Hi All! I was diagnosed in November 2024 with Type 1 and prior to this had always been a keen ultra distance rider and bike packer. I had already booked a trip to Japan to bike tour for 3 months before my admission which is still going ahead! Has anyone done any bike touring or back to back days on the bike as a Type 1? I was figuring it out then had to have another wrist op so just getting back into it now and have 7 weeks to nail it! Any advice and tips welcome on insulin adjustments and fueling!
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Bike Touring
- Thread starter CatK123
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barrym
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Might be some useful stuff here: https://www.teamnovonordisk.com/
Good luck, whatever you choose to do.
Good luck, whatever you choose to do.
Sounds fun 🙂
I've not done many back to back days of any reasonable distance but I do sometimes have a few days of 80km back-to-back rides to a work site. Doing one of those rides isn't far enough that I bother to reduce basal but after doing a few I do tend to drop a unit from both morning and evening doses (I split 50-50% to make adjustments for riding easier) to avoid trending low overnight/during the day.
For longer durations (more days back to back) I think I'd probably end up at something like 75% at each end of the day (which I am thinking about as I'm off to France cycling for 4 or 5 days next week) and also somewhat reduced bolus doses to cover evening food.
For (definitely-not-back-to-back) ~200km+ rides I do reduce morning basal to 50% or a bit less as otherwise I spend the second half of the day needing to eat constantly, which can be hard especially when you're going hypo and suffering from taste fatigue/lack of choice. It works much better for my stomach if I can eat something uncovered with a reasonable number of carbs (normal food) at lunchtime and ideally also afternoon tea time (again also uncovered), then I don't need to snack too much en-route and avoid taste fatigue/needing to carry too many supplies.
I don't usually reduce my post-ride evening basal after these long (for me) rides as I think the reduction in the morning effectively gives me less cover overnight to avoid/reduce post-exercise hypos. I have sometimes knocked a unit or two (of a usual 9) off my evening dose though if I'm doggedly low after eating when I get back home (and will usually have an uncovered bedtime snack irrespective).
I avoid taking any bolus when riding, except for something to cover FotF/pre-ride nerves and perhaps a 0.5/1U if I'm high and not coming down (though I will then need to eat for sure after a couple of hours - usually a good thing), and if I'm able to stop for a decent lunch I will take a bit of bolus (perhaps 1/4 to 1/3 of the normal dose) and then make sure I get going again reasonably quickly before my BG starts to rise too much - once riding again with IoB it tends to drop down again reasonably quickly and I then tend to need to eat something again after an hour or two (which hopefully means I can get to another proper stop to eat something I've not had to carry with me, though I won't then take any bolus for it). In the tail end of a 200km ride I always need to eat more food no matter what I've done during the day, so for anything longer I'd need to make sure I stop again for proper food and rinse and repeat (assuming my gut is happy to play along!)
Not sure how much that will help, would be very interested to hear how you get on, and especially your experience getting back to ultra distances and what you do with insulin/food. Hope you have fun whatever happens 🙂
I've not done many back to back days of any reasonable distance but I do sometimes have a few days of 80km back-to-back rides to a work site. Doing one of those rides isn't far enough that I bother to reduce basal but after doing a few I do tend to drop a unit from both morning and evening doses (I split 50-50% to make adjustments for riding easier) to avoid trending low overnight/during the day.
For longer durations (more days back to back) I think I'd probably end up at something like 75% at each end of the day (which I am thinking about as I'm off to France cycling for 4 or 5 days next week) and also somewhat reduced bolus doses to cover evening food.
For (definitely-not-back-to-back) ~200km+ rides I do reduce morning basal to 50% or a bit less as otherwise I spend the second half of the day needing to eat constantly, which can be hard especially when you're going hypo and suffering from taste fatigue/lack of choice. It works much better for my stomach if I can eat something uncovered with a reasonable number of carbs (normal food) at lunchtime and ideally also afternoon tea time (again also uncovered), then I don't need to snack too much en-route and avoid taste fatigue/needing to carry too many supplies.
I don't usually reduce my post-ride evening basal after these long (for me) rides as I think the reduction in the morning effectively gives me less cover overnight to avoid/reduce post-exercise hypos. I have sometimes knocked a unit or two (of a usual 9) off my evening dose though if I'm doggedly low after eating when I get back home (and will usually have an uncovered bedtime snack irrespective).
