How to Do the Outdoors?

Sports & Exercise
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This is gonna make people’s eyes bleed when reading it. :grinning: Hang with me on it. It’s always just too much detail.

People usually think in general terms of “carbs” for glucose fueling when they are exercising. Most gels are rapid carbs - “simple sugars”. They break down and are absorbed quickly.

That’s great, that’s what we want when exercising and we are low. Fast carbs!

Simple sugars are fructose, glucose, and lactose. We don’t use lactose too much for fueling.

Glucose and fructose are monosaccharides, which means they contain one sugar molecule. Super easy for your body to use!

If you look at some of the gels, they are not using simple sugars. They are actually using man-made processed and complex sugars - polysaccharides - which are many monosaccharides that are bound together. But the bonds are so week, they break down easily and act like simple sugars. An example of this is maltodextrin.

I personally don’t like the fake sugars. I like glucose and fructose, and I will tell you why next (if you are still reading this… :joy: )

Your stomach uses different transports for different sugars. For glucose it uses GLUT2 and for fructose it uses GLUT5.

Why is that important? Because using different types of sugars that use different transports allows our digestive system to be more efficient in absorbing them. It’s like having 2 exit doors in the theater instead of only 1 door.

And while glucose is more focused on glycolysis and blood sugar, fructose not only helps raise our blood sugar but it also helps replenish the liver.

All that is the background for the simple answer that maybe you were wanting.

I use Transcend gels for quick BG help. Those gels are 100% glucose.

I use Huma gels for slightly slower BG help, and they are 2:1 ratio of glucose to fructose.

And I use Untapped energy gels for a little bit slower than Huma. Those are made from maple syrup, and are roughly 1:1 ratio of glucose to fructose.

If anyone read all of this, let me know. I will send you a prize. :grinning:

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That statement reflects ignorance about type-2 diabetes, and a physician who displays such ignorance should be fired immediately, as you did.

Type 2 is a consequence of a genetics that lead to insulin resistance and a progressive inability of the pancreas to produce enough extra insulin to overcome that resistance. It is not a lifestyle choice. Although lifestyle choices sometimes can influence the progression of the disease, nobody causes their own diabetes.

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PREACH!! i wish i had the wherewithal in the moment to tell him so, but i was so shocked and appalled that i just cried in the corner after the appointment and immediately started looking for someone else. horrific thing for any provider to say about any patient, ever: i used to work in medicine (first responder) and you NEVER talk to ANY patient that way!!! (…although it was really really hard that one time not to say something to the guy who tried to catch an excavator bare-handed…)

(in the way of emergency medicine, should anyone fear for excavator joe’s welfare, duderino walked away with four stitches and a broken thumb. don’t ask me :woman_shrugging:t2:)

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As a type 2, I have just been reading the content of this discussion. As Eric wrote Lantus is tricky. The first issue I had was a peak 6 hours after injection. This would cause nightime hypos as I was instructed to inject before bedtime.

My solution was to split the does 2/3 at bedtime with the remainder after my morning exercise. This worked very well for me until I began MDI.

I ended up doing 3 injecting of Lantus of a 25u daily dose, 10u waking, 10 an hour before lunch and 5u an hour before dinner. This countered a postprandial spike I was having 2.5 hours after eating.

I’m not suggesting that you do what I did, especially since you are type 1, but a little experimentation is the only way to learn what works for you.

Someone suggested Sheri Colberg’s book, " The Athlete’s Guide to Diabetes"
This book gives a great overview of blood glucose function and management in non diabetic and the 3 main types of diabetes, and how exercise, drug therapy and insulin affects blood glucose. This is the 1st half, the 2nd is what various diabetic athletes do to excel at their sports.

Dr. Colberg (not MD) is a type 1 athlete herself.

I shamelessly post a link to her book. It helped me enormously and was a good read.

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I can get you hooked up with a running meter. They are all over the planet now. Let’s get one to the PNW too.

I promise, this will be the absolute go-to for getting dialed in.

What is your dogs name? Is m short for something?

Do you eat before you exercise?

Maybe you don’t need to for normal workouts, but you gotta do that before races of any significant length.

Do you know much about muscle glycogen and liver glycogen? I know you have a background in swimming, so maybe you already know about this stuff.

