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Discussion Starter · #1 ·
I'm 23. I've been a diabetic for 22 years. I have signs of DKA and beginning signs of nephropathy. Blood sugar is kept under control 85% of the time or so, having 18 hour days due to classes, work, life, family, etc... It can get rough to do perfect maintenance 24/7, no?

I know my diabetes is a handicap on my performance. I've trained with collegiate national title holders, and I'm just not where I expect to be regardless of riding and nutrition and health management.. This starts to sound like a want... which it is, but diabetes has left me with an incomplete deck of cards to play with.

I am not a licensed USA cycling rider, but do five + century charities during the year, and 200-400 miles a week once the weather is favorable. Basically saying that there are no cycling ethics restricting my curiosity.

What is out there that I could look into to be up to snuff/get a boost/etc? I'm looking at Rx and non Rx options, and want to know what is available. Am I crazy? Maybe, but the health benefits of cycling are so immense that several months out of the year, I rarely have a need for insulin and blood sugar control is optimum. I feel if I could be out there more while enjoying it and not feeling like my body is taxed... this could be a cyclical benefit to my terminal illness. Does that make any kind of sense?
 

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Dr. Flats a lot
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There are no limits on how well you can perform with diabetes. The most important element is tight glucose control. Hypo and hyperglycemia will catastrophically affect your performance. The good news is that cycling will reduce your insulin requirements and make managing your diabetes significantly easier. But there is a huge level of control that you need to have over your food that your peers don't share.
It is nearly impossible to predict what your sugars will be while cycling. For many they develop a good sense of this and will keep fast acting carbs readily accessible when they start to fell symptoms. Glucose tabs are ideal. You need to check your sugars frequently and not entirely rely on your sense of what your sugars will be. Likewise don't run your sugars high thinking it will give you an added level of safety. This will kill your performance.
One of the best technologies to help with this is continuous glucose monitors. These are a huge breakthrough in diabetes management and you should invest in one. Many insurance carriers will cover the expense. There are limits to it's use and they are not as accurate as a blood glucose testing.
Insulin pumps can be a huge help as well. With careful use long acting insulins can be just as effective. It depends on the individual. Omnipods are particularly well suited for cycling.
There are a couple good books on this that you should get. Exercise and Sport in Diabetes is one of the best in my opinion. Ideally get out to one of Matt Corcorans training camps http://www.diabetestrainingcamp.com/. He's the guru on this and will give you the tools you need without having to learn it all on your own.
If you think diabetes is holding you back visit http://www.teamtype1.org/. It's not holding them back and it sure as hell is not a terminal illness. If you don't pay attention to it, it can kill you, but with the right management you can live a full and complete life and win as many bike races as you want.
 

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I think your most important statement was "Maybe, but the health benefits of cycling are so immense that several months out of the year, I rarely have a need for insulin and blood sugar control is optimum.". If the exercise is that beneficial for your diabetes then I'd search out another sport that you can transition to in winter (trail running, XC skiing). As far as maximal performance, use higher quality training, like a well planned program.
 

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haole from the mainland
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You still need insulin when you are riding a lot. I'm assuming you're Type I.

When was the last time you saw your doctor? Getting your sugar under control will provide the most immediate boost.
 

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Discussion Starter · #5 ·
jorgy said:
You still need insulin when you are riding a lot. I'm assuming you're Type I.

When was the last time you saw your doctor? Getting your sugar under control will provide the most immediate boost.
I go every two months, and have an a1c level of 7.3 on the last test, and average about a 7.0-7.5. Even with EXTREME control (6 tests a day, exercise, extreme diet watching etc), it has rarely dipped under 6.8 for as long as I can remember. I've had two decades of experience/education on this, and doctors have claimed this as acceptable :rolleyes: :frown2: [quote="zoiks']One of the best technologies to help with this is continuous glucose monitors. These are a huge breakthrough in diabetes management and you should invest in one. Many insurance carriers will cover the expense. There are limits to it's use and they are not as accurate as a blood glucose testing.
Insulin pumps can be a huge help as well. With careful use long acting insulins can be just as effective. It depends on the individual. Omnipods are particularly well suited for cycling.[/quote]I do have a psychological stigma on a pump though. from ages 3 - 14, I had to use emla cream, sedatives, being papoosed to a table board or other methods of restraint to have them draw blood from me for seasonal tests. It's more than just an anxiety/phobia issue. If something can go wrong during an IV for blood... it has happened to me several times. I still get sick and shake constantly when having my blood drawn for tests, but I am capable of handling myself in a reasonable manner. I cannot imagine having the pump'a needle inserted into me 24/7. Nothing... not even years on my life can change my mind on this... Many doctors have tried to persuade me, but its too much for me. Basically the pump or anything with a semi-permanent installation is not an option.

