Help for new type 1

I was dx in sept and as the weather starts to get a little better I am getting nervous and excited to start cycling outside again. I have been cycling inside for 1- 1.5 hours and I tend to go low a lot, so I am nervous about cycling long distances by myself. I would love any tips on managing bg while cycling (have omnipod and dexcom) and any good supplies to use. Thanks for the help!!

I would recommend decreasing your basals. Remember that when you do that, you need to adjust them 60 minutes or so prior to your intended exercise b/c any changes to your pump now would not be seen for about an hour. So if you want to ride your bike at 4 pm, set your basal back at 3 pm.

I set mine back for the duration of how long I'll be riding. So if I'm going to ride for 2 hours at 4 pm, I set my temp basal at 3 pm for a duration of 2 hours. This way when I'm done riding, the normal basal has been kicked back in for about an hour so it is "active" again when I'm done.

Not sure what kind of food or nutrition you're refueling with during your indoor rides, but you'll definitely want to carry more and/or eat more if you're going low. For endurance based rides (not super high intensity like when I'm racing) I will drink about 1 bottle of gatorade (or other sports drink of your choice) every hour. So that's about 30-36 g carbs. In addition to this for an endurance ride I have my basals set to -40 to -65% of normal (depending on how long I'll be riding, what kind of insulin sensitivity I might have from previous exercise, what I may have eaten beforehand, etc).

When you start riding again outside, I would check frequently. Like every 30 or 45 minutes. This will give you an idea of how you are trending (in addition to the info you see on your dex which may also let you know what kind of lag time that thing has got when your BGs are falling fast, etc).

I'm sure others will chime in w/ slightly different methods that may also be helpful--you'll just have to do some trial and error to ultimately find what works best for you :) Good luck w/ your rides!

  • Mount the dexcom on the handlebar with a smartphone mount.
  • Ride with a group if you can.
  • Start with a BS of around 150mg/dl.
  • Bring easy to eat food. I prefer fruity powerbars. not messy and easy to chew and handle. They usually don't go stale to easily either, so you can eat half and save the rest.
  • Set your basal to 50% or 75%. Or lower depending on the length and type of workout.
  • Use a heart rate monitor, and know your HR "zones".

Anaerobic workouts can raise your sugar during a ride by stimulating muscle growth which causes a breakdown of the liver for protein. If you workout in the 80% or higher HR zone, this *may* be considered anaerobic. Usually this is when doing hill climbs or intervals. If you plan to build biking muscle, don't set a lower basal. Just leave it at 100% and watch the dexcom to correct.

Aerobic workouts will drop the sugar as you are just using your existing muscle and developing your cardiovascular and pulmonary systems.

For me, riding a bike is aerobic and running is anaerobic.

Also, try to figure out how much of a delay your dexcom has. The Minimed Realtime, for me, has about a 20 minute delay in readings. This is affected by my hydration levels too. If I hydrate properly I can get it down to about 10 minutes or less when my heart is pumping hard.

If I'm really dehydrated, my readings will be way off, like hours before it picks up slightest changes. Not enough liquid in my body to move the blood in the cells around the sensor I guess.

I think Bradford explained it well. I ideally reduce basals about an hour before as well, although many of my rides start at 7-8am, so I don't easily have that option, and need the initial insulin to cover a big breakfast anyway. When I was getting into longer rides, it was usually -90% basal that worked best, but now that I'm more used to all day rides, I find that I only need about -50%. Because I have less insulin acting, I found that I almost never have sudden lows while active. I check occasionally (or listen to the dexcom when I have that on) and rarely give boluses when snacking, but don't pig out all at once either. I think during endurance exercise the body digests food slower anyway, so the chance of bgs going up quickly from food is low too.

Usually I start with one bottle of G2, and refill with gatorade/water during the day. Another bottle is juice or soda, which I only sip from if I'm trending down and need the sugar. I try to do one bottle an hour, though that rarely happens and I end up trying to drink a bit more at the rest stops so I'm not carrying it all on the bike. I have a bag in the back where I keep 3 rolls of dex4 for more than enough emergency backup if I run out of juice (and a glucagon if things really go bad, but thankfully never needed that). I usually carry about 1 clif bar per 1.5-2 hours I plan to be out - so an all day 150 mile ride would have me carrying about 6-8 bars. I generally don't buy much food on the road, except maybe peanuts and slim jims for the extra sodium.

I really like the G2. I play 3 hours of hard volleyball one night a week, and a bottle of G2 lets me keep the basal at 100% and not worry about dropping.