I avoid taking any bolus when riding, except for something to cover FotF/pre-ride nerves and perhaps a 0.5/1U if I'm high and not coming down (though I will then need to eat for sure after a couple of hours - usually a good thing), and if I'm able to stop for a decent lunch I will take a bit of bolus (perhaps 1/4 to 1/3 of the normal dose) and then make sure I get going again reasonably quickly before my BG starts to rise too much - once riding again with IoB it tends to drop down again reasonably quickly and I then tend to need to eat something again after an hour or two (which hopefully means I can get to another proper stop to eat something I've not had to carry with me, though I won't then take any bolus for it). In the tail end of a 200km ride I always need to eat more food no matter what I've done during the day, so for anything longer I'd need to make sure I stop again for proper food and rinse and repeat (assuming my gut is happy to play along!)
Not sure how much that will help, would be very interested to hear how you get on, and especially your experience getting back to ultra distances and what you do with insulin/food. Hope you have fun whatever happens 🙂
This is incredibly helpful thank you so much for taking the time to write it all out!! It is a really art and you have clearly helped me see what I could do. I don't think I would have been as aggressive with the basal reductions and was very confused about how I would eat lunch and then ride again... but the key is to reduce insulin I see!! I had couldn't ride for about 6 weeks because of wrist op and now in 3 days I am 97% in range which I am very happy about! I am keeping a food and exercise diary for the next 2 weeks to see any trends and help me track everything ready for my next dietician appointment. I'll keep you posted and have a great trip in France!
CliffH
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Sounds fantastic! I'm a keen cyclist (although not to your level) and I find that a reasonably hard ride of two hours will decrease my need for insulin significantly for the next 24 hours, whereas a ride of three hours will have an impact for up to 48 hours. Of course you'll be different but I think it's reasonable to expect to need to reduce your insulin significantly. Clearly generally your diabetes management is very good, which is a great starting point!
I don't bother with basal at all if I've got a heavy week of cycling and just adjust my pre-meal insulin as needed. Do you have a continuous glucose monitor? That's a massive help for me - especially in terms of understanding that the spike I get from a post-ride recovery drink comes down by itself. Also, I have to be careful to not go too low overnight after a long ride, so I'll aim for my blood glucose to be slightly higher at bedtime than usual.
You're welcome and thanks, finally got accommodation and ferry booked, now just a case of trying to squeeze everything into bags and turning the pedals! 🙂
This has turned into an essay/brain dump and a slightly jumbled one at that, I'm sorry. It may or may not be useful, but even if it's not for you, hopefully someone might benefit 🙂
If anything doesn't make sense, please do ask, likewise if you think there's a better theoretical fit to the data, please go ahead and suggest it - I feel I may well be contradicting myself in some cases below as none of the numbers are particularly hard and fast, it all depends, like all other things in diabetes, plus quite a lot is stuff that happened a few years back now (which I thought might at least add some context even if not very useful for those used to riding a lot). Also n=1, we're all different, etc., etc.
Let's dive in! 😉
I didn't even think about the option of basal reduction when I first started riding (during lockdown), and it was only a post on a random site somewhere that made me think about it as an option.
I used to take all of my basal in the evening, and really only started reducing it as I'd run low overnight post-ride. I did subsequently also think about and try some evening reductions for rides the next day, but tended to go high overnight and I was also not too keen on needing to commit and make the decision the day before especially as I tended to need to reduce basal even for what I'd now see as short rides of say 50km.
As I've ridden more, I need less basal reduction, so these days a spur of the moment 100 mile ride is just about fine ( as long as I can stop for food) and I don't do spur of the moment 200km rides! Yet! 🙂)
Before I started adjusting basal rates (still during lockdown) I usually ended up going really low half way around my ~50 - 80km rides and then needing to eat vast quantities of food, which wasn't much fun. It wasn't helped by the fact that almost nothing was open, so I also had to carry it all with me and sometimes ran out and had to limp home with BG bumping along the bottom (thankfully never more than 20km from home).
Which reminds me that one "advantage" of going low while riding is that if you stop the drop in BG also tends to stop, so you can usually take stock and work out what to do. Still not great if it's late in the evening and cold though.
