Guiness World Record Attempt - Diabetic Advice?

[GStow]

Hi All,

I have been a type 1 diabetic for 18 years (with poor control) but this is the first time i have reached out in a forum (my partner has convinced me that I should reach out to those with Diabetes for advice and tips).

At the end of May I will be undertaking a challenge of playing football for 7 days - Rolling subs, eating and sleeping at the side of the pitch, but essentially 16 hours of play and 8 hours of sleep a day. As far as I'm aware, I am the only diabetic in the squad.

I wanted to know if anyone has undertaken something as strenuous on the body like this before? What training did they undertake? what diabetic precautions did they undertake? and how did they monitor sugars throughout?

I have arranged to speak with the local nurses and I will be reaching out to someone for a continuous glucose monitoring system, but I thought I would see what other tips there might be out there.

Many thanks for reading,

Gary

 

[Juicyj]

Hi @GStow Welcome to the forum Wow, that sounds like a serious challenge, how exciting

I am doing a series of walks in a few weeks for Juvenile Diabetes Research - the walks average 14 miles each and involve hills. As this is a steady exercise my approach is to reduce my basal by 50%, start the day with porridge or some brown toast to bulk up on carbs, then eat around 15g of carb every 1-2 hours, and test every hour as i'll be walking 7-8 hours a day. Your exercise sounds more strenuous, so think about taking on board lots more carbs perhaps, can you do a practice run ahead of the event to test your reaction to the exercise and bg reaction ? A CGM would help massively as you can see exactly what's going on - which would help you after the play as you can then see if you're still burning glucose, this would be the part I would exercise some more caution as your muscles will be reacting to the exercise when you sleep so still burning more glucose, so a CGM will help monitor this. Good luck for the event

 

[catapillar]

How are you managing your diabetes? Do you carb count? Are you using a basal/bolus regime?

What's your training been like so far? End of May is pretty soon to suddenly be doing 16 hours of endurance exercise a day for 7 days if you don't already know you can deal with endurance exercise from training.

You say your diabetes is poorly controlled. What does that mean? What kind of numbers are you seeing? Does poor control mean lots of hypers or hypos?

If your going to use a CGM be aware they run about 20-30 minutes behind what your blood sugar is actually doing.

Roddy Riddle recently completed the 6633 ultra marathon, which is 350 miles over the article circle in 8 days, it might be worth checking out his site for experiences of t1d and endurance exercise - https://roddyriddle.com/living-with-diabetes/exercising-with-t1d/

Run sweet - http://www.runsweet.com - and Ian Gallen/Alistair Lumb are good resources on exercise and type 1.

 

[Robinredbreast]

Hi and welcome and well done for getting the wake up call about your diabetes management, good luck with the football challenge, it does sound full on, good luck and all the best for a safe and a healthy 7 days of football.

 

[Scott-C]

I used to do cycle trips, cycling for about 9 hours a day over 5 days. Because exercise allows you to use glucose with less insulin, I'd normally drop basal by about half a day or two before (even though it lasts for 24 hours, changes take a couple of days to have effect) and bolus would go down heavily too.

Oatcakes with some jam every so often gave a quick boost from the jam and a slower burn from the oats.

Some hospitals do free trials of the Freestyle Libre so you'd get to keep the reader and get given one free sensor, so maybe ask the hospital about that.


If not, starter kit of reader and two sensors is about, can't remember exactly, think it's about £130. The sensor can take a day or two to settle down ( unless you attach and delay activating it for a day) so probably best to attach it a few days before the event or you'll get weird readings.

Or phone up Abbott who make it and ask them to sponsor you with a free one! How good would that be as a publicity stunt for them: Gstow says, " I wouldn' t have been a record-breaker without my libre!"

Best of luck!

 

[TheBigNewt]

Get a CGM for sure, if only for this tournament. You'll have to cut back on your basal drastically. I've heard some marathoners on pump have to disconnect while they run. Good luck!

 

[Chas C]

The CGM will help you but you may need to work on your own methods of control, it will guide you to react to the rises and falls, any over correcting will put you into the yo yo effect of low followed by high BG's.

I would set your self a lower BG limit and if/when you reach that limit and the arrow is pointing diagonally down wards, take a 20 min or so break (remembering that the CGM will be 15-20mins behind your real BG level), take a snack (fruit can be usefull), wait until your CGM arrow is at least level then restart.

Just to give you an idea, about 6 yrs ago I'd been on a white water kayaking trip in Nepal, self supported (food and water) for 5 days. Paddling 8 or so hours each day. For the last 2 days I did not need to take any fast acting insulin for meals and had reduced my overnight long lasting dose by around 75%. This was on pens and finger stick testing.

 

[GStow]

Hi all,

thanks for the great responses. So many questions to answer.


How are you managing your diabetes? Do you carb count? Are you using a basal/bolus regime? - I have a low carb diet and have spent the last few years doing minimal blood tests a month and thats it. I had mostly given up on my diabetes after so long and never managing to really get it under control. I have a Novorapid/levamir regime.

What's your training been like so far? End of May is pretty soon to suddenly be doing 16 hours of endurance exercise a day for 7 days if you don't already know you can deal with endurance exercise from training. - I would like to say I am physically very fit. I currently play football every week and up until a few years ago I had a very good snowboard career (instructor), and used to spend alot of time in the gym.

You say your diabetes is poorly controlled. What does that mean? What kind of numbers are you seeing? Does poor control mean lots of hypers or hypos? - My HBA1C is 12 and has been around that area for a few years now, no matter what i do (many of my insulin sites no longer work)

If your going to use a CGM be aware they run about 20-30 minutes behind what your blood sugar is actually doing. - I did not know this. Thanks for the heads up.

