Diabetic Distance paddlers?

I’m an insulin dependent diabetic who would like to do some canoe tripping.

I recently had to bail out after the first full day on a trip because I could not keep my sugar levels reasonable. It was a hard day of paddling into the wind, poling upstream, and portaging but I don’t think I can expect to trip without running into those kind of days at least once in a while. I crashed hard three times, putting my self at risk and forcing my partners to give up hard fought progress to comeback and make sure I was OK.

Is anybody out there in the same situation doing distance paddling or touring?

I’d like to get some tips on how to prevent the hypoglycemia from kicking in.



Thanks,

Tommy

Good question
It’s kind of ironic to me that I was thinking about this same issue today, however, I need to keep sugar levels low and do not take insulin. I am curious if they have meals / energy stuff for folks with type 2 diabetes / non insulin dependent. I have recently been diagnosed at a ripe age of 31…sucks big time. On the bright side I have lost 25 pounds b/w diet and exercise. Sorry I don’t have an answer for you, but I will be interested to see if you get any and what they are. It comforts me to know there are others with diabetic prognoses that paddle.

early signs
I assume you know the very early signs of low blood sugar. You should be able to take a fast acting glucose tab at the earliest sign.



You might also talk to your endocrinologist. If you know you’re going to have a very physical day s/he might recommend cutting back on your insulin that morning.



With good planning and careful attention to your body you should be able to do anything you want as long as you have the medications on hand to deal with your low bs. Educating your paddling partners on how to deal with either extreme in bs levels is important.



Lyn

Exubera is
Pfizer’s inhalation insulin. By the end of this month, you will be able to get it prescribed and carry the device/doses with you.

Low blood sugars
Hi Tommy. I just went kayaking on the American River yesterday with my insulin pump! Its the best invention since insulin! I am able to reduce my basal rate while I exercise so I’m not going low all the time. My doc put me on it last year, and while its taken some time and monitoring and a lot of tracking food and insulin rates, its been worth it. If you’re on shots, how many and what type of insulin do you take? Before I started using the pump I would reduce both my long acting insulin the day of exercise and my short acting, depending on how much exercise I was planning. You really have to know your body to do strenuous exercise on insulin because often the lows don’t happen until the next day! Its probably best to talk to your doc, but I’d suggest eating a carb with both fat and protein before starting to prolong the sugar effects. Peanut butter works great for me. I also eat glucose tabs during any long exercise. I’ve calculated one 4 carb tablet every 1/2 hour during a run will keep my sugar level. Good Luck! Be safe and wear a medical alert tag!

Try and keep a daily log
of your increased paddling activities, blood sugars, and carb intakes for a couple of weeks. Include potages, laden or unladen boat. Carry your supplies and a good amount of fast acting carbs. Ask your endocrinologist if it would be ok to let your sugars run a bit higher while you are engaging in intense activities and adjusting to them.

Me too
I’ve been on a pump for about six years and the difference in control is huge. There’s more flexability in eating, easier to adjust for different activity levels, etc.



I have a Deltec Cozmo pump which is waterproof and almost bombproof. I stick it inside my wetsuit or drysuit and off I go. I’ve had a few mild lows before, but always keep a Zone Bar in my pocket just in case. I’ve been paddling a few years and never had any real problems. Okay there was this one time when I had this little stupid attack…



http://www.cozmore.com/default.cfm?PID=1.10.4


Tommy----slow release carbs might help.
Sorry to hear about your messed up trip. I went thru something similar on our Current River trip. What should have been a reasonable paddle for me turned into a vertigo nightmare and bonkfest.



I’m not insulin dependent, but I’ve been hypoglycemic all my life and diabetes runs in my dad’s family. After a month of tracking glucose levels and food logging, we think I’m insulin resistant. Turns out that lots of folks have this situation and don’t know it. We’re working on reversing what we can while we can.



I’m going to start incorporating an herbal supplement to help keep insulin levels more constant. I find that diet is critical. Carbs with a low glycemic index work as a slower release reserve. I know you have a more sensitive situation, but I have a friend with Type 1 who is a physiologist and athlete. She keeps dried fruit handy and eats a hardy wheat bread (no white flour)before activity. I notice a difference when I do the same. She also uses glucose tabs when needed and stays up on all the latest management stuff.



The advice about careful monitoring while you do your desired paddling activities is excellent. It’s the only way to test variables and find out what works for you. I hope you have paddling partners who can work thru this with you. I haven’t been in my boat since May, but my hubby and I are working on it together. Don’t give up! It takes more effort, but it’s worth it!

Welcome to the club
we must stick together . . . We don’t have a union.



I also have an insulin pump. I have not done any multi day trips but I do a lot of day trips. I had a hard time keep my blood sugar up during exercise before I had the pump. If your are doing shots then you need to talk to you doc and work out a program which will work for the days you exercise more that normal.



I would check into a pump if you do not have one.