If you reduce basal you can reduce it too much, I've had ~100km rides where my BG has sat stubbornly at say 9mmol/l and I've generally not wanted to take any bolus for fear of going really low as had been happening pre-basal reduction, so tended to just ride back feeling a bit sorry for myself.
Nowadays if I'm running persistently high/higher than wanted and/or I need some food for energy I'll take 0.5U (or 1U if very high/near somewhere I will stop), which is typically enough to cover ~10g of carbs in normal life, and then will probably need to eat perhaps 40g+ of carbs over the next couple of hours once BG comes down. It's a bit hard to separate the effect of the bolus and that of the basal which is always lurking in the background waiting for your liver to stop/reduce production glucose, though having bolus on board has a definite effect for me for the next 5h while riding (especially obvious if riding after eating lunch and taking reduced bolus), though markedly less/shorter duration during normal life.
Re livers and basal, I find there is a trade-off that I accept whereby I can live with going a bit high when I start a long ride (even when I take some bolus to cover it - but I never want to over-do it and need to start eating loads from the get-go) as my muscle insulin sensitivity isn't yet raised and I also often have some nerves due to the long "unknown" ride encouraging my liver to produce extra glucose via stress hormones, vs the inevitable requirement to eat once my liver has given up/calmed down/run out of glucose (3-5h later) and I have heightened insulin sensitivity (and not much muscle glycogen left).
For this reason, if I take reduced bolus when stopping to eat I will further reduce this (or just not bother) based on how long into the ride I am (knowing that the insulin may still be effective 5h hence) and how long I will still be riding. E.g. Early lunch I might take some (I may also still be running higher than wanted due to FotF/pre-ride nerves), but afternoon tea I wouldn't bother at all unless I was going to be stationary for a long time, but that would be a difficult decision as I'd inevitably run low quite quickly after setting off again. Catch-22.
I am much more relaxed about BG when doing long rides than when I'm at home and don't try to control it as tightly (or indeed very tightly at all) - if I run a bit high for a couple of hours so be it - I will have (perhaps) learned a lesson about what not to do (though different every time!), plus the riding will mean I'll always end up dropping and will also run lower once off the bike (so I tell myself that even being high for a while has some positive effects later). Also, I might quite like to give myself a dose of 0.1U but my pen only does 0.5U min, so I have to live with not bothering. This might be easier to manage with a pump, but I'm not eligible for one afaiu, nor am I really that keen.
For shorter rides (of say 3 or 4 hours) BG is fairly stable and/or easy enough to tweak with some food if needed, it's the longer ones where I accept that stopping to eat uncovered meals will make me go "high" temporarily if I hang around too long, but the trade off is that I can keep riding longer (in the latter part of the day once I start going low) without taste fatigue having yet kicked in.
Last but not least, the libre/CGMs are quite laggy and my BG tends to look a bit like a sinusoid while riding so I tend to need to start eating early, well before the CGM is telling me my BG is dropping/I'm actually heading towards being low.
I now reduce basal less for a given distance (or not at all for <80km, or if I decide to wander out and ride somewhat further), which is probably because I'm fitter so the riding is easier. Though one might assume that would mean less hepatic glucose production, so more food would be needed, which is true to a certain extent, my theory is that over longer rides it means there's not the boom of a massive burst of hepatic glucose at the start followed by the bust of it then running out and going low. Needing to switch from eating nothing for hours to then needing to eat loads doesn't seem to work well for me, I'd prefer to start fairly early with something small and keep going so I feel like eating.
It may also be practice which means more confidence that I can eat my way out of any problems up to a given distance.
The more long rides I do in "a season" the better the effect becomes too, apparently the liver adapts to not splurging all its glycogen at once (I must find a reference to the medical paper I read that in.) First long ride of the year seems to be more difficult than the last one in terms of BG control/boom & bust.
Riding easier definitely reduces liver contribution and one can see a definite change based on how much power you're applying, though as the day goes on this becomes less obvious and may in fact go away completely/is completely obscured by muscle insulin sensitivity + basal effects.
Phew!
That's really interesting, how much do you normally take when not riding? I guess the post-exercise overnight insulin sensitivity is enough to keep you in range overnight?
What sort of reduction do you make to your bolus vs a typical quantity of carbs? Also what type of insulin do you take for your bolus as it would be interesting to know the duration of action?
