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Type 1 diabetes and triathlon
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Just recently diagnosed as a type 1 diabetic. Have a dexcom that monitors my glucose levels and am possibly going to be getting an insulin pump as well. Taking shots for now.

Anyone else in the same boat? Seen any issues with training or racing? Do you race with your pump? Any advice? Any nutrition you recommend using?
Last edited by: TNTRI: Jun 30, 20 17:19
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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Sorry to hear about the diagnose, but life moves on with some adjustments here and there. There are a few of us around, check the 'The Official Diabetic Triathlete Thread'

https://forum.slowtwitch.com/...es%20thread#p4839016

I would also recommend considering a low carb approach in the future, to me worked by far as the best way to keep the A1C in very healthy levels while still allowing me to train and race at a decent level (after a very hard adaptation phase)

https://www.ironguides.net/...-carb-high-fat-diet/

Good luck
Vinnie

--
Vinnie Santana, Multisport Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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I've been type 1 for 29 years (since I was 12). I was diagnosed and hospitalised during a swim meet. Been active in sports ever since. First swimming and rugby, then weights and rugby at uni, then triathlon after uni.

The biggest problem I have found is going high for races and trying to get really good levels when my routine is changing from day to day. When I was a swimmer this never happened to me, but for some reason it always has since I've been doing triathlons (did my first tri in around 2003/04).

With the adrenaline rush for a race, it nearly always makes my levels go a bit high on the morning of the race. I nearly always have to give myself an extra injection of humalog (am on injections as opposed to a pump - I don't like the idea of being attached to a pump) prior to a race. Sometimes it comes under control, sometimes it doesn't. So, if you can learn what works for you on race morning that's a good start.

I have found that for sprint triathlons, I should not take any carbs as that only makes me high. Olympic distance tris it is 1 gel and sports drink. Half ironman and above, it is the same as training.

The need for me to have carbs during training has changed over the years. One thing that has remained fairly consistent though is that if I train before breakfast, I don't need any carbs unless I am going longer than 1.5 hours. My levels will usually stay steady if I have nothing. I no longer train evenings after work, but to begin with I would need around 40 grams of carbs each hour trained. This would be a gel every 45 mins on the run or gel every 45 mins plus sports drink on bike. However, over time, I found I no longer needed carbs for evening training. I'm not sure if this is because of my switch from humulin-n to lantus, but this is what happened to me. So, basically for training, whether I need carbs depends on how close it is to a dose of fast acting insulin. Any training after breakfast, I will need gels every 45 mins plus sports drink, likewise for straight after lunch.

For training, always carry a surplus of gels for if you go low in blood sugar. I have gone low on a number of times whilst out training and for long rides will usually take 3 more gels than what I think I will need.

If I am high before training, I will give myself an injection but will inject 1 less unit than what I would normally do for the same level. I've found this reduces the risk of going low in blood sugar.

Another thing is that you may find you need to adjust your insulin doses quite a bit depending on what your routine is. For me, one of the hardest things to juggle is working out my insulin dose on a daily basis if things are changing from day to day. If you can, keep your carb intake the same day to day so that the only thing that changes is the training you're doing. I find I can get pretty much perfect levels if I am on a break from training as every day is the same. It is a bit harder with training though and the timing of that training and whether you have rest days or not.

For myself I don't test during a race unless it is an ironman in which case I test after the bike. That probably is not such a problem for you tho as a dexcom is a CGM right? CGMs are not funded here in New Zealand...

You will need to find what works for you though.
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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I have been a type-1 diabetic since 1997 (I was 12) and have had it during my entire triathlon career.

I have a Medtronic 670G with the CGM and in all honesty I couldn't live without it. I have had an insulin pump for around the last 10-12 years and they are game changers. My A1C is around 6.5-7. I remember taking shots and I truly don't know how people can do that without a pump. They are life changers.

I do have some issues with training and getting low. When I am fasted (morning workouts) I don't have any trouble with it but when I have to train after work I have a really hard time keeping my readings up. I have to start my training high and then it usually crashes pretty hard. I have learned when to eat and always carry gels/etc to keep things up as much as possible. Talked to a couple doctors about it and they really don't have an answer so it has been trail and error for me. I now start the workouts a little on the higher end to curb the crash and just keep an eye on my CGM to see where I am at every so often.

I will say that my diabetes/insulin pump has never held me back from training or racing. I do race with my pump, but I do not swim with it. I either keep my pump in T-1 or I talk to the race director and have it setting somewhere right out of the water (Ironman actually has a table for this type of stuff in their races). Last year I did the USAT AG Nationals and I left my pump with my bike and when I got to it my readings were a little high but it wasn't bad at all.

