Snowboarding and Skiing

Hi @Boozon . I’ll tag @Scott-C . If memory serves me right then this guy may have diabetes and skiing experience.

Hi @Boozon well... it depends! As you know there are multiple factors that affect insulin requirements, and ski / snowboarding is adding in significant variation in altitude and temperature over a day. Longer periods of sustained exercise may generally lower blood sugars, but shorter more intense bursts, or adrenaline filled runs off piste / through the trees may heighten them. Snowboarding can be intense 5 minutes runs, then perhaps 30 mins standing round for a lift.

But generally
1. I'd say as a beginner I used up loads more energy than I do now, all the falling over, getting up especially on a snowboard is brutally exhausting! Now as I'm better it's almost effortless, it's low level / low intensity, it's not a cardio work out at all, so affect is a slight downward influence on my sugars. However, I also ski and did a weeks off piste guiding course a couple of weeks back and fair to say my bs ran a bit higher than I was expecting at times, but lets say the instructor took us to some interesting / challenging places(!) and so I think the fear / adrenaline increased my sugars.
2. Porridge is good for long release energy. Still bolus for it, but maybe a fraction less than normal.
3. I did reduce basal over the week, but only by 5% or so (14 units down to 13). 30% seems extreme to me. But again it does partly depend on how good you are / how much energy you have to put into it.
4. You still have to bolus, but again maybe less than you normally would (a CGM is incredibly useful here so you know the trend)
5. I normally run my bs control very tight, but I did deliberately run a little higher than normal, to give myself a slightly higher margin of error... especially as mentioned most of the week was off-piste... being buried by an avalanache would be bad enough worse if I then hypo'd!

So i'd say generally you still need to take insulin at all times, but generally less: a bit less if it is easy / low intensity days for you; more significant reductions if its more of a work out. Keep fast hypo treatments in pockets, give a friend some to carry as well.

PS - this seems a good thread to put this info in. But for those who use an avalanche transceiver be aware that your CGM may reduce effectiveness of your transceiver when it is in transmit mode... but even worse, when you put transceiver into search mode it may very well fry your CGM!

Hi @Boozon I ski each year and have no problems, although now using a pump and Dexcom G6 which does make life a bit easier. My word of caution comes in regards to hypo awareness, somehow perhaps due to altitude, drop in temperature whatever, I find I lose my hypo awareness a bit, so first couple of days I test every 1.5-2 hours, I use jelly babies as easy to access in a pocket and eat, and if carrying a meter I keep it close to my skin as meters hate the cold. I always run slightly higher. The colder it is the more I burn glucose to keep warm so another thing to be conscious of. I always eat bread for breakfast and take it easy on apres ski for few days, can do easy basal ratios on the pump but if on injections I would instead just top up in carbs and reduced bolus injections as otherwise you can go high overnight when resting if reducing basal unless it's a split dose then slightly easier to reduce your daytime dose, otherwise test lots and have a great time

Hi @Boozon its harder to adjust with Tresiba, so your best off reducing your bolus down during the day and topping up with carbs, I find a mid morning hot chocolate keeps me topped up and a good lunch keeps me going all afternoon, I don't get too bothered by running high as the priority for me when skiing is to avoid going low and for the sake of a week it's not worth getting stressed about as prefer to enjoy the ski without hypos

Hi, @Boozon , and thanks for the tag, @therower .

Don't underestimate the effect of Glut4, glucose transporter 4, when you're skiing.

It's a protein in each muscle cell which comes to the cell surface when muscles contract and lets glucose in to be used as energy without insulin.

If you take your normal bolus for a meal and then the glut4 kicks ins too while skiing, that's a double whammy which will drop you hard.

I skied a lot in my 20s and 30s, every weekend in the Scottish Highlands. The measuring methods back then were fairly primitive (colour changing strips for the first few years), so I'm not going to pretend that anything I did then was precise, being in range was a fairly nebulous concept, but what worked for me was seriously tailing back bolus - a breakfast which would normally need 6 to 8u, would be pulled back to 2u, because glut4 would take care of the rest of it.

I always skied with a small rucksack with a few oatcakes, jam, and dried dates in it. They're always good for a little pick-me-up.

I'd probably play it entirely differently now that I've got cgm, but I'd probably still keep a few oatcakes handy and keep an eye on the after-drop caused by a combination of glut4 still working and liver/muscle restocking the glycogen they've used during exercise.

Come up and try skiing the Tiger at Glenshee - I was standing there once in a total whiteout, there was a dad with his two kids, they were looking troubled so I moved over, one of the kids cracked me up when she said, "daddy, I hate you for bringing me me here!"

Keep your infusion set tubing well under your clothing. If it’s well under freezing you could freeze the insulin in it. Another fear is getting the loose line snagged on something. So keep the line well manage so you don’t loose it.

I’d run with the 30% less basal rate.

Jollymon said:

Keep your infusion set tubing well under your clothing. If it’s well under freezing you could freeze the insulin in it. Another fear is getting the loose line snagged on something. So keep the line well manage so you don’t loose it.

I’d run with the 30% less basal rate.

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The tricky thing about Tresiba is that it lasts around 36 hours so it's not an easy basal to adjust for exercise, hence why it's easier to adjust the bolus and top up with carbs.

Just back from skiing and echo the above, keep just a tad higher than usual to be on the safe side, being low on the mountainside when it’s cold is no fun. It’s also difficult to get get blood temperature up until you hit around 4. I use it as an excuse to have things I normally wouldn’t bother with such as hot chocolate with cream and vin chaud. Watch out later in the evening as the day's hard work can drop your sugar too. This time with all the technology of a pump, Libre and miou miou, I had practically no lows so rather pleased and tolerated a few higher than I'd like sugars. Enjoy the trip and assuming you've briefed anyone you're skiing with about type 1-ness, you'll be fine.

Hi @Boozon no hypos - that’s good.

Yes my levels looked similar - it’s hard to stay in range and it is a learning curve for you, I rarely had stability but my focus was purely to avoid the lows even if it meant I looked like a bouncy ball all day.

Boozon said:

Hi @therower @JaneC @Draco16 @Juicyj and @Jollymon

Day 1 completed......what could be described as an up and down day!

Lovely sunny day with great snow.....enjoyed myself for breakfast and chips for lunch :0)

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So glad it’s working out for you and so agree re having the Libre and not finger pricking in the cold! I had a MiaoMiao attached so could read blood sugar on my Versa ( when connection worked!).