 'honeymoon' period when the pancreas is still secreting some insulin and may need very little extra insulin if excercising strenuously.

In our experience there is a lot of 'suck it and see' Do a fair bit of testing at first to see how you react. I agree with consulting the diabetic nurse/Dr but sometimes find that we adjust what we do contrary to their advice after seeing what happens.

Oh, absolutely, it's often neccesary to cut for exercise. What I meant is that it's not a given.

http://www.runsweet.com is a reasonably good online resource for people with type 1 diabetes who want to lead a sporty lifestyle.

I don't have T1 or T2 DM, but have spent the last 10 years or so working with children & young people with T1DM, and the occasional couple with T2DM.

In terms of ID, then http://www.medicalert.co.uk is handy, and has a UK arm, so isn't US based, I wear one myself, importantly for a child it doesn't display "confidential" info like name or address, just a reg number, contact tel number for medicalert UK, and a couple of diagnosis.

Insulin dosage & exercise is almost a black magic, generally it is accepted that increased execise will cause hypoglycaemia, however I've seen it several times that the more strenuous/stressful the exercise, the more likely higher blood glucose are to occur (Maybe what Northwind experienced for his 10 UTB ride???.
I'm going to assume that the person involved is on multiple injection therapy, in which case they are on the best injectable regime for sports use. The thing to remember on this regime is that the mealtime injections can be adjusted up or down, so a rule of thumb can be to aim for a glucose of around 7mmol on the meal pre sports, and if extra insulin nis needed to correct a higher number it can be given, equally if the glucose is lower pre sports then the pre-meal dose can be reduced – everyone has their own tolerance, but this can be anything up to 50% of normal mealtime dose. Background/basal doses of insulin are less likely to need adjustments unless regular nightime/fasting hypo occurs after sports.

Insulin itself shouldn't be stopped, as that will increase the risk of ketones leading to quite a nasty complication called Diabetic Ketoacidosis. If blood glucose levels are high (over 16mmol) then ketones should be tested for, and if present then exercise should not take place, as the ketone levels are likely to worsen rapidly.

One inportant thing is that glycogen stores will be replenishing for up to 16 hours post strenuous exercise, so a low GI supper is a very important meal.

I'd also suggest for remoter rides that at least one person in the group is trained & familiar with the use of Glucagon injection, which can be given in the event of a severe/unconscious hypo whislst waiting for emergency service back up, who're more likely to administer IV glucose infusion.

There are several events run for young people across the UK, usually at outdoor activity centres, withy the intention of teaching self confidence & self reliance/management skills. Diabetes UK http://www.diabetes.org.uk run such courses, others may be run on a regional or local basis.

Hope this helps!

Good advice there chaps – I will emphasise the "don't be a diabetic cyclist, be a cyclist who happens to have diabetes"

Good luck

Thanks for such an informative thread.

I showed Northwind's post to my stepson.

"Wow! I diabetic guy raced his bike for TEN hours?"

Says it all. Thank you.

As a parent with a 4 1/2 year old daughter with type1 , she can do 2 laps around gt green route ( she does get towed ) she can manage that no problem also she its very active due to the summer time. but it's about getting the right balance between carbs and insulin. There have been mistakes high and low but never stop them from being active good luck

Welcome to the party!

I'm Type 1 and have been for the last 33 years so I've been very lucky in the sense I've only ever known life with diabetes (I'm 34). It has never stopped me doing anything I've wanted to do but it does mean that the preparation process takes a few extra steps i.e. adjusting insulin dosages, making sure I've got food, blood results are fine, etc. To be honest, this extra preparation 'stuff' doesn't add any more time to the process so it isn't like it is a hinderance – just something I do to do stuff. Pretty much the same as any other diabetic really – it doesn't take control of your life (as long as you aren't scared of it), you just need to learn to adjust yourself to make sure you remain i control whilst doing what you want to do.

Saying that, I'm no expert – I know what works for me but I still fluff things up – I'm needing to get back into the game and get right on top of it…a fair few odd months of goings-ons has meant I've not been quite so close to everything I should be – esult is my blood levels fluctuate more than usual as I've not been fully on-the-ball.

I believe the initial shock of finding out you are diabetic can be hard – depending on age and what kind of lifestyle you lead (or whoever it is that is newly diagnosed)…as long as there is plenty of support then they will get to grips with it quickly – but the support is an aid not a molycoddling thing – they should learn to control the diabetes so they remain in control of what they want to do.

The advice/suggestions already posted here are very good, make contact with your local Diabetes unit and make sure you use them; also try to contact a local support group – might not be your thing but it could also help show that this new 'thing' that has just happened hasn't just happened to this 1 person – there are others out there who have a similar story and they cope and get on with things.

Hypos can be scarey, but with some preparations and emergency food (jelly babies are superb!) then they can be reduced to virtually none – they will get caught out now and again but it's a learning process until they feel confident they know what they are doing – then it is just making sure the diabetes remains in check.

Northwind – were you on the orange Marin that was kind enough to chum me 100 yards up the fireroad climb then took off like I was stationery? If so, how did you get on?

"Wow! I diabetic guy raced his bike for TEN hours?"

HAH! I only did 3 laps 😳 But don't tell him that. Not because I'm diabetic though, more due to a bolted-on leg and a general lack of MTFU.

I was on me Soul Dickbarton, but if it was the big orange Wolf Ridge he's on here somewhere as well I think, kept seeing him all day.

Another Type 1 here, have been for 34 years since age of 7, my eldest son is also Type 1, diagnosed 2 years ago. Everything said above is brilliant, one thing I would add though is, where possible, do NOT inject in your legs when riding or pre ride if you need to inject, the insulin will be absorbed much faster and can result in unexpected hypos etc. I am fortunate that I managed to get funding for an insulin pump a couple of years ago and it has totally transformed my life, my son has just started on one too, would definitely recommend it if he gets the chance to get one. I have done the last 5 mountain mayhems in a team of 4 and am also doing this years, managed to get through ok on injections but with the pump it was even better. Any further questions feel free to e-mail me, also, as above, he is not diabetic, he has diabetes which means he can do everything that everyone else can, just needs to think about it a little more. Just to add, my son is 12 and loves his mtbing too and his swimming, football, rock climbing…