Let me put it into a swimming perspective. You probably have only 20 minutes of liver glycogen for a hard swim. The rest is what you have in your arms and legs.

And as far as what is in your bloodstream, that’s only about 1 minute worth of hard swimming!

Seriously, there is no fuel in your blood! It is crazy!

All of that is to say - you gotta eat your Wheaties!

Not super necessary for general workouts, but for hard workouts and races, you need your breakfast.

We’ll get there. Just a few things to start processing.

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I’m thankful I had some time on MDI before pumping. Injections pretty much always make all the insulin go in, and this makes it easier to learn cause and effect and how to dose insulin, provided you’re willing to take numerous injections per day. But then, especially when active, the pump is a much better choice. It makes it easy to take small doses whenever needed, dosing is less cumbersome when active, and an appropriate pump can be automated with a CGM to try to push the BG in a good direction every 5 minutes, which can reduce the burden of managing BG, especially overnight.

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taking notes, taking notes: sorry everyone, there is a ton to process and respond to here, not ignoring anyone just drinking it all in!

and m’s full name is mara. she’s a belgian malinois and she’s about a year and a half old. loves trail running, fruit snacks, apple slices, and snow in any format. crazy beastie but she picked up the BG detection lightning fast and is progressing well with her public access training. we ran our first race together on thanksgiving - a 5k put on by the high school xc team- and have a veterans memorial 10k coming up in march. we are running that with our neighbor/bestie to honor my late husband.

historically i run before i eat and have always gotten away with it, but have been coming to grips with the fact that has to change, especially as i scale back up to bigger mileage.

whats a running meter? pardon my ignorance…

and whoever it was that suggested finding an endo elsewhere in WA and maintaining on telehealth… brilliant! why didn’t i think of that :sweat_smile: thanks!

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aha! @jessicad - you were the one with the brilliant point about telehealth, thank you! and thanks for all your other insight too, still combing for details, super appreciate it!

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So this is not really something particular to diabetes, but actually just for longer endurance sports in general.

You can run a 5k without eating. No big deal there. Same for a 10k.

You can do a 15 mile easy run without eating.

But for 1/2 Marathon races and longer, that is when you are completely using all your muscle glycogen. Your liver glycogen is an important fuel tank.

And in the morning, people’s liver glycogen is somewhat depleted (everyone, not just people with diabetes).

That’s why breakfast is so important.

From your college career, did you guys ever talk about glycogen? Did you have a team nutritionists who worked with you on diet? Where are you with understanding it? Do you know about fat metabolism vs carb metabolism based on exercise intensity?

We can go over it if it will help.

:heavy_plus_sign:
:100:
:heart:

It’s a BG meter you use while running.

I don’t mean you stop running, test, and then re-start your run.

I mean, you use it while you are continuing to run. :open_mouth:

You can use it for other sports too. Except for swimming. :joy:

We can get you hooked up with one. Just gotta get some of the fundamentals knocked out first.

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aha! yes i was wondering about having to pull over and do the stabby-stabby :sweat_smile: glad to know modern tech has an answer for that. i am so grateful you all know about these options, i would be so lost without this help!

i do have some nutrition background, but not sure how useful it is nowadays. first off i just have always been a little sloppy. :sweat_smile: i didn’t say it was smart or optimal for performance. in a way, this is a chance to improve that, too, and just generally become a more thoughtful and effective athlete. swimming is all relatively short distances, i only got into the more endurance or distance stuff later in life, so not much guidance for that, specifically… it’s also like a decade and a half old info/science so i am sure we know more now… :grimacing::grimacing::rofl::woman_shrugging:t2: in other words, i have no special expertise in endurance nutrition, educate me please! you seem extremely knowledgeable and you write so clearly!

and one further note: i do know there is mixed research out there on diabetic alert dogs. based on my own experiences, she was ahead of the cgm and the cgm did confirm her about 85% of the time, so i decided to proceed, and we are entirely homeschooled (no business involved). we did her scent training just like for a drug dog: i collected breath and sweat samples on cotton balls for hypo/hyper and stored in sealed containers, then placed those samples in vented containers for training. she had to pick out the correct sample - the high or low from a lineup that included a varying number of in-range/“blanks” - in order to get rewarded, and we went from there! in my experience she seems pretty on the ball and since i live alone in the boondocks, it’s a real blessing. she isn’t a replacement for other tools like a cgm, but i have found her to be a helpful addition to other tools. she runs at my heel at all times.