CliffH
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I don't know if it makes a difference that I've got Late Onset Type 1 (LADA): I was diagnosed in my early 50s. One of the things that seems particularly controversial on this Forum is whether or not LADA (sometimes called 'Type 1.5') is actually a different condition from 'usual' Type 1, given that it seems less severe.
Even more controversial is my theory that perhaps many forms of diabetes actually sit on a continuum between 'usual' Type 1 and 'usual' Type 2, given that my LADA certainly doesn't behave exactly like either of those, in that a combination of diet and (particularly) cycling reduces (but doesn't quite eliminate) my need for exogenous insulin very markedly. That is, if I'm doing lots of cycling I can go for a week with taking no exogenous insulin whatsoever, before gradually my blood sugar levels creep up to 'normal' Type 1 levels.
Anyway, ignoring the howls of outrage that the above paragraph will provoke, if I've had a week completely off the bike I usually take a total of about 20 units of Novorapid per day - depending upon what I'm eating, of course. It needs me to take more like two weeks off the bike though before I start needing to take any Lantus at night - in which case my 'standard' dose is 14 units. However, that's usually more trouble than it's worth, as then I have to keep watching my blood sugar levels during the day, especially if I'm driving. So, my Consultant's agreed with my strategy of usually just using bolus. For context, at all times I find it reasonably easy to keep my blood sugar level between 4.0 and 7.0 70% of the time - and my HbA1c is about 36.
For me, the most interesting thing about my own type of Diabetes (and the thing that my family and friends probably find the most boring) is that cycling has a much bigger impact on my need for insulin than what I eat. That is, a few days of hard cycling and even a big bowl of pasta will only raise my blood sugar within normal limits - and it will come down of its own accord. I think that part of it's stress-related: I feel relaxed (and smug) after a hard cycle ride and when I'm on the bike I can pretend that I'm not diabetic.
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CliffH
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I find that taking energy drink, bars and gels with me makes it much easier to fine-tune blood glucose levels when on the bike - when, as you say, going low is tough to bounce back from!
Of course any serious cyclist knows the feeling of 'the bonk' - and how it's too late to do anything once one's blood sugar's got that low. In one of the first races I ever did (long before I became diabetic) I took no food or drink with me (it was only 25 miles: we didn't bother with bottles for such a 'short' race back in the 1980s!) and blew up so comprehensively with just three miles to go that I had to get off the bike and lie down on the grass verge (of the A3 dual carriageway) for a few minutes, before eventually getting back on and crawling to the finish, in what was probably a world record slowest '25' time.
CliffH
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You might be interested in the new book 'Further', by the racing cyclist Michael Hutchinson: a companion to his earlier book 'Faster'. He goes into detail about the different on-bike fuelling strategies used by various competitive long-distance cyclists, including himself.
I think it would be very reasonably to think that there is a continuum, there also seems to be difficulty in working out quite what category people should be assigned to unless they are diagnosed as a child as I was, which again makes one think that perhaps the categories are either porous or require more divisions.
That does sound like a different kettle of fish though, but I think it's really useful to hear a wide range of experiences even if they don't match what happens with one's own diabetes (which is something the medical profession seem unhappy to provide for fear of confusing people, which means one usually ends up with almost no guidance or some very broad ideas that are obvious and not very useful.)
I do sometimes think that for cycling I might be better off with the combination of a much faster bolus insulin (to remove the tail) and a much shorter acting basal (to again avoid the tail towards the end of the day), I will have a chat to my consultant to see if there are any useful options I could try.
Interestingly I don't know what a non-diabetic bonk feels like as I was already diabetic around the time I first learned to ride a bike as a child. I wonder if the feeling of tiredness associated with my basal-experiment ~100km and no food is similar, or perhaps it's more like the feeling when BG is dropping sharply but not actually hypo yet. Neither of those compare with actually having properly low BG though.
I saw that recommended on Amazon the other day. I found both Faster (which I'm reading) and Re:Cyclists (which I've read and thought was good) interesting so I'll add it to my list. I also quite enjoy his back page-ish column in Cycling Weekly (iirc - I get it online via my local library so don't pay much attention to the name of the publication!)
How do you define the severity of Type 1 diabetes?
