Hiking with diabetes

[Rusne]

Hi, I just went for my first hiking trip after being diagnosed with T1. I went to peak district and what an amazing weather and such a nice views!
I barely used any bolus insulun and when I did I had to chew all my glucose tabs because my BG was going low and seemed not to be getting back up.
Usually if I would be 3.7 and eat 1 tab that would bring me up to 5 but this time it was so different!
I wanted to ask if there is anyone who had similar experience and how did you change your usual routine and doses?

I think the next time i should either eat carby food (bread, granola bars etc.) Which I do not do in my usual routine. Or reduce bolus insulin?

Thanks!

 

[Salvia]

Hi @Rusne, sorry can't help with your query but just wanted to say thanks for the stunning scenery! A grand reminder of what weekends used to be - 20yrs or so ago; sadly, no more.

 

[Alison Campbell]

Wow, amazing pics in my county as well, thanks for sharing.

Some good advice for you might be found in this thread in the T1 section

https://www.diabetes.co.uk/forum/threads/managing-exercise-and-insulin.127691/

 

[AdamJames]

Hi, I just went for my first hiking trip after being diagnosed with T1. I went to peak district and what an amazing weather and such a nice views!
I barely used any bolus insulun and when I did I had to chew all my glucose tabs because my BG was going low and seemed not to be getting back up.
Usually if I would be 3.7 and eat 1 tab that would bring me up to 5 but this time it was so different!
I wanted to ask if there is anyone who had similar experience and how did you change your usual routine and doses?

I think the next time i should either eat carby food (bread, granola bars etc.) Which I do not do in my usual routine. Or reduce bolus insulin?

Thanks! View attachment 26743

Chalk me up as another one who can't help, but who appreciates the picture

I'm also struggling to adjust my routine now that I've started hiking - it was all going so well until then! But I suspect my solution will be very different to yours, me having T2. Though coincidentally I am going to try upping the carbs to see if that helps.

The Peak District used to be my stomping ground about 20 years ago, so I was hoping I'd recognise where you were, but the memory plays tricks and I'm not sure. I'm going to go for Kinder Scout with Kinder Reservoir in the background?

 

[kitedoc]

I did lots of hiking back in the day.
I would look at the map for the day's march and try to figure out where lunch , next campsite etc would be AND what the terrain was like. If we were going to be going mainly up hill in the morning I would ease back my morning short and long acting insulin by 20 to 30%.
Even if the reading was up a bit at lunch time I would tend to keep any lunch time bolus at abut 10 to 20% less than usual. depending if the next section was downhill or not. I would keep my blood sugar above 5 mmol/land less than 14 mmol/l if I could.
Lower than 5 mmol/l risked hypos , falls and tumbles and higher than about 14 mmol/l I would take an extra shot of short-acting dose say a half of usual bolus of short-acting insulin and wait.. The reason is that at around 13-14 mmol/l and above the body starts to think it is starving with a high sugar not getting into cells fast enough and starts to cause the liver to release more blood sugar. So the exercise at that point will just tend to send the sugar up higher, I feel rotten and ache all over. It sounds like a crazy thing for the body to do but our bodies were not designed with diabetes in mind.
Once blood sugars had dropped below 12 mmol/l I would start up walking again. At dinner time I try not to eat too much but ease back both short and long acting insulin by at least 20 %. My reason? Yes, I was not going to exercising at night (unless the river rose !) BUT my muscles had been releasing their glucose stores during the day to use for fuel, along with what I was eating AND 6 hours or so after exercise is complete my muscles would demand payback of glucose to restock their fuel supply. Where does that glucose come from? Yep, my blood stream, so if I do not keep the insulin lower than usual I will have a hypo at say 2 am and will be stuffing my face with food. And the other thing you do not want to do is be hypoing day and night by not easing your insulin back and run out of food. Also I found that if I kept my insulin dose the same as usual on a hiking trop the extra food I would need to eat all the time was causing me to be sluggish and my stomach to ache. I also found that the blood sugar would be up at lunchtime because the adrenaline released during a fund morning walking would push the sugar level up. The trick was to not let that tempt me to up my insulin dose, except if I got above 13 to 14 mmol/l. If the day turns out differently in that it starts to rain and we stop early to pitch camp I do not drop the evening insulin quite so much, but the morning walk and some of the exercise of setting up camp in the rain, finding wood to burn etc will still affect my blood sugar. Night down dose, sleeps well. night and normal dose , sleeps like hell. It is all worth it to see the views and take pictures. It is all about experience and learning.
Now that I have an insulin pump, I just alter the basal and bolus %-wise with the pump controls.