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It’s super cool you have a training partner! :star_struck: That’s awesome!

I can do a deep dive on fueling stuff in a little bit.

But in the meantime, let me give you a homework assignment.

This homework assignment lasts forever. :man_facepalming:

But it is really easy to do and will be very helpful.

And the reason I recommend this is because I come from a background of about 11 years without a BG meter of any kind. And about 20 years without a good meter that actually gave reasonably accurate numbers. :joy:

I also have about 43 years of diabetes without a CGM. :open_mouth:

What did all that time without any BG info do for me? It made me pretty darn good at knowing what my BG was at all times without the help of a meter or CGM!

Here is the thing to do that helps you know your BG.

Before you ever look at your CGM, and before you ever do a BG test…say what your BG is. And then check and see how close you were to the number.

Every time, before you look, say the number to yourself.

Use everything you already have in your head.

  • How do you feel?
  • Are you tired? Hungry? Cranky? Sleepy? Thirsty?
  • When was the last time you ate?
  • What did you eat?
  • When was the last time you took insulin?
  • What was your BG the last time you checked or looked at your CGM?
  • How long ago was that?!?!
  • What have you done since then?!?

How close were you? Were you way off? If so, why do you think you were far off? If you were close, that’s great!

Every time, you just analyze your guess and the result. And then reset your brain and do it again before your next BG meter or CGM check.

It’s just practice. You can get good at knowing your BG.

And if you think this is ridiculous, consider that this is how we used to have to do it! We had no choice! (“We” meaning us old-timers. :grinning:)

Around here, that is know as “The Force”. I have preached this to so many people here.

image

Here is a link to a discussion about it on another thread. BTW, Liam is awesome! I got to meet him. :heart_eyes:

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challenge accepted! …and major tip ‘o the hat, i don’t know how i would ever do this without modern tools, it would be like me trying to drive somewhere before google maps and gps navigation :sweat_smile::woman_shrugging:t2:

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I am going to get you a running meter, but I need to get some very important information first!

What is…your favorite color or sports team?

:joy:

No sense having one that isn’t right!

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That’s a great exercise Eric. I also love the checklist of ways to get an estimate that you’ve added. I just guessed based on how I was feeling - I thought 130 and came in at 215 - oops.

but I didn’t go over your checklist, and think through the mechanics. I relied solely on my personal body feeling, and I very rarely feel if I’m going high. But if I had thought about my BG the last time I checked, and what I’d been doing, I would have guessed much better.

e

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Thanks @bostrav59.

I am sure there are many other checklist things that people use that are not in my list!

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Oh, I wanted to add this for the BG guesses.

I find that there are 2 things that are helpful indicators that tell me I am low when I am running.

  1. If you are not tracking a straight line and have a lot of left and right movement.
  2. Lower cadence.
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That is awesome that you have trained M. I would like to see her training videos and in action.

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@Eric uhhh haha would something neutral like black or gray be an option…? that would be amazing in any color, let me know how to make it happen, cost/payment etc!

@Rasheedacoo shoot it doesn’t like the video clip, let me see if i can link to it somewhere for you!

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youtube:
mara at work

here @Rasheedacoo : i just popped a clip up on youtube, link above. it was originally formatted for a different media platform so sorry about the formatting/weird crop!

context: i had just wrapped a workout and sat on the couch after because i was feeling a little funny, but not how i usually feel when i’m crashing. i wasn’t watching my phone and didn’t hear any alarms go off, i was just being kind of embarrassingly and totally oblivious (especially that’s an obvious time to watch your sugar, right? stupid…). but she noticed from across the room, and here she comes! to the rescue! :joy::woman_shrugging:t2:

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Yay, Mara is awesome! :star_struck:

Hey @panda, your meter is in process. It takes a while though. You can’t rush “art.” :stuck_out_tongue_winking_eye:

One other question, are you right-handed or left-handed?

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