 

[GStow]

I used to do cycle trips, cycling for about 9 hours a day over 5 days. Because exercise allows you to use glucose with less insulin, I'd normally drop basal by about half a day or two before (even though it lasts for 24 hours, changes take a couple of days to have effect) and bolus would go down heavily too.

Oatcakes with some jam every so often gave a quick boost from the jam and a slower burn from the oats.

Some hospitals do free trials of the Freestyle Libre so you'd get to keep the reader and get given one free sensor, so maybe ask the hospital about that.


If not, starter kit of reader and two sensors is about, can't remember exactly, think it's about £130. The sensor can take a day or two to settle down ( unless you attach and delay activating it for a day) so probably best to attach it a few days before the event or you'll get weird readings.

Or phone up Abbott who make it and ask them to sponsor you with a free one! How good would that be as a publicity stunt for them: Gstow says, " I wouldn' t have been a record-breaker without my libre!"

Best of luck!

I have reached out to Dexcom as i know they offer trials of the G4 (ive inquired in the past) but its the G5 id like. Plus from what I gather it has a better alert system/potential apple watch integration (currently only in US) than the Libre. I would like that sponsorship though

 

[Scott-C]

I have reached out to Dexcom as i know they offer trials of the G4 (ive inquired in the past) but its the G5 id like. Plus from what I gather it has a better alert system/potential apple watch integration (currently only in US) than the Libre. I would like that sponsorship though

Sure, alarms are great, but I was put off dexcom by the higher start up costs and the fact that unless you can tease the sensor life past seven days ( admittedly, lots of people manage that) it works out more expensive than the libre.

I've found the libre great even without alarms. So much easier to see highs and lows developing and do something about it before it gets too mad. Just so easy in idle moments to run the scanner over my arm and see things I'd never see with strips. It's been a bit of a game changer for me, and that's high praise coming from a guy who'll normally not say much more than, "aye, it's no bad".

There's a few guys who've figured out hacks to make it alarm: librealarm, transmiTTer, but takes a bit of technical know how.

Ambrosia Systems is bringing out a device called blucon at the end of April which sticks a bluetooth transmitter on top of libre to push results to a phone. They've said it will alarm, and then they've said not till the second version, so it's all a bit vague at the moment, but I'm keeping an eye on it. It's a small start up in Silicon Valley, seems quite amateurish, so whether they ever actually get round to producing it remains to be seen. If it works, it'll basically dex the libre.

 

[GStow]

Sure, alarms are great, but I was put off dexcom by the higher start up costs and the fact that unless you can tease the sensor life past seven days ( admittedly, lots of people manage that) it works out more expensive than the libre.

I've found the libre great even without alarms. So much easier to see highs and lows developing and do something about it before it gets too mad. Just so easy in idle moments to run the scanner over my arm and see things I'd never see with strips. It's been a bit of a game changer for me, and that's high praise coming from a guy who'll normally not say much more than, "aye, it's no bad".

There's a few guys who've figured out hacks to make it alarm: librealarm, transmiTTer, but takes a bit of technical know how.

Ambrosia Systems is bringing out a device called blucon at the end of April which sticks a bluetooth transmitter on top of libre to push results to a phone. They've said it will alarm, and then they've said not till the second version, so it's all a bit vague at the moment, but I'm keeping an eye on it. It's a small start up in Silicon Valley, seems quite amateurish, so whether they ever actually get round to producing it remains to be seen. If it works, it'll basically dex the libre.

Well depending on how the conversation goes with Dexcom I may reach out to Libre over the next week as in many of the different forums a CGMS has been highly recommended. I may look into those alarm options. As my phone will be sat at the side of the pitch and so if im going low i could potentially be signalled to come off or grab something to eat. for example today i noticed my sugars drop from 18 to 3.8 in the space of 3 and half hours. (admittedly all i had was scrambled egg on toast for breakfast before)

 

[catapillar]

I have a low carb diet and have spent the last few years doing minimal blood tests a month and thats it. I had mostly given up on my diabetes after so long and never managing to really get it under control. I have a Novorapid/levamir regime.

I currently play football every week.

Carb counting is monitoring how many units of fast acting you need to deal with carbs, you end up with an insulin (units) to carb (grams) ratio. So if you carb count and are using a 1:10 ratio, you might want to consider reducing this to 1:20, or more coming up to and during exercise. It's also helpful to know how many grams of carbs you need to take on to treat hypos.

Novorapid is bolus, levemir is basal. So you are on a basal/bolus regiem. As others have mentioned you might want to consider reducing your basal for the exercise, levemir is pretty flexible/responsive so you would be able to reduce as you go if you need to.

So do you have any knowledge of how one game of football effects your blood sugar? Or do you not test around exercise at all. That would probably help in working out what to do to mange blood sugar for 5 back to back games of football. Really exercise needs a bit of testing. Even if you have a dexcom that needs calibrating twice daily, it can sometimes struggle to keep up with swift blood sugar changes that can come from exercise, you can't always trust any CGM to be entirely accurate.

 

[Scott-C]

As my phone will be sat at the side of the pitch and so if im going low i could potentially be signalled

You'll be playing a pretty close game if you do that! Bluetooth range on dexcom is only about 20 feet!

Libre reader is tiny, would fit easily into pocket on shorts or top, and costs £57 so tolerable if it gets smashed. Transmitters alone for dexcom are a few hundred quid, not sure how well they'd stand up to a stud attack!