Any tips for long distance walks? (miss you, Copepod)

[Pigeon]

Hello, I'm doing a long distance walk in April (Yorkshire 3 Peaks) and it's the first walk of this distance (with hills!) I'll have done. I have walked 18 miles in a day before, but that was flat, and this will be 25 miles, with erm, 3 big peaks! I'm doing it with 30 people from work so I don't want to slow anyone down with my hypos - not that most of them know about my diabetes anyway, I'm a "swig lucozade and carry on" kind of girl!

Just re-read Copepod's Keswick to Barrow walk log, which was very helpfuil, and I have a guidebook for the 3 peaks walk, but I wondered if anyone has any further advice, preferably about using a pump, as my pump is quite new to me!

I have done some training walks but I seem to end up constantly hypo or going too high, haven't managed to get it right yet. A TBR of around 60% seems about ok for walking briskly, but it's complicated by the earlier meal doses, which seem to cause crashing hypos, and we'll be eating all meals on the go on the big day.

On my last training walk I reduced my lunch dose by 40% and did a 60% TBR and was hypo all the time. I took 1u for a 60g carb flapjack part way round and came crashing back down again so ended up reducing to 10% TBR while I recovered.

Today we did 4 miles after lunch. I did a 50% reduction in lunchtime bolus then a 50% TBR and ended up around BG 10 at the end of 4 miles, with lunchtime insulin still active, so I think if I had walked further this would have been about right.

I'm going to try walking to and from work (7 miles each way) to get experience of walking and eating on the go at those times of day. Anyone else got any input or experience of doing a full day event such as this?

 

[Matt Cycle]

Not done any long distance walks for a long while so can only relate what I do on the bike. I usually just reduce basal (still experimenting but currently on TBR's of 55% for a 3-5 hour ride now but used to take less Levemir) and not mess with the bolus. It is probably different from what you will be doing as I tend to have my breakfast with bolus and then anything I eat on the ride (cereal bars/gels.banana etc) I treat as free carbs as I don't have a meal when out. The exception to this was in 2016 (on MDI) on the Wales ride which took nearly 9 hours of riding and I was out of the house for 11.5 hours. I did stop for a meal on this one and took a slightly reduced bolus although of course I was guesstimating carbs in the cafe. I always think it's easier to eat something if dropping low (without of course wanting a rapid drop into hypo levels) than trying to reduce blood glucose when high. I'm not keen on corrections although occasionally these are necessary but for me they introduce another potential complication.

Of course this is diabetes so what may work one time may not work another but you're doing it right with the training walks and building a picture because it's going to be quite a bit of trial and error. Your walk today with the 50% bolus reduction and 50% TBR sounds like it was promising. 🙂 One thing I found was the more exercise I do the less fluctuations I seem to get. I thought it was my body becoming accustomed to it but that could be rubbish. The libre though is invaluable in these sorts of situations. Also bear in mind that with the walk you may have blood glucose reductions overnight and into the next day. TBR's again may be required.

Most of all enjoy yourself in the lovely Dales. 🙂

 

[Stitch147]

I can give you tips on the walking side of things as its something that I do a lot of. I cant advise anything at all on the insulin front though. I always use a libre sensor when Im taking part in long walking events so it doesn't slow me down when testing I can just scan as I go. Im doing the moon walk full marathon distance in May so Ive just started my training for that.

 

[trophywench]

Well - I certainly wouldn't pre-bolus for any food on the day - since the prior exercise will automatically make you more insulin sensitive, don't forget to reduce your basal at least an hour if not two before you set out on the walk and don't forget you can have a TBR of 0% any time you want to!

 

[Redkite]

My son did Duke of Edinburgh expeditions a couple of years ago, i.e. long hikes with heavy rucksack. We did a full practice run beforehand including an overnight camp in the back garden, so we could get some experimental data!! He reduced meal boluses (breakfast and lunch) by 25% - the hike started straight after breakfast. At lunch he used a 1hr square wave bolus. Throughout the hike he used a programmed basal pattern of a flat rate 0.2U per hour - his normal basal requirements are quite "spiky" so a temp basal wouldn't have been appropriate for the whole duration, but 0.2 is roughly between a quarter and a third of his normal rate. For his evening meal he needed the full amount bolused, with no reduction, to compensate for the delayed effect of the earlier lack of basal.

In addition, he tested his BG hourly throughout the hike (he has CGM but the sensors lag behind true BG when doing strenuous exercise, so can't be trusted). He had a chart of actions to take for different BGs - 5-7 eat cereal bar 22g carb (no bolus), 7-10 eat fig roll 13g carb (no bolus), 10-14 no action, 14+ check ketones and bolus a half correction. Levels tended to stay around 6-8 (with these additional carb snacks) within 3 hours of a meal bolus, and then would tend to rise, requiring a half-correction at the next meal. No full corrections due to the effect of prior exercise. Then overnight, perversely, he needed his normal full basal (which for a teenage boy is his highest basal rate of the 24hr period). He did check BG at 2am to be on the safe side. Same protocols on day 2.

This worked very well the following year when we walked up Snowdon.

 

[Brando77]

I walk miles along the coast several times a week, never gets boring, always something happening. Before moving to the Kent coast I lived next to the Thames and it was the same. Walking with great views is the best 🙂

 

[Pigeon]

Aw thanks guys, you're full of top tips! Never thought of using a square wave when walking and eating, but that's the perfect solution to insulin absorbing faster than food does! Am still quite new to pumping so still realising what's possible. Also top tips about snacking on the go rather than having larger meals with a bolus, this is something I hadn't really though about as normally on shorter more casual walks we'd stop and have a picnic rather than just marching on. Definitely Libre is a good idea, much easier than stopping to test as I go.

So today I walked to work, it was a beautiful morning for a wander across the fields. I set off at 6.50am with a 2.5 hour 50% TBR and did a 50:50 dual wave for half of my breakfast carbs, which was a few slices of Lincolnshire Plum Loaf (try it if you ever get a chance, very tasty!) which I munched on the go. I kept scanning my Libre as I went and swigged a bit of Ribena every now and then. I managed to stay around 8-9 mmol for the entire journey, and did 7.5 miles in 1hr 50. Then tonight I walked about another 3 miles to a bus stop then got the bus the rest of the way home. I sat still most of the day so didn't keep a TBR on during the day, but I did have a big piece of cake mid-afternoon to prevent a low. Had a few more swigs of Ribena on my walk to the bus stop and got home to a level of 9 mmol. Obviously I would love it if I could have kept steady at 6mmol all of the journey, but I thought 9 was still an achievement!

So definitely an improvement on my last long walk where I was hypo the whole time. Saturday I'm going to do another long walk (with hills!) but this time it's complicated by "difficult" foods - going for a Staffs oatcake full of cheesy goodness first then fish and chips afterwards. I'm not one to change my life to make the diabetes easier!

Hope all of your endeavours go well, and good luck with your traiing Stitch!

Thanks so much for all of the tips, you're all founts of knowledge!