To all of my fellow type 1 diabetic endurance athletes I have a question concerning nutrition: how do you handle training/race day nutrition? Ie. Carbs vs. calories, nutrition products, water vs. electrolytes etc. I am entering my first training/race season as a type 1. I was diagnosed on 8/14/15. Prior to diagnosis I had my nutrition pretty dialed for 70.3 and 140.6. Now I’m entering a grey area. I’m currently working on how much my glucose drops while I’m training and what I need to set my basal rate at. I’m using a tandem t slim, and a Dexcom G5 for my pump and cgm. Just looking for a little guidance. Thanks.
Race day nutrition won’t be a ton different than a regular racer. Electrolytes/carb-protein ratio/etc are something you’ll have to figure out for yourself but they shouldn’t require too much adjustment for t1d. Of course you scale back basal based on your system and intensity level.
For training only thing to remember is ALWAYS have a convenient carb with you. Some people can go 3 hours without eating but we can’t.
In general I get by with lots of gu, clif bars, granola bars and gatorade /skratch (training/racing)
I’ve spent years dialing in my race day nutrition and it changes, year to year, and it changes race to race. Other people get their nutrition wrong, they have a bad day. If a Type1 gets his or her nutrition wrong, it can easily be a trip to the hospital, or worse.
I have carbs for breakfast, oatmeal, toast w/ peanut butter, whatever you like. I take a gel just before the swim. I like to start a HIM at around 180 to 200 mg/dl. I don’t use a pump so I just go to 8 units basal the night before and 2 units bolus 2 hours before race start. Very little insulin. But then everyone is different.
I take a gel in T1 and then wait for my CGM to sync up while on the bike. If all goes right it is still around 175 mg/dl. Taking in 350-400 calories on the bike per hour will keep it right around 150-175. I get 250 calories from GU Roctane drink. The rest from whatever I have. Gels. Power bar. Etc. I’ve tried everything.
If I don’t take in enough calories then by mile 40 or so I’m down at 100 and I can’t run. It will drop to 65 and lower before I am a few miles into the run. If it is 150 or so then I’ve found I can hold that and still be around 100 through the run. Still have to take in 200 calories or so. I have found a gel in T2/start and then something every 30 minutes works. Usually. Every race is a challenge. Heat. Cold. Sleep. The moon. It doesn’t matter. This is a disease of constant management and it can change on you.
I found myself at 50 mg/dl at a run turn around out in the boonies and it was still falling. It was a hot day but I didn’t expect a 50. I set my alarm at 100 and was ignoring it. Stupid me. Real stupid since I can’t tell when I am low until I am really low. I stood at the turnaround for 10 minutes, at least, eating and drinking all the carbs and sugar I could to make that damn arrow point up.
As soon as a race is over I need carbs because my blood sugar will immediately start going down. It stays low for hours which is fun because I can eat whatever I want. I go for a milkshake and cheeseburger with fries. Going to die anyway.
You may still be in the honeymoon period, I don’t know anything about your case, and if you are, things are going to keep changing and you will have to see what works for you.
I’ve noticed no difference as far as electrolytes needs. Mostly it is a calories needs to keep blood sugar in a safe zone and the not fun need to have to slow or stop when it gets into the danger zone.
But never be anywhere in training or racing without glucose tabs or a glucose shot/gel thing or something as fast acting as that. I made that mistake once. I hear being in a coma or dying is not fun.
you are definitely honeymooning!
I fight highs and have to be more aggressive with insulin. At the start I will dose a unit, gel mid swim, T2 usually a big bolus.
But I keep messing this all up. Long course annoys me with T1. I did a 70.3 yesterday, and got too aggressive with insulin prior to the swim. Went from 11.8mmols to 3.1 in about 5 minutes. I had to have 3 gels mid swim and fight cramps. Yes, cramps in the swim. Needless to say the rest of the race was fighting cramps and just balancing out blood sugar.
To the OP since your newly diagnosed, I would say you will still be producing a bit of insulin and will, so will just have to fight off lows during the race. BUT I will say that I believe we require more electrolytes and magnesium than others - especially if you go high for longer periods.
For training and racing for my first (and only, so far) IM, I used a custom mix from Infinit. It actually made it incredibly easy for ongoing fueling, as you can control exactly how many carbs/calories you’re getting per hour, and once you’ve got your basals and insulin:carb ratio dialed in, it’s pretty easy. Unfortunately I’ve found it’s pretty much trial and error until you get to that sweet spot. And while this may not be true for everyone, race day is always crazy for me…once I get stabilized I’m good, but I always either seem to start off really high or really low. My #1 piece of advice for anyone that asks me about racing with T1 is ALWAYS carry more fuel/emergency glucose than you think you need. I can’t tell you how many times this has saved me in races where I was “sure” I’d never need all of that Gu.
Also, check out the Riding On Insulin team on Facebook…a group of 30+ of us T1’s did IMWI this past year and there are tons of experienced folks there to answer questions or anything else.
