Cycling and Pumping!!!!!!!

docvern said:

hi all
started cycling about 3 months ago - getting addictedto it but my body is haywire,,,,,,,,,,,im on an insulin pump and before i start i check blood which ishopefully around 9-10. pump gets took of and put in pocket. after about an hours cycling my bloods are about 3.3 and i feel fine , normally i would be hypo'ing by now, i eat half amars bar and 1 hour later my bloods are around 16 and i feel awful,,,,,,,,so pump goes back on and i bolus to allow ,,,,,,,,
what is happening to me or what is the solution,,,,,,
any tips very much appreciated

thanks in anticipation
philip

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Before exercise reduce your basal a couple of hours before you start. It stands to reason your blood sugar would go up to 16 at the time you mention because when you took your pump off that's when your basal stopped. So with the action of your insulin plus the carbs you end up so high. Pump off no delivery of basal 2 1/2 hours later then you would expect a massive high.
Why are you eating mars bars to treat a low? It's all goo and fat so a very slow rise anyway and pumpers should only use quick acting carbs to treat a low.

Ah another cycling addict! I got hooked on it a few years ago and absolutely love it - particularly if I can find a nice little pub en route!

I always have to reduce my insulin if I am cycling. If I do have hypos I find the Lucozade works best and doesn't make my levels rise too much. Having said that, this is just my personal preference.

If I were you I'd reduce your insulin before your next cycle and see how you get on. Cycling can be pretty intense so it's perhaps not a huge suprise that your sugars dropped. One of the guys I cycle with teach spinning at a local gym. He was telling me that different heart rate zones affect how you burn sugar and fat. Apparently, if you heart rate is between x and y you will burn sugar. If it rises above y you will burn fat. I can't remember the figures, and I have no idea if there is any truth behind it! Maybe he was just saying that to make me push myself harder so I went into fat burning mode!

Em

Hi Phillip,

I cycle upwards of 120 miles a week as part of my triathlon training and although I'm not T1 (apparently T1.5) I am insulin dependant and I would not recommend eating something like a mars bar for energy on a ride.

Any of the cyclists I know would normally favour something that releases its energy (glucose) far more slowly than chocolate and caramel (or Lucozade for that matter).

Typical cyclist non sports specific food favourites (as opposed to gels and energy powders) are bananas and buttered Soreen malt loaf.

So I would suggest eating say half a banana after 1/2 an hour and then the other half after an hour and see how that affects your levels.

It's worth considering that you probably need far fewer carbs than you get in that mars bar to sustain you on the ride but this will depend on the level of exertion you are undertaking.

So baring in mind I'm not T1 and not on a pump so things may be different to you and purely as an example I typically would eat, at most, 1 banana on a 2-3 hour ride with an average speed of 20mph and come off the ride with levels anywhere around 5-8. I usually start rides by eating some cereal just before and therefore with bg on the high side around 8-10. I maintain my basal insulin dose but do not take any bolus before or during the ride. I usually find I am far more sensitive to insulin after the ride as well and therefore cut back my doses for the rest of the day (and sometime next morning).

I can't comment on you use of the pump as I have no experience but I know one guy in my cycling club (Team Milton Keynes) who has one and I'm pretty sure he cycles with it on but have no idea of what settings he is using (maybe he has it on just for the cake stop )

It might be worth searching for local cycle clubs and asking them if they can see if they have any pump based members who might be prepared to discuss usage with you. Worth a shot and you might find some cycling buddies!

Andy

docvern said:

hi ,
thanks for responding to my post. you both seem to know what you are talking about. if i reduce basal before starting my bloods are going to go high,,,,,,then i feel like plop, are you suggesting i reduce basal to say 50 % while cycling and pop a couple of jelly beans as i ride??? As far as the mars bar goes I thought a slow release of sweetness would be good to bring me home!!!
Thanks for any info
Philip

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Hi Philip,
with a pump you have to think ahead, now you say your start a ride with blood sugars at 9 or 10. I call that high :lol:
The idea of your pump is so you can control your basal to your needs. So you need to think ahead which means cutting your basal before the ride. This will stop the hypo and also stop the massive rise after you have had to correct the hypo. Having no insulin whilst you ride is pointless as the effect only takes 2 hours plus later. So you need to learn how your body reacts to this form of exercise. Take jelly beans/babies with you and test as you go along. Test every half hour until you have it sussed. Some people will have a massive high after exercise like that so monitor and see what happens over a couple of rides. If this does happen then you know to increase your basal for an hour or two.
Trial and error and plenty of jb's will get you there in the end.

docvern said:

hi all
thanks for the detailed and informative replies, i guess the answer is trial and error and a bit more testing,,,,hate stopping to test but thats a by product i guess!!!!!!!
going to try reduce basal to 50% and half and half banana to see how i get on , will keep you advised, as i say at the bottom of my post the people to learn about diabetes is diabetics,,,,,,not alot of faith in nhs!!!!!!!
again many thanks
philip

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If you are cutting your basal why are you going to eat a banana? The idea of the pump is to reduce your insulin so you do not have to feed hypos.