CliffH
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I suppose I was thinking 'level of dependence on exogenous insulin'.
CliffH
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It's hard for me to know, because long before I became diabetic I'd learnt enough not to bonk seriously any more! However, I don't think it felt significantly different to when I've experienced hypos since becoming diabetic - and I guess that technically bonking is a hypo. I doubt though that bonking could ever reach the level of a severe hypo caused by too much exogenous insulin, as I think it would be impossible to cycle (or run) when in such a state.
Certainly if I tried to do 100km with no food I'd be bonking for Britain! There was a fad a few years ago for 'fasted' rides (to train the body to burn fat rather than carbohydrate) but all it seemed to do was lead to rubbishy (albeit painful) training sessions.
Looking at my profile of blood sugar during rides on my CGM afterwards, if my blood sugar has dipped a bit too low (say 4.5) at any point during the ride, it correlates very well with (at least) a slight sense of sluggishness at that point in the ride. I can see then why professional cycling teams sometimes toy with the idea of using CGMs with their (non-diabetic) riders, to try to optimise on-bike fuelling. However, my sense is that professional teams have it down to a fine art nowadays anyway. My CGM does mean though that I can be confident that whatever on-bike fuelling I'm doing is reasonably optimal in terms of blood sugar - and luckily I don't need to worry about having to lose that final kg!
Yes, Hutchinson's a very interesting character! He obviously has an enormous brain and yet couldn't fit into the academic world - and had no interest in being a practising lawyer. Even when he was racing his interviews and magazine columns were always good value for money and I think he's developed into an extremely talented writer. His book about the Hour record is my favourite.
Just to report in on my mini-tour.
In the end I didn't do all that much cycling - the weather was generally cool and wet in the mornings though fine by late morning and until that night (which was very kind of the weather Gods 🙂), also the Tour was riding past late afternoon so we'd generally need to get into position ready for that, then ride (or walk!) home for beer/wine/food. Also we were on Mont Cassel, which isn't far from the UK anyway so even the out and back legs were quite short rides. Nevertheless it was very pleasant all around and both of my friends are enthused and we're planning more, which is great 🙂.
I'm, however, not sure how useful this will be for someone actually touring. I usually do more "miles" most weeks just going back and forth to work/getting out for lunch rides when WFH and then a couple of long-ish or one actual long ride at the weekend
In any case here's my daily kilometerages in the run up, across and once back:
My normal basal is 9 + 9U split breakfast/bedtime. Talking about nights below, they are the night which follows the day (with the date)
In the end I didn't do all that much cycling - the weather was generally cool and wet in the mornings though fine by late morning and until that night (which was very kind of the weather Gods 🙂), also the Tour was riding past late afternoon so we'd generally need to get into position ready for that, then ride (or walk!) home for beer/wine/food. Also we were on Mont Cassel, which isn't far from the UK anyway so even the out and back legs were quite short rides. Nevertheless it was very pleasant all around and both of my friends are enthused and we're planning more, which is great 🙂.
I'm, however, not sure how useful this will be for someone actually touring. I usually do more "miles" most weeks just going back and forth to work/getting out for lunch rides when WFH and then a couple of long-ish or one actual long ride at the weekend
In any case here's my daily kilometerages in the run up, across and once back:
My normal basal is 9 + 9U split breakfast/bedtime. Talking about nights below, they are the night which follows the day (with the date)
| Date | Description | Km | Dose (basal, pre-breakfast + pre-bed) | BG commentary |
| 3th - Thu | Pre-positioning ride | 33km | 9 + 9 | fine overnight |
| 4th - Fri | To the ferry, to Cassel | 97km | 9 + 8 | sensor failed during the night, but pretty good levels as indicated by blood tests at either end |
| 5th - Sat | Exploration pre-Tour arrival | 42km | 8 + 9 | low that night, needed to eat food |
| 6th - Sun | Beers in Belgium (skipped the Tour, it was south of us and Belgium is north) | 74km | 7 + 8 | Forgot to reenable alarms. Slept through that night and woke up low the next morning, which was fine, just like the good old days 😉 |
| 7th - Mon | Positioning ride to see the caravan + Tour away from Cassel. Could have made it a longer ride but we were conservative on timings and the caravan + Tour takes a long time to go past so food + beer was calling us by the end of the day. | 24km | 8 + 7 | ran high overnight, looks like 8U is the optimal evening dosage for low mileage days! |
| 8th - Tue | Ride home (headwind!) | 94km | 8 + 8 | ran low that night, ate food, went high, took correction. meh |
| 9th - Wed | Recovery day - stretch the legs | 30km | 9 + 9 | fine overnight |
| 10th - Thu | Ride to work and back | 75km | 8 + 9 | touching hypo when I got up in the morning, worked fine (I can eat breakfast!). Ran high during the day, should have taken normal morning basal |
Having just read the above, it's rather confusing - it's not helped by the fact that my overnight BG often does a U-shaped thing as I tend to eat fairly late so there's still food + bolus in action when I go to sleep, and when not doing much exercise FotF in action when I get up (the latter went away while I was away - partly exercise, partly alcohol)
In general my approach was that I will err on the side of running a bit higher overnight if it's a short night/I'm knackered as I don't want to have to wake up to treat a hypo, and can live with running a bit high one night. Obviously I try to avoid this, but am happy to take some pre-bed bolus to push me in the right direction (though not too much if I've just been riding).