 

[Rusne]

Chalk me up as another one who can't help, but who appreciates the picture

I'm also struggling to adjust my routine now that I've started hiking - it was all going so well until then! But I suspect my solution will be very different to yours, me having T2. Though coincidentally I am going to try upping the carbs to see if that helps.

The Peak District used to be my stomping ground about 20 years ago, so I was hoping I'd recognise where you were, but the memory plays tricks and I'm not sure. I'm going to go for Kinder Scout with Kinder Reservoir in the background?

Hi yes thats Kinder reservoir, I walked Kinder Scout route. You guessed right!!

 

[Rusne]

I did lots of hiking back in the day.
I would look at the map for the day's march and try to figure out where lunch , next campsite etc would be AND what the terrain was like. If we were going to be going mainly up hill in the morning I would ease back my morning short and long acting insulin by 20 to 30%.
Even if the reading was up a bit at lunch time I would tend to keep any lunch time bolus at abut 10 to 20% less than usual. depending if the next section was downhill or not. I would keep my blood sugar above 5 mmol/land less than 14 mmol/l if I could.
Lower than 5 mmol/l risked hypos , falls and tumbles and higher than about 14 mmol/l I would take an extra shot of short-acting dose say a half of usual bolus of short-acting insulin and wait.. The reason is that at around 13-14 mmol/l and above the body starts to think it is starving with a high sugar not getting into cells fast enough and starts to cause the liver to release more blood sugar. So the exercise at that point will just tend to send the sugar up higher, I feel rotten and ache all over. It sounds like a crazy thing for the body to do but our bodies were not designed with diabetes in mind.
Once blood sugars had dropped below 12 mmol/l I would start up walking again. At dinner time I try not to eat too much but ease back both short and long acting insulin by at least 20 %. My reason? Yes, I was not going to exercising at night (unless the river rose !) BUT my muscles had been releasing their glucose stores during the day to use for fuel, along with what I was eating AND 6 hours or so after exercise is complete my muscles would demand payback of glucose to restock their fuel supply. Where does that glucose come from? Yep, my blood stream, so if I do not keep the insulin lower than usual I will have a hypo at say 2 am and will be stuffing my face with food. And the other thing you do not want to do is be hypoing day and night by not easing your insulin back and run out of food. Also I found that if I kept my insulin dose the same as usual on a hiking trop the extra food I would need to eat all the time was causing me to be sluggish and my stomach to ache. I also found that the blood sugar would be up at lunchtime because the adrenaline released during a fund morning walking would push the sugar level up. The trick was to not let that tempt me to up my insulin dose, except if I got above 13 to 14 mmol/l. If the day turns out differently in that it starts to rain and we stop early to pitch camp I do not drop the evening insulin quite so much, but the morning walk and some of the exercise of setting up camp in the rain, finding wood to burn etc will still affect my blood sugar. Night down dose, sleeps well. night and normal dose , sleeps like hell. It is all worth it to see the views and take pictures. It is all about experience and learning.
Now that I have an insulin pump, I just alter the basal and bolus %-wise with the pump controls.

Thanks so much for sharing this is very useful. I found that my BG drops a lot more rappidly on the hike than in the normal day and yes, I was worried about my BG at night and set alarms to check, and it was going low after hikes.

