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Hiking

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Hi.

It's been a while since I've posted in the forum. I've got into a routine for walking, jogging and strength routines but haven't done anything lasting more than an hour. I was wondering how some of you who hike regularly or even occasionally prepare yourselves and what do you do during it. I know it always comes down to the individual but looking some experience to be shared. Do you find you need to reduce basal or bolus before ? Do you snack during the hike and what snacks do you have ? Fast acting or slow acting? Or both. It's probably about a 4 hour hike im going on but I'll be going on a longer one after that.

Cheers
 
I do a lot of hiking - I love the outdoors and great scenery.
I know this sounds like a bit of a cop out of an answer but I find it depends on the type of hiking. I can walk on the flat or downhill for hours with no affect but uphill affects my levels.
If I am unfit, my levels rise ascending mountains as I get out of breath and need to stop to "admire the view". If I have been doing a lot of exercise (such as towards the end of a week's walking holiday), my levels will drop.
More constant is that my basal needs are significantly reduced for the next 24 hours so I turn down my basal but about 15 - 20% for the next day. And this can be cumulative if I do multiple consecutive days walking - after 7 days walking in the Himalayas by basal was half of its usual dose.
I tend to take plenty of hypo treatment along with fruit and nuts to nibble along the way.
 
Hi Helli

Thanks. Hiking in the Himalayas, I'm sure that was amazing! It will be uphill and down hill hiking. So you are saying its likely my levels will go up rather than down then? I imagine there wouldn't be much need to bolus correct for that unless they were very high? The basal reduction makes sense, I noticed the last time I was on holiday I was going low a lot as I tend to explore more than sit about. So apart from the basal I should really just see what happens at the time?
 
Are you still taking Levemir just once a day?
The reason I ask is that for me my night time basal needs are most affected by a long hike. I may need a bit of a top up during the day whilst I am walking but sometimes I don't need anything at all. It is usually when I sleep the night afterwards that my muscles seem to replenish their stores from my blood and drop my levels and I usually do at least a 2 unit reduction in my Levemir the first night. If I am doing more walking the next day, I need another 2 units off and so on but often my daytime needs remain about the same. As @helli says, the cumulative effect can be quite significant which is why split dose Levemir is such a useful basal insulin in that you can adjust it independently day and night and day after day to get almost real time adjustment rather than the 3 days that other basal insulins need to adjust and settle.

A general rule of thumb with exercise is that if you are huffing and puffing and finding it tough and perhaps feeling muscle burn, your levels will likely increase at the time but decrease later. If you are just tootling along at a steady pace for some time (usually about 40 mins for me) within your fitness level/comfort zone, then levels will start to drop.

Do you have Freestyle Libre? That makes it so much easier to keep an eye on your levels and top up before you drop too low, particularly when you are doing extended periods of activity like hiking.

I carry a bag of dried fruit (apricots, prunes and figs) in my pocket for topping up levels. An apricot or prune is about 5g carbs and a fig about 8g. Obviously I also carry hypo treatment like glucose tablets or jelly babies as the dried fruit doesn't release fast enough to treat hypos for me.
 
@rebrascora
Still taking once a day before bed. Down to 4 units at moment. Cant see me taking a split dose any time soon. Its really going to be a one off hike then not another for a while. The last time I did this hike it was tough. Quite steep and usually out of breath. This is even when I was exercising most days of the week. So maybe I wouldn't need to decrease my basal before hand, maybe increase? Id be happy with small increases in my glucose. I guess I wont know until I do it.

I do have the freestyle libre. I have read general guidelines on carb intake per hour for exercise but I assume that only applies to exercise that causes a drop rather than an increase. Obviously I'll still carry snacks on me.
 
jazzchicken said:
Hi Helli

Thanks. Hiking in the Himalayas, I'm sure that was amazing! It will be uphill and down hill hiking. So you are saying its likely my levels will go up rather than down then? I imagine there wouldn't be much need to bolus correct for that unless they were very high? The basal reduction makes sense, I noticed the last time I was on holiday I was going low a lot as I tend to explore more than sit about. So apart from the basal I should really just see what happens at the time?
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I find my levels drop even when I’m going uphill. Possibly because I try and find a pace and rhythm where my breathing is quicker but steady, but I don’t actually get completely out of breath and need to stop. Like @rebrascora , I find my liver replenishes itself overnight, and I need to drop my basal quite a lot, until my body has adjusted after a few days. I also find it depends where I’m walking. A higher altitude, eg, the Dolomites, and I go hypo a lot quicker, again, until I’ve acclimatised.
 
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I would keep your Levemir the same as usual, the day before the hike (I certainly wouldn't increase it, but I would reduce it the night after the hike as for me I would hypo through the night unless I reduced it after the hike. You may be different but best to play it safe and make some reduction in evening basal especially if it is going to be a hard hike.
 
Appreciate all the tips, I think being on so little basal just puts me off reducing it, especially when its only in the evening I take it. I guess I could try 1 unit reduction for now to see how I fair. Have to say though I won't be going to any great mountain range, its literally just a big hill haha
 
I have found reducing the bolus for the meal before, and snacking during the route really helpful.

Plus, as I am on an insulin pump I can reduce my basal profile for the duration.

I tend to find these days that my body gets a bit twitchy when doing even light intensity walking if I have any insulin on board, so reducing the level of circulating insulin is a good strategy for me. As is taking way more snacks and hypo treatments than I think I could possibly need! Last thing I want is to see a plummeting BG trace when I’m in the middle of nowhere and I’ve already eaten everything I brought! 😱
 
@everydayupsanddowns I have found walking is enough to send me down a bit. The hike went well, I maybe was a bit on the lower side than I should have been, high 4s and low 5s throughout and I ended up snacking on a mixture of carbs every hour. Brought loads with me like you say you do. I'll know next time to reduce my bolus for breakfast a bit to help start me higher. I found at my next meal the insulin hit me very quickly and I went low soon after I finished eating. I do tend to run lower on the weekends in general. Good thing I've noted all this for next time I go.
 
Sounds like you’ve made a pretty good start on a basic approach for this kind of hike @jazzchicken

Glad you enjoyed it. Hopefully next time your BGs will behave and you’ll be able to relax and not have to think about it so much.

Reducing the bolus before always feels like reducing insulin on board and increasing relative carbs on board to me. Essentially setting your BG on a gentle upward trend if you weren’t hiking, which the hike then levels out 🙂
 
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