I've found that with dexcom too. I try to stay hydrated early and often. I usually drink a full glass or two before going to bed before a long ride, and another round when I first wake up (hopefully about 1hr before riding). It helps both physically and with the Dexcom readings.

Hi it helps to start a log of what you do and eat and you will figure it out intensity level, wind, hills, time, for me I use Hammer products and fuel before a ride and then about every 10-15 miles keep fueling and then check BG after to see what works have fun with it enjoy the Cycling. take care Bob

I, personally, do not go cycling by myself although I didn't ride alone pre-dx either.
Here are some things I do - I start a 50% temp basal 1 hour pre-ride. I pack gu and also peanut butter sandwiches. I know many people like mix Heed into their water bottle, but I personally cannot stand the taste.
I am not familiar with Dexcom, but I am sure it's pretty similar in function to Medtronic (which is what I use). I have set up predictive alerts for lows 30 minutes in advance. I also test about once an hour.
Hope that helps a little.
I am SO ready for some sunshine and warmth!

I decrease my basal rate to 65%. I put Cliff Blocks in my pocket of my biking shirt. Cliff blocks has 15 grams of carbs and it is not sticky like gu. I test myself a hour into my ride. I do have a CGM. But sometimes it comes out or doesn't track right. Most of the time it works. I put 4700 miles on my bike last year. I did have a small pack that goes on my top tube by my handlebars. It fits my meter, my cell phone and cliff blocks. For long rides I also eat a cliff bar. It has more complex carbs.

Did you use the paradigm, or just start with the revel? I'm still on the paradigm 522, and I get weekly calls from a Lindsay asking if I want to upgrade. Not sure, since I have a high deductible insurance right now. Maybe last year when I had a new baby in the house, but this year I think I need to hold off until I know if I'll reach the deductible.

Unless, of course, the Revel is really that great...

is it the little block-bag that goes on top of the top tube? I picked up a wedge bag because the seat bag was blocking my rear light/brake light.

I have always had the Revel, but my daughter started with the 522 and she only upgraded because she needed the larger reservoir. She says that she doesn't really notice a huge difference. They do have the upgrade program, so you should check with them to see how much your out of pocket would be. I think it's a pretty big discount.
Otherwise, unless there is a specific need to upgrade (such as needing a CGM or bigger reservoir), it can't hurt to stick with what works :)

Everybody has given you good advice, and I'll just add that you can totally ride by yourself longer distances with a bit of trial-and-error and really good record keeping (so that the times that didn't work become improvements for the next time). I go for long rides by myself all the time, sometimes for as long as eight hours.

I set a slightly lower basal rate (70-80%), and I use energy drinks, gels and real food. For me, the key thing is to get about 20-30g of carb every 45 minutes. I also bring a tube of glucose tablets along with me. I tend to test every hour or so--despite having CGM--using an OneTouch Ultra Mini that I put in my bike pocket.

I also carry my phone to call out the "team car" if things get too dicey, as well as some cash to buy extra snacks.

Have lots of fun!!

I'm curious if you've played with the basal reduction and carb intake. I sometimes find it difficult to eat as much as you are recommending, so apparently I have made up for that by reducing basals more (I was around -50% at the end of last year).

I used to feel forced to eat a certain amount while riding, and that got old fast. I feel more in control now, since I don't have as much insulin kicking in, but at any time can choose to eat more.

I don't mind eating this much, because I find that I get wicked hungry when I'm riding. Eating is the only way I've found to keep from running out of energy... regardless of what my blood glucose is doing. Makes sense, no? :^)

But I hear you: sometimes, eating when you don't want to is really hard to do.

Hi Megan-
Have you been going low while on the bike, or hours afterward? Just curious. Some people go low hours after an extended ride due to glycogen replacement processes. I'm one of those, so my basal has to be reduced somewhat for a good while after a long ride. I typically don't reduce enough, go low, and react by eating more carbs. I'd rather be able to predict neatly in advance, but it does not always work out.

As others on this post have said, every individual is different, but the great people on this forum can help you in your learning to react to your particular physiology.

Best to you,
-Tom

No there are 6 blocks per package. Each have 15 grams and they are not sticky!

Passing 90 minutes is a threshold to pay attention close attention to. I do this a lot. Try the method I've described in this post. It's not trial and error, it's science from the best: http://www.tudiabetes.org/profiles/blogs/proven-formula-rough-draft

Cycling is my thing and I never leave without my Gu...works great for me. Easy to carry, works fast and has never let me down. Where do you cycle?