Very active and newly diabetic...where do I begin?

Hi all,

I was diagnosed as a T1 diabetic two days ago. I'm 34 years old and I'm a vegan athlete. I've played roller derby for 5 years now, and I'm on the all star team. Up until this diagnosis, I was on skates 10 to 15 hours a week. I ate quite a bit before as I consider myself an athlete and wanted to ensure I was fueling enough for my training schedule.

Now that I'm diabetic, I don't even know where to begin! I won't be working out for about two weeks, to stabilize. But what happens when I'm ready to go back to skating? Our practices can be three hours long. Do I try to begin workouts with a higher blood sugar? Help!

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Permalink Reply by DanK on December 14, 2011 at 12:20pm

Hi Janie - everyone is different, so you have to test often and experiment.
What I learned in the beginning that was most helpful to me is that generally there are two types of exercise. Endurance exercise drops your blood sugar instantly as you do it and you have to fuel as you go. Burst or adrenaline exercise uses stores within the muscles. When you do this type, your blood sugars may remain stable while you're playng, but you need a lot of carbs afterward because your muslces will basically try to suck all the glucose back from your blood stream. Some sports, like surfing, have both effects. You might find roller derby fits into this category as well. One important thing to remember for burst exercise is that afterwards the effect of your insulin will also be multiplied. This is because exercise increases sensitivity of insulin receptors. The result is that you get rewarded for your hard work by being able to eat a lot of carbs with a very small dose of insulin :)

I've only been diabetic for a year and a half and remember having a serious case of information overload at the beginning, so I don't want to bombard you. However, one good place to start is the book "Think Like a Pancreas". It's a quick read and very informative. Another good place to start is the 4-part video series here - http://www.1happydiabetic.com/apps/videos/channels/show/1499150-spo...

It's tough no doubt. I was in your position just a short while ago, but with experimentation and frequent testing things have gotten much easier. You've also come to the right place. People on these forums have been and continue to be very helpful to me as I attempt new activities.

Permalink Reply by Mike on December 14, 2011 at 12:29pm

Hi Janie G,

I'd HIGHLY RECOMMEND two books:

1. Using Insulin, by John Walsh
2. Diabetic Athlete's Handbook, by Sheri Colberg

These will get you started in the right direction, in terms of managing your insulin need and balancing exercise-diet-insulin. There are plenty of other books and program out there, but these two will get you going.

Good luck, and welcome to our crappy club!

Cheers, Mike

Permalink Reply by FHS on December 14, 2011 at 12:40pm

Hi Janie,

Best wishes for you as you begin this new journey.

Your life will defintely change in many ways but, luckily, your activity level and choice of activities don't necessarily have to. The biggest change is that, as you're beginning to find out, you are no longer on auto-pilot when it comes to activity and nutrition.

The only advice I have to give is that, whether you begin with a higher BG, or normal BG, always monitor your BG. Don't be hesitant to check your BG many times to see how the changes you feel physically correlate to the changes in your BG. Many people report similar experiences, but it really is a very personal thing for diabetics to know how they are feeling during a hypo, or during a BG spike, especially for athletes who are also experiencing all kinds of physical and emotional stimuli.

It will take diligence, a lot of trial and error, and a lot of constant reevaluation, but it is all worth it.

This site is a great resource but always remember that you have to filter everything through your own experiences and how your diabetes managment is working for you.

Permalink Reply by IMVic on December 14, 2011 at 1:07pm

Good info in the other responses - keep in mind too since you are newly diagnosed - you may go through a honeymoon period where additional insulin required is minimal.

Test early, test often - and as you do monitor (track) what you're doing and what's happening (ex. ate ## of specific carbs 1 hour before workout, covered with ## units of insulin - workout = 15min warmup skate, 20 mins of sprint skate, tested BG=###, 30 min of whatever, 15 min cooldown, tested BG = ### - postworkout nutrition of ##g of specific carbs/protein/fat, ##u insulin, 2 hr post recover BG = ###, etc.) Bottom line see what's happening to you with what you're doing. Guessing that your training will be more like endurance with some bursts, and your events more like bursts (almost similar to a football practice vs. a game).

Good luck - lots of resources here!

Permalink Reply by jm on December 14, 2011 at 1:31pm

Jamie

I am in a group called triabetes.org, we are triathletes and I personally love the tool called Dexcom, it is they best tool
I have ever used in my 22 years of trying to participate in athletics. The Dexcom warns me when my sugar is going high
Or low..before I was always stopping to check sugar, but now I can carry this in my hand when running or in shorts
During soccer..u should check one out

Permalink Reply by Janie G on December 14, 2011 at 2:41pm

This looks AMAZING!!! Is it spendy? I can imagine that it's not covered by insurance?