I forgot another important piece of information. According to USAT and USADA you need a TUE for your insulin. Novolog, Levemir, etc, all on the banned substances list.
really? didn’t know that. How could it be an aid? this whole disease is a hindrance.
It is an anabolic hormone. Bodybuilders have been known to use it for doping. Endurance athletes too. Marion Jones doped with insulin, among other things, if I remember correctly.
We are just using it to stay alive, but it is on the banned substances list.
Look up Kris Freeman. He’s one of the top Nordic skiers in the US and has type 1 diabetes. He has a very scientific and successful approach for managing it and still performing at a very high level in endurance events. I believe he has a blog where he’s written about how he manages it.
I understand it’s use in bodybuilding but unsure how it helps with endurance sports?
Marco Pantani got caught with it at the 2001 Giro, right? I’d say let’s ask Patani how he used it, but he’s dead.
Insulin moves glucose out of your bloodstream and into your cells, storing it as glycogen. That’s what keeps us alive. And glycogen is fuel. More glycogen stored equals more fuel stored. Or I guess that’s the theory. I’m no expert. I just do what my doctor tells me to do. I think it also helps with moving protein into muscle cells and then you wouldn’t lose as much mass. Maybe that’s why bodybuilders use it. I’m not a bodybuilder so I don’t know. I’ve read that hypoglycemia also elevates growth hormone. Since too much insulin causes hypoglycemia, there’s the reason to dope with it. What I read, it was Humalog being used. I’ve always used Novolog insulins and don’t know if Humalog is different. Nor would any sane person purposely try to induce hypoglycemia. I would guess that not losing muscle mass is more recovery related than performance related, but it is all doping.
I only looked into this when Triathlete magazine ran that article about age groupers doping and had the link to the website with all the banned substances. Article here: http://triathlon.competitor.com/2015/01/features/2015-changes-anti-doping-code-means-age-groupers_111422 … “as many as 1 in 7 Ironman athletes admitted to using an illicit substance”
That’s when I called USAT and USADA and did the paperwork for a TUE just to be safe.
While many here and in many other places will tell you the diet and race day fueling should be the same as a non-diabetic, I learned the hard way it isn’t the truth, you should look into yourself as someone who is somewhat allergic to carbs as your body don’t process them well at all. While you may be able to get away in terms of performance, it may do some long term damage to your health but the main annoyance is the roller coster that it can be (check all the suggestions of carrying sugars with you).
Since I’ve shifted to a very low carb diet, performance is still pretty solid, maybe 5% slower than a full carb up mode, but glucose levels and diabetes management in general has improved drastically. I’ve been T1D for over 15 years now and raced triathlons for all of these across all levels, from beginner in the sport to Kona as a Pro and 8h50 IM finish. Wrote a little piece on it here: http://www.ironguides.net/triathlon-on-a-low-carb-high-fat-diet/
Hope this helps and good luck,
Vinnie
We had an athlete this year who was diabetic as a by product of a liver transplant. The end result as he progressed through training was that it was minimized.
Long story short a lot of work outs and strategies had to be vetted by his team (several people above my pay grade) as there were several complications. In the end it turned out that because he had to look carefully at execution and always err on the side of caution in terms of input/output, he was one if not the best (likely the best) athletes on the team in terms of execution to abilities.
Maybe take a read through the diabetic thread:
Maurice
Marco Pantani got caught with it at the 2001 Giro, right? I’d say let’s ask Patani how he used it, but he’s dead.
Insulin moves glucose out of your bloodstream and into your cells, storing it as glycogen. That’s what keeps us alive. And glycogen is fuel. More glycogen stored equals more fuel stored. Or I guess that’s the theory. I’m no expert. I just do what my doctor tells me to do. I think it also helps with moving protein into muscle cells and then you wouldn’t lose as much mass. Maybe that’s why bodybuilders use it. I’m not a bodybuilder so I don’t know. I’ve read that hypoglycemia also elevates growth hormone. Since too much insulin causes hypoglycemia, there’s the reason to dope with it. What I read, it was Humalog being used. I’ve always used Novolog insulins and don’t know if Humalog is different. Nor would any sane person purposely try to induce hypoglycemia. I would guess that not losing muscle mass is more recovery related than performance related, but it is all doping.
I only looked into this when Triathlete magazine ran that article about age groupers doping and had the link to the website with all the banned substances. Article here: http://triathlon.competitor.com/…-age-groupers_111422 … “as many as 1 in 7 Ironman athletes admitted to using an illicit substance”
That’s when I called USAT and USADA and did the paperwork for a TUE just to be safe.
My understanding is that because insulin moves glucose out of the bloodstream into the cells, a dose of rapid-acting insulin together with some carbs post workout can accelerate recovery. Pretty sure that’s how bodybuilders and athletes are using it, and if you know what you’re doing (big caveat), doesn’t seem super dangerous to me. But if you don’t know what you’re doing, the hypo risk is significant.
If you don’t know what you’re doing the death risk is significant.
If you don’t know what you’re doing the death risk is significant.
Killing a healthy person via exogenous insulin is surprisingly tough. But a severe hypo less so, so I would put this in the same category as other highly risky things some athletes do.