I've been pretty active all my life. Baseball, track, surfing, etc. Hyperglycemia has never been an issue during activity throughout the years.

Its been a pretty steady progress, but its a fact. My kidneys are in the beginning stages of failure for several years. I've had to get a light perscription of glasses about five years ago, and it has changed twice since then. They have had me on lisinopril (ACE inhibitor) for several years. My liver has also had anomalous run-ins with unkown issues. They thought I had liver cancer two years ago, and even did two biopsies. No cellular change was found, but they claimed it was Hepatitis E. It was literally a gift from God from what the doctor said. Whatever levels they were measuring from my blood showed that my liver was the one of a 60 year old man with a chronic drinking problem nearing death to showing no problems two months later.

But back to the real part... Kidney damage as you know is irreversible. I feel some sort of kidney pain nearly every week regardless of blood sugar and ketone levels. You know that poisoning feeling that just gives you the blahs? Yeah. I get that about once a season too.

Diet has been modified to a pretty strict standard for a decade or so by different dieticians, and stress/sickness is about the only unmanagable variable that adversely affects my diabetes. Military medical centers have really treated me well, and I'm not sure there is much else I can do on my part.

Diabetes management aside, unless I spend an exponential amount of time more on keeping my blood sugars down another 20-40 mg/dl's on average... there isn't really much else that needs to be improved on except kidny health (zero-sum war, there).

I mean what can I do to increase on-bike performance to negate this slow trend into permanent malaise?
 

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Fellow diabetic here.

I've been racing with type 1 for going on six years now and you're right, it does have its own set of issues and I won't pretend to have gone through everything you have. I can think of many times hypo/hyper glycemia has ended a ride sooner than I would have liked. However, I've had some success too. Particularly two years ago, I was able to win a couple races (cat 4), while my A1c was 8.5. So good performance is possible and its not necessarily contingent upon tight control.

I've raced both with and without the pump, just having got it last year. For years I was resistant to the idea of a pump. Like you say, the idea of having something constantly inside of me was revolting, something I just couldn't stomach. After that 8.5 year I decided it was time to get over myself and get a pump with a CGM. The thing is fantastic and if there is any way you can find a way to live with it, I guarantee it is many times better than injections.

OK, sorry I realized I haven't answered your question as to what you can do. I know there are times and places where insulin injections will improve recovery, like in your legs immediately after a workout. As far as other PEDs, I'm sure there are doctors who would prescribe you something, but I'd worry about the kidneys (they're probably more important than finishing a fast century). There are other diabetic racers out there on the interwebs too. The MTBR forums have quite a few riders and there are type 1 specific forums too.

http://forums.mtbr.com/showthread.php?t=277284
http://www.type1rider.org/forums3/

My other advice would be to pick your events carefully. I've learned that as much as I'd like, I'm never going to be an endurance specialist. Too much **** goes down past hour 4 of a race for me to ever excel there, even with a CGM. Short, faster races have been much easier for me to perform in, train for and manage my BS's in. Anyway, best of luck.

Now its time for me to go to bed, I have an 80 mile ride tomorrow morning. :cool:
 

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Dude,
Give the damn pump a try!
Low to mid sevens just ain't gonna cut it. You ain't gonna be wearin' the needle while using the pump, it's removed just leaving a tiny silicone infuser. It's changed every three days, on average, and if you can handle giving yourself multiple daily injections you can do this standing on my head. This ain't no time to be squeemish. I put off going to the pump for a few years because of multiple excuses and let me tell you that I was a damned fool!
This pump allows me to stay in the low sixes and I've heard people keeping theirs in the FIVES. My God, I don't know how they manage that.
I would also recomend the Continuous Glucose Monitor but I won't because that damned thing, as much as I count on it, still creeps me out every time I renew it.
 