Permalink Reply by Jerry Nairn on December 14, 2011 at 4:18pm

Continuous Glucose Monitors like Dexcom are being covered by more and more insurance plans. If yours doesn't automatically cover it, then you can submit a letter of medical necessity. Dexcom has been willing to help with that in the past.
I am a Dexcom user. There are other CGMs out there. It's possible your insurance would want you to use a different one.

Permalink Reply by Bathyscaph on December 14, 2011 at 1:34pm

Hi Janie,

I'm rather new at this myself; still going through a honeymoon period 1+ years on after being diagnosed with Type 1 at 41. The advice you've been given ( and book recommendations) so far is really solid and I think you'll find that you can still do all of the same things but like someone said, not on autopilot. When I was first diagnosed I had no idea what it actually meant to be on a honeymoon phase but it what it meant in my case was that after the first few days I had to be super careful about taking less and less insulin each day because I was hitting dangerous lows. So test a lot and expect things to be kind of crazy at first.

For me, I find that it is absolutely essential to eat before long intense workouts or any workout that isn't competitive or strength-based. Even when I was taking no insulin (first part of honeymoon) and even if I started with a high BG I was dropping into potentially dangerous lows through exercise. How your body is going to react to your workouts is going to be very individual. You'll hear that a million times and it's true. Definitely read the books people have mentioned. I find "Think Like a Pancreas" the most approachable for getting the overall picture of things. Good luck.

Permalink Reply by Janie G on December 14, 2011 at 2:38pm

This is all fantastic advice and I already feel so much better...like I CAN do this. I think that I've been afraid that I wouldn't be able to skate at the level that I was. Thanks SO SO much for all the advice and book recommendations.

Roller derby training is just as IMVic describes...endurance and short bursts/interval for training and then just short bursts for games. I'm a jammer as well, so it requires a lot of speed and short hard bursts of energy. I will definitely track my training religiously and test often. The league knows and I've already got people researching so that they will know what to do if I get low.

DanK's note about insulin reception is really great, I didn't know that and I'm excited to be able to eat more carbs after training...I'll want train so that I can eat!

Bathy: thanks for your warning about the honeymoon period. I didn't know exactly what that meant, but I'll be extra careful over the next few weeks.

Oh man, *sigh of relief* thanks!
JG

Permalink Reply by DanK on December 14, 2011 at 3:04pm

glad we're being helpful. just a clarification in increasing insulin sensitivity - this may also occur from non-burst exercises. it generally occurs when there's some sort of increase in phyisical activity. If you're always training hard, there might not be any increase in sensitivity. However, this is something I even experience when I go on vacation and I'm walking around from place to place all day. last time i went on vacation my insulin requirements were cut in half.

for me, I don't exercise every day, but i usually do at least two strenuous activities a week like soccer or ultimate frisbee, and more recently surfing. on these occasions the difference in my food/insulin requirements is tremendous. i remember after the first time i tried surfing i had 1 piece of lasagna for dinner with only 2 units of insulin to try to compensate for this increased sensitivity and refuel (normally i wouldn't touch lasagna, or i'd need about 8 units to have some at dinner). I tested a half hour later and was already almost going low. I wound up eating 3 pieces of lasagna to cover the 2 units of insulin! it was amazing, one of those small moments only a diabetic can enjoy :)

Permalink Reply by Jamie on December 15, 2011 at 2:15pm

Hi,
I am definitely not an expert, but I ran a 7 mile race. My adviser had me cut back on my meal time insulin and my night time insulin just by one unit. For my morning meal I had 1/20 instead of 1 insulin to 15 carbs. I hope that makes since to you. I am still rather new to carb counting.

Permalink Reply by anotherbattlewon on December 19, 2011 at 1:03pm

Hello friend....I say that because you sound a bit like me. I am very athletic...at least I think I am. I run, workout with weights, do a little Krav training - and I just discovered a few months ago I have type 1 diabetes. Well, actually I think they call it 1.5 from what I'm reading. Now that my levels are somewhat stabilized, I'm back to my regular workout routine. I check my levels before I go workout so that I can make sure to take in enough carbs to get me through the workout. I have had levels drop almost 100 points with a really hard workout so making sure I have enough in me is vital for me! I prefer a protein drink before I workout and that's usually enough for me. Then I make sure to eat after.
I also keep glucose tablets handy, just in case. On my runs, I carry the tablets and also have made sure that a couple of friends on the course know to help keep an eye out for me. So far, I've had no problems. I even find that I'm doing a LOT better on my runs and workouts than I was before. I have the stamina to finish and had gotten to the point where I just ran out of gas, so to speak.
I'm sure there are others that can give you better advice - who have been diagnosed longer than me. Since your workouts are 3 hours, I'd make sure to keep at least a 1 carb snack that I could eat quickly if needed.
I'm looking forward to the day when this is all second nature.
Looking forward to learning from others on this site!
Donna