I use insulin pens and when I noticed that my normal bolus gave me hypos I ate without insulin and it was quite ok that way (around 15gr carbs in a meal+ protein and fat).

Now I am thinking, perhaps in the first day of a hike I had to drop my basal by couple of units and that would solve a problem?

 

[Resurgam]

Waaaah - I did not even think - oh where is that - it was like Cupid's dart to my heart - home - and I want to be there.

It is wild though - even today with helicopter services and GPS - I'd advise less insulin, not because I know about insulin, but I know the land.
I've sat under a rock over hang and watched a snowstorm in June above Alport Castles having passed the farm in bright sunlight with my jacket on my pack.

 

[AdamJames]

Waaaah - I did not even think - oh where is that - it was like Cupid's dart to my heart - home - and I want to be there.

It is wild though - even today with helicopter services and GPS - I'd advise less insulin, not because I know about insulin, but I know the land.
I've sat under a rock over hang and watched a snowstorm in June above Alport Castles having passed the farm in bright sunlight with my jacket on my pack.

Speaking of the Peak District and strange weather, ever since seeing the pic in the OP I've been thinking of the time when I visited Kinder Downfall in epic wind. It was hard to breathe at times, and when I tried jumping straight upwards I landed about a foot from where I started.

When we got to Kinder Downfall, it was Kinder Upfall. The water was going over the edge, falling a couple of feet, then getting blown high into the air and landing back at the top, upstream. It kind of begged the logical question where exactly was the water going? It certainly wasn't making it down to the bottom of the waterfall!
We tried throwing a rope down over the edge as we wanted to abseil down to the bottom, and the wind had the same effect - the rope just blew right back up over our heads, and we ended up tying a rucksack to the end of it and lowering it.

It seems it wasn't a one-off and there's something about the shape of the land there that channels the wind, as there's some photos and videos of the same effect. This is a good one. A lot of the water is making it to the bottom in this vid, but if you watch till the end there are some moments when pretty much all of it gets turned back!

 

[Salvia]

I'm going to go for Kinder Scout with Kinder Reservoir in the background?

Well done that man! I thought it was probably Kinder but after all this time - & knowing that my memory is shot to pieces these days - I didn't quite dare to say so

Hi yes thats Kinder reservoir, I walked Kinder Scout route. You guessed right!!

Thanks for confirming @Rusne
Hope you manage to sort an insulin regime that suits your body and your walking; sounds like it might be a case of 'trial and error' which it often seems to be, from reading posts on here.

 

[Rusne]

I just got back to London and started planing the next hike
Thanks for tips, I will definately do more trial and error

By the way, weather was great, a little windy at the top but nothing too extreme, which made the walk quite nice.
I went up Tryfan in Snowdonia in wind and rain last summer and that for me was quite extreme but in a way I really enjoyed the challenge.
Any other good hikes in UK?
So far I have been to Breacon Beacons and Snowdonia

 

[AdamJames]

I just got back to London and started planing the next hike
Thanks for tips, I will definately do more trial and error

By the way, weather was great, a little windy at the top but nothing too extreme, which made the walk quite nice.
I went up Tryfan in Snowdonia in wind and rain last summer and that for me was quite extreme but in a way I really enjoyed the challenge.
Any other good hikes in UK?
So far I have been to Breacon Beacons and Snowdonia

The weather looked very nice from your picture. Was it this weekend? I've been stuck indoors for various reasons this weekend, but I'm not sure I'd have ventured into the hills anyway, because of the virtually non-stop lightning yesterday (Sunday) and the night before! You did well to escape it if your walk was this weekend.

I guess being in London means that you might not have the time to venture too far north at the weekends? If it's the bigger hills / mountains that appeal to you then obviously you're limited to Snowdonia, the Lake District and the Scottish Highlands so the latter two might be out of range? All I'd say is don't give up on Snowdonia even after you've done the bigger stuff like Tryfan. I've started going back there a lot recently, and the amount of new stuff I'm discovering is making me realise that you could spend a lifetime in that area discovering lots of stunning new places which just aren't very popular / don't get mentioned a lot.

