riding with diabetes - I Love Bicycling

There are an estimated 387 million people living with diabetes worldwide, which is approximately one in twelve adults. The figure is expected to rise to 592 million by 2035, with all types of diabetes increasing in prevalence across the globe but particularly type 2 diabetes. Diabetes changes a person’s life forever. It’s one thing to just live with it comfortably, but cycling and diabetes in the same equation takes on new meaning.

Cycling and Diabetes – Type 1 Diabetes

Type 1 diabetes is characterized by increased glucose levels in the blood and urine, excessive thirst, frequent urination, acidosis, and wasting. It is also called insulin-dependent diabetes because the pancreas has ceased to produce insulin. For the young cyclist, this can be especially challenging as a host of psychological implications may be present as coming to grips with the idea of vulnerability can be a new challenge.

Type 2 Diabetes

Type 2 diabetes typically appears first in adulthood and is worsened by obesity and an inactive lifestyle. This disease often has no symptoms, and is usually diagnosed by tests that indicate glucose intolerance and is initially treated with changes in diet and exercise. It is also called non-insulin-dependent diabetes. In some instances though, insulin may be required to help regulate glucose in Type 2.

Type 1 Cyclists

Type 1 diabetic cyclists face a complicated equation. Insulin manages blood glucose levels. Without it, that fuel remains in the bloodstream where it damages organs and tissues. It’s fatal without treatment. Type 1 and sometimes type 2 diabetics use pharmaceutical insulin to replace the body’s natural insulin; but it’s a critical equation. They have to carefully synchronize insulin injections and blood sugar levels, factoring in the food they’ve eaten, how far they ride, and at what intensity.

Type 2 Cyclists

Type 2 diabetic cyclists can’t really be generalized, since type 2 diabetic cyclists typically control their symptoms with food or fluid intake. Each has different needs depending on body and amount of exertion. Type 2 diabetes should always be based on the individual cyclist’s body composition, weight goals, medication regimen, and blood glucose control.

Cycling and Diabetes – How to Make it an Equation that Works

The answers to controlling diabetes in cyclists can only be interpreted as educational only and not serve as specific advice. It’s typically necessary for cyclists with diabetes to work with their own personal health care provider, sports nutritionist, or dietitian to determine their own strategies for daily diet and eating and drinking when on or off the bike.

Food Quality and Quantity

Marcey Robinson, MS, RD, CDE, BC-ADM, is a diabetes and nutrition Coach for Team WILD. She sums up nutrition needs for cyclists like this: “Athletes use food as fuel. All bodies, whether diabetic or not, perform best when food is geared to properly fueling the body for energy and health. During exercise, your bodies main source of fuel is carbohydrate and you need to pay attention to quality and quantity. High-quality carbohydrate fuels includes whole grains, veggies, fruits, beans and low-fat dairy.”

ADA Recommendations

The American Diabetes Association (ADA) recommends 45-60 grams of carbs per-meal for women and 60-75 grams of carb per meal for men. (Source) If your goal is to lose weight it may be less, maybe 30 grams of carb per meal. If you’re performing regular endurance exercise, it can be more.

Carbs and Cycling

Robinson takes carb intake into account for diabetic cyclists. “Now with diabetes,” she says, “carbohydrates can significantly impact blood sugar and some of you may even have put limits on your carb intake. It may take some balance with your insulin or diabetes medication so please make sure you are sharing your goals with your health care provider.”

Insulin Strategy

“Managing your blood sugars while fueling your exercise is vital”, says Robinson. “If you have Type 2 diabetes, you will need to experiment with your carb intake and work to match it to your exercise effort in order to maintain blood sugar control. If you take insulin, you will need to figure out your insulin strategy to cover the carbs. Talk with your health care team.”

Pro Cyclists Agree

Mondique Ryan, MS, RD, LDN is a nationally recognized nutritionist. Monique was the adviser for Saturn Cycling, Volvo-Cannondale Mountain Bike Team, the Gary Fisher Mountain Bike Team and USA Cycling. She was also member of the Performance Enhancement Team for the Women’s Road Team leading to the 2004 Athens Olympics.

Get Control

Monique says that: “Generally speaking, it is best to not start any serious exercise program until you are in good control of your blood glucose levels. Moderate exercise combined with calorie restriction can facilitate weight loss and improve your glucose levels if needed. Medication changes must be made by a physician and for many persons with diabetes, an endocrinologist who appreciates the impact of exercise and training, and can be the best type of physician to manage diabetes.”

On-Bike Nutrition

“Training rides present the greatest challenge as your energy needs are higher and it will not be convenient to check blood glucose levels,” Monique says. “So your on-bike nutrition strategies can vary depending on the intensity and duration of your ride. The exact timing will depend on your schedule and blood glucose levels, but generally eat one to three hours beforehand, and start with blood glucose levels over 100 mg/dl.”

Glycemic Index

“You can emphasize foods with a lower glycemic index”, say’s Monique. “Some good choices include oatmeal (the long-cooking type not instant), oat bran, muesli (no sugar type), milk, and yogurt, and fruit and fruit juices. Foods with a very high glycemic index include refined cereals, bread, and bagels. The glycemic index of foods does not always follow logic, so look for a good resource list.”

Diabetic Hydration

“You can cut a sports drink concentration by 50 percent, but this may not meet your carbohydrate needs during hard training.” Monique says. “For a drink that has a low glycemic index, you can dilute fruit juice with water, half water and half juice, and consume 16 to 32 ounces every hour for 30 to 60 grams of carbohydrate. For moderate exercise, 15 gm of carbohydrate per hour may be adequate. However, the effect of exercise on blood glucose levels varies greatly from cyclist to cyclist. There are also some beverages on the market that replace fluid and electrolytes, but are very low in carbohydrate and may even contain artificial sweeteners.”

In Summation

Monique sums it up with simple advice: “It would be ideal if you could try to train at the same time everyday and develop a program that consistently works for you. If this is not possible, the results of blood glucose monitoring are the key to determining how you can safely train, and what pre-exercise and on-bike food and fluid strategies are most effective.”

Tour de Cure Red Riders

If you have diabetes, you’re welcome to join the community of diabetic riders. The American Diabetes Association’s (ADA) Tour de Cure is a series of scenic and challenging cycling events held nationwide that raise funds to aid in the fight against diabetes. Rides are held in 40 states and 84 cities, mainly during the spring cycling season of April through June. Tour de Cure is for all cyclists who live with type 1 and type 2 diabetes.

Cycling and Diabetes – Team Novo Nordisk

With cycling and diabetes, there’s no reason to leave out a career in professional cycling. Team Novo Nordisk is the world’s first all-diabetes professional cycling team. Their mission is to inspire, educate, and empower people affected by diabetes. Effectively managing diabetes will not only ensure a healthier, more enjoyable life but also the means to be able to ride to the level that you wish. If this is a new endeavor for you, cycling and diabetes, seek out another cyclist who has diabetes and they will not only help you ride effectively with it but also will be a great mentor and friend with a similar background.

Cycling and Diabetes

Cycling and Diabetes – Type 1 Diabetes

Type 2 Diabetes

Type 1 Cyclists

Type 2 Cyclists