Having diabetes for a long time and wishing for a break from it

I’ve had Type 1 diabetes for 34 years and have not let it slow me down. I was diagnosed in my early 20s and have been very physically active for most of that time. I’ve done Spartan Races, triathlon sprints, etc. But lately my husband and I have been watching extreme physical endurance shows (Race to the Center of the Earth, Eco-Challenge, etc.) and I realized that I am very sad that I will never participate in any physical activity that doesn’t require watching my sugar levels or worrying about my pump or CGM. As these guys/gals are pushing themselves to the limit, they don’t have to stop and take care of lows, etc. As I see them slog through rivers for hours at a time, all I can think of is that it would be impossible to wear a pump. It would be nice to decide to go for a hike, etc. without ever having to think about bringing glucose, snacks, etc. I am grateful that I have diabetes in this day and age with all of the technology but for whatever reason lately I’ve wished it to be different.

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Tell me what event you want to do, you train for it, and I can help you create the D gear you need to make it happen.

You may need to change up a little bit of the regimen you are currently using. But it can be done. You just need the gear and to practice with it. And you need access to carbs. It can be easy to create carb and insulin solutions.

You can do what you need to manage it.

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Our very own McGyver (@Eric), and others have proven that there is no physical challenge you can’t participate in if you set your mind to it. You just have to figure out how YOU need to do it and plan for it.

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I get it. I experience that, too. I think being diagnosed as a young adult makes it easier to wish for non-diabetic days bc I had a solid, memorable history of life without diabetes. I don’t know if I would think about it similarly in other scenarios.

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My next adventure, I hope, is another Spartan Race. The last one I did I had a hard time with the water obstacles. I had my pump on with it wrapped in many layers of cling wrap. I was about due to get a new one so I wasn’t too worried about it however I did skip 2 of the obstacles because I didn’t want to be totally submerged in water with it on. I was able to take it off toward the end of the race and hand it to someone so that I could finish it. Have any suggestions on this?

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@HippieNerdBabe
What do you do with basal during a race? Do you still have your basal going?

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I would recommend figuring out what basal you need for the race and injecting it, that way you don’t need a pump during the race. That is what my son does, and it works very well.

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Put the pump in an Aquapac? I did that when swimming with a Medtronic pump. No need to disconnect just because of going underwater.

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Can you tell me what pump you use? The Tandem is mostly waterproof. (At least enough for shallow swimming events.) OmniPods are waterproof too. The PDM is not, but can be put in a waterproof bag so you can still bolus with it.

Events up to roughly about 4 hours (give or take a little bit) can generally be handled well with a zero basal, as long as you are continually moving.

So in many events, you don’t actually need the pump for basal. And you can bring syringes for fueling boluses. (I can help you with syringe dosing.)

If the event is longer, then it might help to have a small background basal running.

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Can I hop in on this? Most of my early life I’ve raced boats but am returning after a 6 year break. (not me in the picture, but have raced against him a number of times)

It seemed like before that I was able to set things up and only deal with the blood sugars every 30 minutes whereas now I need to rebuild a routine.

I usually have AAPS set up via cellphone but instead decided to have it provide normal basal without adjustments (which ended up being too much) and had the black dexcom receiver in a waterproof case in the back. One thought was to attach it near the thwart (cross-piece in the middle) so it is within reach.

Nutrition-wise, had 3 turkey burgers, a Perfect bar, water, and water bottles with mango juice although this is another area in need of optimization.

Each of the races are around 45 minutes and the total time on the water is about 5 hours.

Here’s a quick video of what things look like when racing:

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That is really cool looking!

How easy is it to fuel up between jibes or tacks? Gel’s (like GU Energy, for example) come in waterproof foil pouches, those might be easy to use. You can do them one-handed, by tearing the top off with your teeth.

I assume you are already wearing a racing watch. How about wearing a 2nd watch to give you Dexcom readings, and set to stay on with the Dex reading, so button pushes are not necessary and you can always see it?

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Good point, I haven’t used GU in a while so forget exactly how it affects the BG, or perhaps there are GU-like pouch products that have different speeds of action. The video is highlighting maneuvers but the reality is that upwind you generally stay on the same side for a while and can cleat the sail to make a hand available. Downwind is generally a bit easier than what’s being shown in the video when the wind is less than 20 knots but doesn’t take too long to get back to the bottom gate.

Is there a waterproof watch that can receive dexcom numbers? I think one possibility would be to have the phone in a waterproof (or able to get splashed or go underwater briefly) and have it broadcast to the watch if a standalone watch isn’t available. The bluejay doesn’t seem particularly water resistant.

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Yep. Any of the higher series Apple watches are waterproof enough for sailing. (I think series 3 and above).

If you have Dexcom G6 running on your iPhone (which can be stashed anywhere in your vest), then the Apple watch would show your number. And having it set to stay on the Dex reading means there are no button pushes necessary. You just look at it. Simple!

I am not sure if there are exceptions, but all the ones I have tried, it seems that most of the gels are very quick. They use simple sugars.

But you can just take a smaller amount out of the pouch.

(For slower stuff, things like Cliff bars are probably your best bet.)