My biggest suggestion when you are training is to always carry a credit card. On rides and runs there will almost always be places to stop (gas stations, etc) if your readings get low and you will always be able to buy something to take care of that if you have a credit card. Like the other said you can always have gels with you at the same time.

Everyone will be a little bit different so there really isn't a one size fits all. I would have these discussions with your Endo and make them aware that you race and you might be surprised how much information is there. I used to be really self conscious about my diabetes but once I opened up about it I found that a lot of people are more than welcome to help you, especially my doctor who connected me with some local groups and stuff.

It might take a little tinkering but once you figure things out you will be able to adjust for yourself and feel more confident about it.
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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TNTRI wrote:
Just recently diagnosed as a type 1 diabetic. Have a dexcom that monitors my glucose levels and am possibly going to be getting an insulin pump as well. Taking shots for now.

Anyone else in the same boat? Seen any issues with training or racing? Do you race with your pump? Any advice? Any nutrition you recommend using?

May I suggest checking out:

TT1 Zwift Facebook group:
https://www.facebook.com/...teamtype1/?ref=br_rs

TT1 Zwift race group:
https://www.facebook.com/groups/RaceT1/

Team Novo and TT1:
https://www.facebook.com/TeamType1Page/
https://www.teamnovonordisk.com/

All good resources as well as the topic posted here. TT1 isn't just bike racing, they have triathlete stuff and other sports as well.
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Re: Type 1 diabetes and triathlon [wei5209] [ In reply to ]
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Thanks for the info about the pump at races, thats great to know. My endo is suggesting the pump but the one they are wanting me to get is looking like it will initially cost $2,800.00 so I am having to sort a few things out there.

I seem to have the same issue. I will do simple runs after dinner when my numbers look good and I seem to drop pretty quickly.
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Re: Type 1 diabetes and triathlon [burnthesheep] [ In reply to ]
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Thanks for the heads up! I was told to check out team novo nordisk
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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Yea, it is criminal that it is so expensive to get an insulin pump that will keep you so much healthier so you don't end up at the doctor/er more. Don't get me started on that part of it. I think I paid something like that for mine. They will have you talk to someone from whatever company you use, just let them know you obviously can't pay that much for it and they can set you up a payment plan (interest free). It will take you a bit to pay it off but I was able to get to a number that wasn't too bad that I just pay every month.

Yea, those drops suck. I handle them way better than I used to but it will never be perfect. Just know that you can get by it. I actually just did a virtual 24 hour ride (stayed up for 26.5 hours, riding for almost 19 of them) and I had plenty of times where I started dropping but since I had dealt with it before I was able to go off of past experiences to put the carbs/sugars into my body that helped me bounce back in the past. For me gummy bears work really well.
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Re: Type 1 diabetes and triathlon [wei5209] [ In reply to ]
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Oh, thanks for the payment plan idea. I hadn't thought to ask that. The rep from the company called me yesterday so I will ask into that option.

Right now I keep a small bag of skittles on me whenever I ride or run.
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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TNTRI wrote:
Any advice? Any nutrition you recommend using?

Get to know what food does what to your body, at what time of the day and pre/post exercise. A journal may be useful for a while.

Generation UCAN is an amazing product for keeping your glucose levels stable.
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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TNTRI wrote:
Thanks for the info about the pump at races, thats great to know. My endo is suggesting the pump but the one they are wanting me to get is looking like it will initially cost $2,800.00 so I am having to sort a few things out there.

I seem to have the same issue. I will do simple runs after dinner when my numbers look good and I seem to drop pretty quickly.

Great resources already provided and I have always been impressed by TT1 (cool kit on Zwift as well). Reach out to JDRF and/or ADA, etc. to see if any available assistance for expenses associated with devices, medication, etc.



I miss you "Sports Night"
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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I do not have Type 1, but my daughter does. She is young, so it is something my wife and I manage for her on a daily, if not hourly basis. As you proceed with this new lifestyle, you'll begin to see how your body responds to different activities, foods, etc and you'll discover your own game plan and what works best for you. You have probably received more advice than you can take in, so I'll stay away from that. I'm sympathetic towards you and understand the difficulty of this change. You've got a lot of resources available, I'm sure, but you are always welcome to reach out if you have questions.
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Re: Type 1 diabetes and triathlon [Peppe89] [ In reply to ]
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I've been type 1 for close to 30 years, and have been involved in endurance sports for most of that, whether swimming or triathlon, and I've been having a weird blood glucose situation if I exercise in the morning before breakfast. In the past my levels have always remained steady if I exercised first thing unless I go for longer than 1.5 hours pre-breakfast where I will need to take a gel, but lately I've been finding them rise quite a bit during and after exercise.

