Author Bio: Anne Marie is a long-time CIM supporter, having first participated in the Ottawa marathon weekend and Annual canoe trips in 2012. She has lived with Type 1 Diabetes for over 30 years. She’s an Ironman triathlete, an MD, and a mom. She lives with her family in Oakville, Canada and can’t wait to take part in future Connected in Motion events. She’s super passionate about coaching athletes with Type 1 Diabetes and helping them realize their athletic dreams. She can be reached on social media @SweetRunMD.
If you’re an athlete living with Type 1 Diabetes, you have many additional challenges when it comes to training for, and racing, your events. From picking a race to knowing how to manage your blood sugars and your nutrition, factoring in your diabetes into your training and racing plans can be difficult. In this blog, we delve into some key considerations and advice for both beginner and the experienced athletes with Type 1 Diabetes training for a race so that we can all achieve our athletic goals!
Source: unsplash.com
1. Ready? Set? Goal Set!
So you’re ready to train for and complete your first race! Congratulations! Before you get too excited about toeing the line though it’s important to think about your specific race and diabetes goals! After all, how will you know if you have succeeded at accomplishing your goals if they are not well defined? To start off, think about choosing a goal that aligns with your values and gets you excited to get out of bed to train. Is there a specific race or event that you have been eyeing for years? Want to complete your first 5km race? Or maybe qualify for the Boston marathon? Why does the race in question matter to you? Does it seem impossible (hello Ironman!) or simply like an amazing experience? What’s your starting point? Want to complete an Ironman but you don’t know how to swim? That’s ok. Be realistic when choosing your goal and plan for the steps that need to take place in order to achieve your goal. Lastly, know your end goal. Want to be a finisher and cross the finish line? Or are you hoping to podium and get a personal best time? Being specific about your goals and matching them up with your values and your WHY will make training for, and completing, your goal race that much easier and more enjoyable!
2. How to choose the best event and/or race?
No matter your sport – whether you are a runner, a cyclist, or a triathlete – choosing the best event for YOU is important. If you don’t like complicated logistics, maybe flying out to Europe for a multi-stage race isn’t your best idea. If you love the thrill of adventure alongside racing though, maybe finding a race down in the Peruvian mountains is just the right fit! When choosing a race or event it’s important to remember that you are an athlete who lives with Type 1 Diabetes, especially if you have concerns about your blood sugar levels while racing. For example, if you choose a trail running race that takes place far from an urban center, be prepared with additional resources in case you need a glucagon injection or a GPS-enabled device. Think about whether there is a medical team on-site, what the aid stations look like (are there even aid and fuelling stations available to you?), will the race be self-supported, is it near a hospital, can you receive a medical exemption to carry a CGM device or your phone, and how will the weather changes affect your diabetes management? Other considerations include the travel logistics and the sleep arrangements. Remember, anything that can have an impact on your blood sugars needs to be considered when planning out your race. The more you plan, the more confident you will feel as an athlete and a competitor. So plan ahead and toe that line with utmost confidence!
Source: unplash.com
3. Yes, you might have low and/or high blood sugars while exercising
Although it’s commonly understood that exercise can make your blood sugars drop, it’s also important to remember that certain types of activity and racing conditions can actually make your blood sugars go up! So, rollercoaster-ing BGs can happen and we need to plan ahead to make sure that our blood sugar levels don’t interfere (too much) with our training progress and our race day! Steady aerobic activity that tires your heart and lungs will generally lower your BGs both during and following your training, mixed activity (think basketball or soccer) can make blood sugars both rise during, and fall following the activity, as the intensity and duration of exercise varies. High-intensity workouts that are more anaerobic in nature (think of sports like weight lifting, for example) cause blood sugars to rise both during and immediately following activity, with blood sugar drops that are possible hours later (Riddell, 2017). What is most important to remember is that you might both experience high and low blood sugars. Take the time to test often or mark down CGM trends so that you are able to know how your body responds to activity. If you are new to working out you might notice larger blood sugar swings, so be prepared with fast-acting sugar, or try exercising in the morning when your body is naturally ‘sweeter’ with morning hormones, which makes it less likely for you to go low. Test, try out different times of day, and remember that your insulin doses will also need to be tweaked as you plan out your training and racing. Speaking of insulin, let’s see how your insulin needs might change as you chase those athletic goals!
Source: Riddell, 2017
4. Tweak your insulin with confidence
Knowing how and when to make changes to your insulin dosages while working out can be challenging. Without adequate knowledge and experience, we often make rash decisions that may negatively impact our performance as athletes. There are a few things to keep in mind when making tweaks to your insulin doses. First off, know your technology. If you are using an insulin pump that has an activity mode setting, make sure that you understand the setting before using it. If you manually change your basal rate, experiment with lowering your basal rate by 50-80% 90 minutes pre-exercise if you tend to go low during activity. If using injections then be sure to lower your basal rate by 20-50% before the exercise begins (a morning dose reduction of a long acting insulin for example) and also consider increasing your carbohydrate consumption during exercise. On another note, if you notice that your blood sugars are trending high during activity, be sure to make small insulin dose adjustments. Be patient. Hydrate. Consider a longer aerobic warm-up. Lastly, if race nerves make your blood sugars rise, focus on learning skills to offset stress (Riddell, 2020). Your insulin needs will most likely change as you become a stronger and faster athlete. Make sure to re-evaluate your plan every few months and practice your strategy so that you can be confident in your management decisions when race day rolls around.
Source: unsplash.com
5. Don't forget to feed the athlete!
Last but most definitely not least important is the topic of nutrition! You cannot talk about training or racing without talking about food and fuel. And although so much attention is placed on blood sugar management for Type 1 athletes, it is almost more important to speak about our fueling needs. First of all, you are an athlete. You exercise with a purpose. You train. You set your sights on various race goals and you accomplish them. Sure, you have Type 1 Diabetes. But you are an athlete and you need to fuel your body accordingly. Far too often, we see athletes with Type 1 Diabetes training for a race and eating too few calories or carbohydrates because they don’t want to mess up their steady BGs. They rather under-fuel than figure out nutrition and insulin dosages. Not sure if you are eating enough while training or racing? Based on the athletes that I’ve worked with I can confidently say that you are most likely not eating enough. And here’s why: If you’re an endurance athlete and doing anything longer than a 60-minute session you should be taking in about 30 – 60g of carbs per hour. An endurance session that is over 3 hours should be fueled with 60 – 90g of carbs per hour. And let’s not forget about hydration and salt needs –under 60 minutes you are ok with only water, but over 60 minutes you need to take in water, and with sessions that are over 3 hours you definitely need to add in salt replacement too. Not sure where to start when it comes to nutrition? Take a look at your current race nutrition strategy (don’t have a nutrition strategy? This is a great place to start!) and see how much you are taking in. Need to increase your calories and/or carbohydrate consumption? Start with incremental increases and see your performance improve! Nutrition really is one of the most important keys to athletic success!
Source: unsplash.com
So there we have it – a few important considerations to become an endurance athlete with Type 1 Diabetes who sets big exciting training and race goals, eats enough, and manages their insulin needs like a pro! Remember to enjoy the entire process and go easy on yourself. Being an athlete with Type 1 is hard work but the pay-off of a race that sees steady blood sugars and goals achieved is priceless!
References
[1] Riddell MC, Gallen I et al. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol. 2017 May; 5(5): 377-390.
[2] Riddell MC, Scott SN, et al. The competitive athlete with type 1 diabetes. Diabetologia. 2020 Aug;63(8):1475-1490.