As I said I cant really comment on pumping but if it where me I would not change my insulin initially and eat the banana (half after 30-45 minutes, the rest after 75-90) instead of the Mars bar and see how you go.

General wisdom in my experience is that you don't really need to eat anything during exercise for anything up to an hour but after that it will help if you do (but not over eat) but with you going slightly low after the hour it would be good sense to eat a little earlier.

It's almost certainly going to be a case of trying different things to see what works for you and I would suggest trying one thing at a time (i.e. change only food initially) gives you the best chance of achieving good levels for the exercise you are doing.

Andy

arcaic said:

As I said I cant really comment on pumping but if it where me I would not change my insulin initially and eat the banana (half after 30-45 minutes, the rest after 75-90) instead of the Mars bar and see how you go.

General wisdom in my experience is that you don't really need to eat anything during exercise for anything up to an hour but after that it will help if you do (but not over eat) but with you going slightly low after the hour it would be good sense to eat a little earlier.

It's almost certainly going to be a case of trying different things to see what works for you and I would suggest trying one thing at a time (i.e. change only food initially) gives you the best chance of achieving good levels for the exercise you are doing.

Andy

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Hi Andy,
the idea of the pump is to allow changes to insulin needs (basal) which can be done by the hour. thus no food is needed. It's a pocket pancreas. OP needs to learn how to use his pump and understand how insulin works

docvern said:

Ifsuper confused now,,,,,,,pump of =hypo,,,,,,,,,,,reduce pump and eat ?????
what should i do carbsrok??????

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If you cut your insulin as I suggested the drop in basal will coinside with your low blood sugar on previous rides and also stop the massive spike you have after the low due to not having any basal.
As I also told you, you need to test and see what is happening throughout the ride and take plenty of hypo treatment with you.
If things don't work out then look at your results and think :!: about what needs to be adjusted and when. Repeat until you get it right. If nothing else you will be nice and fit by the end of it :lol:
You need to understand the basics of insulin durration and how to adjust your pump.
Invest in the book pumping insulin by John Walsh worth it's weight in gold. I suggest you look for a 4th edition as the 5th is very expensive.

docvern said:

hi all
started cycling about 3 months ago - getting addictedto it but my body is haywire,,,,,,,,,,,im on an insulin pump and before i start i check blood which ishopefully around 9-10. pump gets took of and put in pocket. after about an hours cycling my bloods are about 3.3 and i feel fine , normally i would be hypo'ing by now, i eat half amars bar and 1 hour later my bloods are around 16 and i feel awful,,,,,,,,so pump goes back on and i bolus to allow ,,,,,,,,
what is happening to me or what is the solution,,,,,,
any tips very much appreciated

thanks in anticipation
philip

Click to expand...

You might like to read the experience of this man who cycles wearing a pump.
http://www.runsweet.com/Cycling.html

(about to post when saw Catherines post, we've given the same link!)
When and by how much to reduce the pump pre exercise is perhaps individual.
On the runsweet site it says

The optimal reduction is not clear, but for most people it probably lies somewhere between 50% and 100% (the suspension of basal insulin). Whether there is a benefit of an earlier reduction in basal rate has not been investigated. The available evidence suggests that circulating insulin levels at the start of exercise are important, and the time-action profile of the available rapid-acting analogue insulins suggests that the earliest effect of a reduction in basal rate will occur at around 10-15 minutes(12;13). In order to reduce circulating insulin levels at the start of exercise, therefore, it would sensible to suggest that a reduction in basal infusion rate should be made some time prior to starting exercise.
Unfortunately there is as yet no evidence to suggest when this should take place. An extension of this would be the consideration of whether basal rate should be increased again before exercise finishes, as insulin levels in those without diabetes would increase at this time. Again, while this strategy makes physiological sense and has been used with some success in individual athletes, there is as yet no data to support whether this might be beneficial in general

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The team at High Wycombe (where the runsweet site originates) have obviously been trying to find out as there was a brief report produced at a major conference last month. They reported that reducing the basal 80% rather than 50% was much more effective for preventing hypos. The exercise took place 90 mins after a meal with 60g of carb and the usual bolus They tried reducing the basal at different times (0, 30, 60 or 90 minutes before exercise. )They didn't find any clear pattern as to when was the best time to reduce .

These data suggest that a basal insulin infusion reduction of 80%
rather than 50% is preferable to avoid hypoglycemia in adults during aerobic
exercise, and this should be refl ected in clinical advice.

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http://diabetes.diabetesjournals.org/co ... l.pdf+html
This advice reflects what I now do . I used to reduce by 50% for all exercise but I started reducing reducing it by 80% a while ago for running and cyling (up to a couple of hours). The time I reduce it at depends to a certain extent on when I remember!. Sometimes I do it right at the start of exercise and sometimes about half an hour before. I still find I need to eat something about an hour later but unless it's very hilly I am avoiding early lows. ( I run, and do a little bit of off road cycling. none of it at very fast rates) I think though you have to watch your levels because it might be that you later have to increase the basal later during exercise of longer duration.
The runsweet site itself has a lot of useful info, including the quote above http://www.runsweet.com/InsulinPumps.html
and this section on cycling with a pump could give you some ideas
http://www.runsweet.com/Cycling.html