Snowdonia also extends a lot further south than people sometimes realise - e.g. there's a lot of nice walking to do near Cadair Idris. If there's one walk I'd recommend in that area it would be the 'New Precipice Walk' which starts near Dolgellau, is relatively easy, you can probably be up and down in 2-3 hours, but if you time it right the reward is spectacular - you get to see the sun setting in the sea at the mouth of the estuary. I can't find my photo of that just now but if you imagine the sun setting slap-bang in the middle of the photo on this page you'll get the idea! I think mid-January might be the best time for that alignment however due to the way the solar system works, I can't remember!

http://snowdonia.info/top10/new-precipice-walk-dolgellau/

The only things I've tried nearer to you are the south-west coastal walks - there appeared to be virtually non-stop coastal paths around Cornwall for example. There's also things like the Cotswold Way.

I guess it depends on what type of environment does it for you. One place I'd love to visit which is much nearer to you is the New Forest. It's much flatter than the kinds of areas I'm used to but I think I'd love it.

 

[Rusne]

The weather looked very nice from your picture. Was it this weekend? I've been stuck indoors for various reasons this weekend, but I'm not sure I'd have ventured into the hills anyway, because of the virtually non-stop lightning yesterday (Sunday) and the night before! You did well to escape it if your walk was this weekend.

I guess being in London means that you might not have the time to venture too far north at the weekends? If it's the bigger hills / mountains that appeal to you then obviously you're limited to Snowdonia, the Lake District and the Scottish Highlands so the latter two might be out of range? All I'd say is don't give up on Snowdonia even after you've done the bigger stuff like Tryfan. I've started going back there a lot recently, and the amount of new stuff I'm discovering is making me realise that you could spend a lifetime in that area discovering lots of stunning new places which just aren't very popular / don't get mentioned a lot.

Snowdonia also extends a lot further south than people sometimes realise - e.g. there's a lot of nice walking to do near Cadair Idris. If there's one walk I'd recommend in that area it would be the 'New Precipice Walk' which starts near Dolgellau, is relatively easy, you can probably be up and down in 2-3 hours, but if you time it right the reward is spectacular - you get to see the sun setting in the sea at the mouth of the estuary. I can't find my photo of that just now but if you imagine the sun setting slap-bang in the middle of the photo on this page you'll get the idea! I think mid-January might be the best time for that alignment however due to the way the solar system works, I can't remember!

http://snowdonia.info/top10/new-precipice-walk-dolgellau/

The only things I've tried nearer to you are the south-west coastal walks - there appeared to be virtually non-stop coastal paths around Cornwall for example. There's also things like the Cotswold Way.

I guess it depends on what type of environment does it for you. One place I'd love to visit which is much nearer to you is the New Forest. It's much flatter than the kinds of areas I'm used to but I think I'd love it.

Great tips thanks! I want to spend as much time as possible outdoors in summer so probably will do some more shorter trips, the walk in Snowdonia you mentioned looks beautiful.
I hope to travel to Scotland and Lake District too but need more planning for it.

Thanks!

 

[AdamJames]

Great tips thanks! I want to spend as much time as possible outdoors in summer so probably will do some more shorter trips, the walk in Snowdonia you mentioned looks beautiful.
I hope to travel to Scotland and Lake District too but need more planning for it.

Thanks!

For shorter stuff in Snowdonia, you could do much worse than basing yourself in or near Betws-y-Coed for a weekend. There's camping or b&bs there, or even just 30 minutes drive away there will be the campsites you probably saw when you did Tryfan. The smaller campsite right at the foot of Tryfan is one of my favourites - if you venture over the rocks on the left as you drive in there's a bit of space where you can pitch a tent right by a river.

The streets of Betws-y-Coed are usually full of tourists eating ice-cream, but many great shorter walks start there on foot, and as soon as you leave the village things get very peaceful and beautiful.