For the day, I'd typically take more basal, though it depends very much on food availability (no/uncertain food means I might take less so I don't end up hypo and desperately searching.) If the rides are short (< a couple of hours) then I can get through whatever happens so probably take more/normal (I shouldn't have reduced basal for my ride to work when I got back), if the rides are long/there are timings which must be met (ferry for example) so I don't want to run low then need to stop or ride slower than expected, then I'll probably err on the side of taking less unless I have lots of food available.
It's not a hard and fast rule though, it depends how I feel, which isn't very useful for anyone else. Sorry!
P.S. I did take bolus while out riding, which was interesting. I think I took too little in general, though again erring on the side of not needing to stop to fix things. A faster acting (or rather shortened total duration) bolus would probably be useful here (cf my normal Novorapid)
For example, we stopped to and got a pizza on the ride down as the ferry was delayed and we were running late (the shops were closing, and in fact the supermarche we'd targeted happened to close 30min early that day due to roadworks so we just missed getting in there to buy supper. We saw a pizzeria on the way past so looped back to that as the fallback. I didn't take any bolus with the pizza but then took 1.5U of bolus an hour later as I could see my BG was rising, I should probably have taken 2U at the time of eating the pizza. I did then have to take a couple of extra bolus injections later that evening once we'd arrived to sort out the standard long digestion (not helped by exercise which also slows it down).
A whole pizza was probably not my first choice, but beggars couldn't be choosers! 🙂
In general my approach was that I will err on the side of running a bit higher overnight if it's a short night/I'm knackered as I don't want to have to wake up to treat a hypo, and can live with running a bit high one night. Obviously I try to avoid this, but am happy to take some pre-bed bolus to push me in the right direction (though not too much if I've just been riding).
For the day, I'd typically take more basal, though it depends very much on food availability (no/uncertain food means I might take less so I don't end up hypo and desperately searching.) If the rides are short (< a couple of hours) then I can get through whatever happens so probably take more/normal (I shouldn't have reduced basal for my ride to work when I got back), if the rides are long/there are timings which must be met (ferry for example) so I don't want to run low then need to stop or ride slower than expected, then I'll probably err on the side of taking less unless I have lots of food available.
It's not a hard and fast rule though, it depends how I feel, which isn't very useful for anyone else. Sorry!
P.S. I did take bolus while out riding, which was interesting. I think I took too little in general, though again erring on the side of not needing to stop to fix things. A faster acting (or rather shortened total duration) bolus would probably be useful here (cf my normal Novorapid)
For example, we stopped to and got a pizza on the ride down as the ferry was delayed and we were running late (the shops were closing, and in fact the supermarche we'd targeted happened to close 30min early that day due to roadworks so we just missed getting in there to buy supper. We saw a pizzeria on the way past so looped back to that as the fallback. I didn't take any bolus with the pizza but then took 1.5U of bolus an hour later as I could see my BG was rising, I should probably have taken 2U at the time of eating the pizza. I did then have to take a couple of extra bolus injections later that evening once we'd arrived to sort out the standard long digestion (not helped by exercise which also slows it down).
A whole pizza was probably not my first choice, but beggars couldn't be choosers! 🙂