As to how I manage it when paddling, well I always carry several individual cans of orange juice in my deck bag along with some fruit. I also carry my meter in a plastic waterproof box and check my levels when we take a break. You can get these boxes at almost any outdoor store. It is a pain in the ass (as well as you finger) but, hey what-you-gone-a-do, sit home all the time.



I also race a small sailboat. Each race takes about 1 1/2 hrs. to do. I check levels just before going out. With the pump I can reduce the amount of insulin I automatic get (basal rate). I usually reduce it by 1/2. More if the wind is really blowing. I also carry those cans of juice and some kind of energy bar on the boat.



You can learn to balance all this. It will not be easy but it sure beats sitting in the living room all the time. Your doc should be able to get you on the right program for high energy days. If he can’t help you ask him to refer you to someone who can.



Feel free to e-mail me if you have question you do not wish to post in an open forum.



Hang it there for a while. It can be done.

…But your paddling judgement wasn’t
fuzzy at all Tommyc1/T! Ditto most all previous, …particularly pamskee’s to the letter. My pre-paddle/ski/hike preparation is now 7x24 diet/training for a healthy life…



Steve

Tommy…one more piece of advice…
pick your paddling pardners carefully, and make sure they KNOW of your condition. In addition, it would good if at least one of them knows the steps to take should you crash beyond the point of self-help. I paddle with an insulin-dependent friend on a regular basis and I make it point to keep an eye on him. I’m a certified First Responder and I try to make sure he’s doing well and don’t get too far away from him…and when it’s time to stop and rest, or eat…we stop and do just that. The rest of the party can do what they want, but when it’s time for him to eat…‘we’ stop and eat. I also carry extra food of the "right’ type with me on those days when I go with him. Never know when he might need it.

I know someone with an insulin pump
You can actually see it when he wears a wetsuit. I don’t know what kinds of distances you are talking about, but if it weren’t for the pump outline I wouldn’t know this guy was insulin-dependent.



I have diabetes myself, so far (keeping fingers crossed) kept under control with metformin (and of course exercise, which I always did anyway).



One thing I would really watch out for is energy bars that have high-fructose corn syrup in them. There are plenty of others that don’t use it.

Breakfast really, really matters

– Last Updated: Jul-05-06 3:21 PM EST –

What do you eat for breakfast on these trips?

I do best with a breakfast that has moderate to high protein and moderate fat and carbs. Breakfasts of pancakes, toast, bagels, donuts, etc. just don't cut it for keeping energy levels steady. If you also have some eggs, meat, milk, or peanut butter that will work, or at least it does for me--just not the carbs by themselves. Yet very high-carb breakfasts are exactly what many people eat on such trips.

If eggs/meat are too messy or a PITA to keep cool, bring a container of peanuts, almonds, and other nuts to munch on. Peanut butter on Triscuits makes a decent super-quick breakfast. Tillamook makes beef nuggets that are easier to chew and tastier than beef jerky, and it's almost all protein. Or make your own jerky. If you like cheese and can tolerate the lactose, that's another option for protein and calories.

With a solid breakfast in the burner, snacks can be granola bars, GORP, or chips (I get tired of all-sweet snacks), if eaten at not too great intervals. Most energy bars have more protein than granola bars; read the nutrition labels to check. I've done well on small feedings of energy bars, GORP with nuts, and the like between breakfast and dinner. Lunch does not have to be one big sitting, and in fact it's better to not do it that way.

Don't go too long between eating anything. I've always done best if I have a snack no later than 2 hrs into the activity, whether it's cycling, hiking, or paddling. Better if it's less, depending on how long or strenuous a day it will be. If I'm only going 10 miles I will just paddle the entire 10 miles nonstop even though that's more than 2 hrs. But if I'm going 25, I make sure to stop before or at the 2-hr marks.

Good luck. Long trips are something special, worth the tweaking to find what fuel content and schedule works for you.

fruits
My wife is on the pump. A great device, but you still need to monitor. The FDA just approved a Medtronic device that monitord blood sugar levels, but we are waiting for the insurance companies to bless it. Should happen in a few months



She is what is known as a fragile diabetic and her blood sugars can crash without warning. She has had incidents while riding a bike , while out sailing or rowing with the team.



The most important thing is letting your friends know of your condition and warning signs indicating a blood sugar crash.



Equally important is having sugars that are easy to administer and readily available. I’ve found that fresh fruits (especially oranges) are probably the best source of sugars, if she is able to eat and coherent.



But the best way to pull someone out of severe blood sugar crash is frozen orange juice concentrate. You can keep a can with you on trips. its still good to consume after it defrosts. just keep it cold








I agree
frozen orange juice is great but beware . . . it can give you a monster ice crean headace.

I agree

– Last Updated: Jul-05-06 10:09 PM EST –

frozen orange juice is great but beware . . . it can give you a monster ice cream
headace.