One walk I'd recommend from there is up to LLyn Elsi. You can be up and down in about 3 hours. It's one of the more popular walks, but even so, it's surprising how few people are often doing it in spite of how busy Betws gets.

Another one I'd recommend from there is up to LLyn y Parc, another lake but in the hills to the opposite side, and similar distance / time.

Basically if you turn up in that area and buy a local walking guide book from one of the many outdoor shops there, I think you'd probably have a very enjoyable weekend! You can fill your time with lots of the smaller walks in that area, or if you feel more full of energy you can be at the foot of Snowdon in 30 minutes drive.

Speaking of driving one of the most stunning drives in that area is from Betws-y-Coed to Beddgelert. And Beddgelert also has some very beautiful shorter walks.

Anyway I'm rambling (do you see what I did there) but in summary I think if you turn up to that area with a tent or a B&B booked, and get a local guide book, you can't go wrong.

 

[WHM]

Hi Rusne
Well done
I am a type 1 and last summer I hiked the first 140 miles of the Pennine Way combining camping and B&B.
I am a pump user which made diabetes management easier, I reduced my basal rates by 50% on hiking days and a little less on rest days.
I also used a Freestyle Libre for the 2 weeks on the trail, so much easier than trying to fingerprick in the cold and frequent rain, the directional arrow was extremely useful in planning carb intake. Kept the reader in a sealed plastic bag to keep the rain out.
No reason why type 1 diabetics shouldn’t fully experience the joy of the wonderful footpaths that Britain has in abundance.
In my experience you just need to plan in more detail than the average non diabetic.

 

[KevCB]

I spent a week hiking in the Peak District last summer (such a beautiful part of the Country).

Now, I'm slightly different due to being Type 3c however do inject insulin....I didn't alter my dosage but snacked more - I favoured SiS Go Energy gels and bars to ensure that my Carb/Glucose intake was higher that usual.

As a result, my levels stayed pretty much normal.

I guess it's pretty much a case of being aware of your body (and the terrain!)

 

[ziawattoo54]

Hi @Rusne, I'm a T1 patient and it's been 18 years. I've been living in Islamabad (Pakistan) for last three years, and the city being surrounded by green mountains, has made hiking once in a month thing for me. What I do usually is, I reduce my insulin dosage before hike i.e. if I take 12 units of humalog in routine, I take 8 on a hike day and same reduction for a dose after the hike, with some fruit drinks on the way. And it doesn't mess with my BG levels. Just some precautions and it's all set.
Nice scenery btw

Sent from my SM-G950U1 using Diabetes Forum mobile app

 

[DunePlodder]

I'm originally from Derbyshire and have walked Kinder a number of times - you were very lucky with the weather!
If you like coastal walks I can recommend Sidmouth to Beer in East Devon.
I use a split dose of Levemir & reduce my day time dose by about 30 - 40% for a day's hike.

 

[AdamJames]

Hi @Rusne, I'm a T1 patient and it's been 18 years. I've been living in Islamabad (Pakistan) for last three years, and the city being surrounded by green mountains, has made hiking once in a month thing for me. What I do usually is, I reduce my insulin dosage before hike i.e. if I take 12 units of humalog in routine, I take 8 on a hike day and same reduction for a dose after the hike, with some fruit drinks on the way. And it doesn't mess with my BG levels. Just some precautions and it's all set.
Nice scenery btw View attachment 26772View attachment 26773

Sent from my SM-G950U1 using Diabetes Forum mobile app

Nice pics. Islamabad is somewhere I normally only hear about in the context of bad news. It's clearly a lovely place for walking.

 

[ziawattoo54]

Nice pics. Islamabad is somewhere I normally only hear about in the context of bad news. It's clearly a lovely place for walking.

Thank you. It's just media and their crisps. Other than that it's lovely place to live and visit. Weather is awesome and the natural sceneries are a blessing above all.
You're most welcome to visit, if you get a chance.