Another option would be Gatorade gels like this. They are individually wrapped, so you can take only what you need.

https://www.amazon.com/Gatorade-Prime-Energy-Chews-Sleeves/dp/B00HTAPFV8

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Fantastic, was able to get Prime to send a watch for this Thursday, in time for this weekend’s race.

Glad to hear that GU is quick. I think I read somewhere that it was considered a complex carb. The goal in these situations would be to get 25 carbs as quickly as possible. (which might require 2 packs). Also looks like the gatorade chews achieve that goal as well. I remember gatorade being a good BG-raiser.

So far I’ve used iPhone for phone purposes and Android for diabetes purposes but will be interesting to mix that up. It would be nice to be able to bolus from the watch via NS or Loop, but that doesn’t appear possible yet, although might be engineer-able with what’s out there.

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That looks like an awesome hobby! Those little boats look like they are moving fast, and require quick reactions. Sounds like loads of fun!

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Thank you, it started as a summer camp (babysitting for my parents), then over time there were bigger boats and highschool/college/adult competitions

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This is where it’s a bit silly, and requires a little understanding of the definitions.

A simple sugar is either a) a carb that has one type of sugar molecule, such as glucose or fructose (those are called monosaccharides), or b) has two types of sugar molecules, such as table sugar which has glucose and fructose (those are called disaccharides).

A lot of the energy gels have more complex and longer sugar chains, but they are designed to break apart very quickly.

So even though they might be called “complex carbs”, they are actually quite fast. They are not complex carbs in the same way as a potato is a complex carb.

So for example, something like maltodextrin might technically be classified as a “complex carbohydrate”, but it is actually ridiculously fast. It has a glycemic index that is over 100.

For getting fast carbs, most any sports gel will be very quick. It’s just a matter of finding a pouch that is easy to open and eat from one-handed, and one that has the right number of carbs in it.

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Thanks for the explanation. Intuitively, this seemed true, but would’ve been better for me to stick with the GU rather than shift to juice. I ended up getting GU, Huma Chia, and Gatorade chewables. I also remember trying Hammer Gel back in the day so will have to give that a go as well.

In terms of iPhone+watch. Do you loop with the original omnipods/dexcom and have the blood sugar show up on the watch face? If so, what software combination do you use? I noticed Spike and Loopkit and have heard of interactions with the dexcom app as well. In a perfect world I’d have the ability to bolus from the watch face but right now the BG is by far the top priority.

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I had Loop setup so that I could bolus from the watch. That concept was incredible, but the problem was that sometimes the bolus would fail and I did not get feedback on the watch telling me that it failed. I could not resolve that problem, so I abandoned using it for exercise. For me the bolus needs to be 100% fail safe. I can’t be in a situation where I “think” I got a bolus but am not totally sure.

I wish that had worked for me. But as it is now, I am just using the old PDM, which is much easier to use than a touchscreen phone.

Bolusing from the watch may work for you though, if you want to give it a go. I am just saying that I was never able to be 100% sure because I saw occasional failures with it. Not sure why.

However, if you want it for Dexcom readings, I still think the Apple watch is the easiest.

As far as what software to use, I am the wrong person to ask. I just test my BG, I don’t use any fancy setups. I don’t use the Dex for exercise. The delay is too long for me. It only tells me what my BG was.

It might be helpful to create a post with something in the subject line for advice on watch and Dexcom software setup that would call in the experts at FUD.

@ClaudnDaye would be a good person to ask. @Trying uses Loop for exercise. @dm61 is a Loop expert. And @Chris knows all the players at FUD, so he could direct you in the right place too.

There are a lot of others here that can give you good advice on setups for that. It’s just a matter of getting their attention, so the right subject line in a post is your best bet.

But I can tell you about carbs and fueling and insulin and BG management during exercise. :grinning:

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Yes, I use Loop and do bolus from my watch. I never take my iPhone out during my runs. I have both Dexcom and Loop complications configured on my watch face, so I can see both values. They will often be different which means one is lagging behind a bit. That is actually helpful because it gives me the delta! The Loop watch app allows one to bolus and view carbs, IOB, etc. You can confirm that you actually did receive a bolus by looking at the IOB. Eric mentioned that boluses sometimes failed. This is true. On the phone, Loop will notify you that it may have failed, but I don’t believe there is any mechanism on the watch to notify of a possible failure. I always check to confirm IOB has increased appropriately. Also if you are using OmniPod, you can hear the clicks, if surround sound is not too loud!! Maybe while racing boats, wind is way to strong to hear the clicks!! :sailboat: When I initially started on Loop (2 years ago this week!!), I was hesitant to shell out the money for an Apple watch, but it is so worth it. I really only use it for exercising and the BG management!

Btw, prior to switching to Loop, I was an xDrip+ user on Android, and used the Sony Smartwatch SW3 in standalone mode to retrieve BGs from Dexcom. I did not even bring my phone with me on runs. SW3 would sync the BGs once re-connected to the Android phone. The SW3 is also waterproof. However, once cannot do boluses. I believe if you use AndroidAPS (instead of Loop) you can do boluses from the watch. You still need the RileyLink though.

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