I've taken no carbs when this occurs. The exercise is very easy, so shouldn't be any adrenaline response. Any other diabetics experienced this sort of thing when previously your levels have been fine?
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Re: Type 1 diabetes and triathlon [fulla] [ In reply to ]
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I feel for you diabetics. I know how hard it is to plan for a race/activity without having diabetes. I could not imagine the work and effort that goes into a nutrition plan having type 1 diabetes. I am not a type 1, but like a previous poster has said, my daughter is. She is now 8 and was diagnosed at 3.
She is very active and always has been. She has never let her diagnoses get in the way of anything she does.
To your point, we have noticed that she was rising a bit more lately during her 3 hour gymnastics class. My wife went to a nutritionist and explained our situation since our diabetic clinic in our area is a joke.
As you know with diabetes there can be 1000 different reasons for certain outcomes but the one that hit home with us and the one that worked was MAGNESIUM.
I can not and could not believe that it was this simple for our daughter.
95% of diabetics are magnesium deficient along with other important supplements, but it works hand in hand with insulin.
The way it was explained to us, and I have verified by reading many articles, is the insulin helps regulate the transport of the magnesium. Basically gets it to where it needs to go faster and more efficiently. In turn, magnesium promotes a lot of the reactions in glycolysis. This has lowered our daughters blood sugars during gymnastics and tennis where we would usually see highs and lows depending on other factors, like weather, stress, anxiety etc.
Being a diabetic for over 30 years, I'm sure your body has built up somewhat of a resistance to insulin compared to when you were first diagnosed.
We have asked our Endo to add magnesium testing to her blood panel so we can track it, and up her doses as required as she grows and gets older.
We are getting some of our best numbers ever since she has started taking it. It's just a powder that gets put into water, it dissolves and she drinks it.
This was a shock to us that it was this simple, but as I mentioned above, our clinic is a joke and didn't mention anything about magnesium being deficient in diabetics.

Best of luck. Hopefully this article can help you in some way or at least get you on the path of getting your numbers back to where they were.
With that being said, my daughters Dexcom just alarmed LOL. (4.2 mmol/L). So I'll wrap this up.
Good luck, stay healthy and keep us posted

Cheers

Quinner
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Re: Type 1 diabetes and triathlon [Quinny98] [ In reply to ]
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Cheers Quinny. I’m actually taking magnesium at night at the moment as it’s also meant help recovery from concussion- which I’m also currently going through. I’ve found over the years that sometimes my blood sugars will just do weird things. I still have a pretty good response to insulin only needing 4 to 5 units of humalog each meal and 12 or so of lantus.
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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look up Kris Freeman's blog and facebook . he's type1 olympic XC skier who is into tri's now that he is retired. tons of helpful info for athletes
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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Can you give us an update on your diabetes? How has the last year and half gone for you?
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Re: Type 1 diabetes and triathlon [TNTRI] [ In reply to ]
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Edit: Just realized that this is an old thread and you were actually diagnosed a couple of months before me. So the below doesn't make too much sense anymore. Anyway - maybe it helps someone else reading this thread...

----

I was exactly where you are 1 year ago.
Had been doing tri for a decade before that and then suddenly T1 diagnoses at the age of 36. ("LADA" they call it)
In this last year as a new T1D, I ended up doing a full tri season with two halves and 1 full. Using a CGM but no pump.

Can't say it affected my performance significantly.


Since there's already a lot of good advice on this thread, let me just add this:
Be aware that no 2 people with T1D react the same to certain foods, dosages and general treatment strategies.
The key is to find out what works for you and ideally be somewhat systematic in your experimentation.
As an example: I was told to start workouts with a little higher blood sugar as a security buffer. But it turns out: The higher I was at the start of a workout, the steeper the drop was right after I got going. When I started around or below 100 mg/dl (5.6 mmol/L), the drop wasn't nearly as bad and my blood sugar only started to gradually go down as the workout went on.

Also: Don't underestimate the honeymoon phase. For me that first year was a lot different to what things are like now.
At the height of Ironman training, my body was so sensitive to insulin that the small amount my pancreas can still produce was enough to keep my levels pretty good. I only had to inject very little amounts for very large meals.

All the best and feel free reach out if you have questions!
There's for sure more experienced diabetics and triathletes in this thread than me already, but maybe I'm the one with the most similar situation.

if you can read this
YOU'RE DRAFTING!
Last edited by: flogazo: Dec 6, 21 4:28
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