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Desa

See if DESA has a chapter that is near enough for you to join.
That's the Diabetes Exersize and Sports Association.

http://www.diabetes-exercise.org/index.asp

This is their national web-site and should be able to steer you towards a local chapter. I'm talking about a room full of Diabetic Athletes here! Cyclists,Triatheletes,Hockey Players,Swimmers,Soccer Players, even Body Builders for petes sake!
I'm from the Chicagoland area and was at the local chapters meeting this morning. There were at least 30 Sports Minded diabetics at that meeting. That's a LOT of Help, Support and Advice in one place.
I'm lucky because Chicago has one of the largest chapters in the country, but there's like 40 chapters across these United States so you should find one that you can attend.
These are people who share your malady and are willing to share their experiances.
Shux, there was a woman and her daughter who drove in from Michigan for todays meeting.

Here's a forum for diabetic atheletes

http://type1rider.org

You may want to check out.
 

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velodog said:
See if DESA has a chapter that is near enough for you to join.
That's the Diabetes Exersize and Sports Association.

http://www.diabetes-exersize.org/index.asp

This is their national web-site and should be able to steer you towards a local chapter. I'm talking about a room full of Diabetic Athletes here! Cyclists,Triatheletes,Hockey Players,Swimmers,Soccer Players, even Body Builders for petes sake!
I'm from the Chicagoland area and was at the local chapters meeting this morning. There were at least 30 Sports Minded diabetics at that meeting. That's a LOT of Help, Support and Advice in one place.
I'm lucky because Chicago has one of the largest chapters in the country, but there's like 40 chapters across these United States so you should find one that you can attend.
These are people who share your malady and are willing to share their experiances.
Shux, there was a woman and her daughter who drove in from Michigan for todays meeting.

Here's a forum for diabetic atheletes

http://type1rider.org

You may want to check out.

Good link dood, but you spelled it wrong...

and they only have 15 local chapters and 2 in Canada.

http://www.diabetes-exercise.org/includes/support_groups.html
 

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Sorry about the spelling.

I went to the site after writing the post and saw I had the chapter count wrong. Not to make excuses but that 40 count was 2nd hand informatiion.
But there may be some new chapters that haven't made it to the page yet. I do know that one of the central members here in Chicago will be moving to St. Louis soon and has every intention of starting a chapter there.
 

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7.3 is HORRIBLE!!!!!!! You need to change your insulin around or get a pump. AND freaking weigh everything you eat for several months to get a handle on portion size. With intense exercise even 1/2 unit of insulin or <40 calories can have a big impact on control.

Dump your doctor. Anyone in modern medicine who's telling someone with renal insufficiency from diabetes that >7 is ok is dangerously incompetent or too jaded to give a sh!t. At that level you will be having a transplant in a few years, and believe me if you think you're behind the 8 ball now wait until you become a walking human chenistry set of corticosteriods and testosterone suppressing, neurotoxic, nephrotoxic, anemia inducing immunosuppressive drugs. It ain't pretty.

There's a book called Using Insulin by Walsh, Roberts, Varma and Bailey. I highly recommend you get it and do everything in it. Control needs to be a process you do, not something where you are winning or losing with every reading. Keeping emotions out of it and just responding to what's going on gets the best results.

Any reduction in average BG levels will help but getting under 6 hga1c will significantly slow the progression of renal failure (along with getting your BP as low as you can handle - taking ACE and ARB combination preferably). Also reduce your protein intake. With high levels of exercise you may have to stay around 1g/kg/day to avoid deficiency but try 0.8g/kg/day first and see what happens.

Lastly what makes you think your genetics aren't the real problem? Not everyone can be competitive, at any level, no matter how much they train or how healthy they are. The reason LA exists is because there is a lot of variation in the population and not everyone can be average or above.

Did I mention I hate bad doctors?
 

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I wish you all the luck and best wishes. I had a student with Type 1 in 5th grade last year. I cannot imagine going through life like that. It is an awful disease. He eventually went o the pump, but the few weeks after his levels were all over the place going from hyper to hypo. I'm sure he got it all sorted in the end, but I never did find out as the year ended and I moved on.

I really do admire team type 1 and all they are doing.
 
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