I lately acquired an electronic mail from a fellow lively T1D asking how I handle my blood sugar throughout a surf session. I believed my strategies might show helpful to different T1Ds hitting the surf or performing any strenuous bodily exercise.
Browsing with kind 1 diabetes might be difficult. There are a whole lot of components to contemplate and variables which are out of your management.
I had a troublesome time getting again within the water after my analysis in 2013 however after many low blood sugars and ketone scares, I discovered from failing and have give you a fairly environment friendly, albeit removed from good system.
Going browsing with kind 1 diabetes? Learn on and discover ways to keep protected and worry-free within the water.
Disclaimer: I’m not a diabetes or healthcare skilled. Seek the advice of your physician or diabetes care specialist earlier than altering your therapy in any manner. Additionally, everyone seems to be totally different, these methods are what have labored for me however the specifics could range for others.
Why browsing with Type 1 Diabetes might be tough
Browsing is bodily taxing on everybody. Always paddling, battling the ocean to be within the actual proper spot on the actual proper time to catch waves, after which turning round and combating those self same waves to get again out into the lineup requires a sure degree of bodily health.
Browsing burns energy and carbs like a wildfire. For somebody with kind 1 diabetes, browsing can drop blood sugars quick, inflicting extreme and harmful hypoglycemia. Moreover, the adrenaline launched by the intoxicating rush of driving a wave can masks the normally apparent emotions of a low blood sugar.
Epinephrine, also called the struggle or flight hormone, is accountable for inflicting the signs diabetics usually really feel throughout a low blood sugar however can also be launched whereas browsing or throughout different thrilling actions corresponding to driving a curler coaster or snowboarding.
Browsing with an insulin pump or steady glucose monitor (CGM) poses one other set of points. Insulin in a pump can overheat and lose its efficiency or inset websites can rip off in heavy waves. CGMs lose their sign to the receiver as a result of they aren’t waterproof and transmitters pose a threat of being ripped from the pores and skin.
Okay, I do know, all of that makes browsing with kind 1 diabetes appear daunting however keep on with me. Browsing modified my life and is essentially the most enjoyable and rewarding exercise I’ve ever skilled.
It’s 100% attainable to surf with T1D. Right here’s how.
Carb loading pre-surf
Carb loading is a method utilized by many T1D athletes. It consists of consuming a meal excessive in carbs earlier than an exercise and both taking a smaller than regular dose of insulin or skipping the dose altogether in order that blood sugars are barely greater, stopping train from dropping them to harmful ranges.
Carb loading poses a few dangers if not accomplished rigorously. Excessive blood sugar or hyperglycemia could cause complications, issue concentrating, and fatigue. That is most undesirable earlier than a surf session or any bodily exercise. Intense train and purposely growing blood sugar also can put a T1D at threat for elevated ketone ranges or diabetic ketoacidosis (DKA).
My methodology of carb loading for browsing is to extend my blood sugar to round 225-250 mg/dl earlier than paddling out. Excessive sufficient to soundly enable for a major blood glucose (BG) drop through the session, however not so excessive as to trigger extreme hyperglycemic signs or elevated ketone ranges.
I accomplish this by consuming round 25-40 grams of carbs (relying on my present blood glucose degree) with out taking my mealtime insulin.
I attempt to carb load as near paddling out as attainable, in order to not enable the hyper signs to set in earlier than the session. This isn’t at all times straightforward, as mom nature might be unpredictable and plenty of components can delay the precise time of paddling out. With my blood sugar round 225-250 mg/dl, I can normally surf comfortably for 2-3 hours earlier than needing to go in and test my blood.
Adjusting insulin doses
Adjusting long-acting insulin doses earlier than a day of browsing or different exercise is a generally prescribed methodology to stop hypoglycemia.
Sadly, in relation to browsing and mom nature, the whole lot is so unpredictable that you can change your basal dose within the morning or evening earlier than after which the waves couldn’t cooperate, leaving you sitting on the seaside with not sufficient insulin in your system. That is why I select to maintain my basal doses the identical and simply skip my mealtime insulin earlier than browsing.
Determining precisely how a lot to eat and adjusting insulin earlier than a surf took time and a whole lot of trial and error. There are various components that have an effect on what number of carbs are burned whereas browsing. Consistency and dimension/energy of waves, size of paddle out to the lineup, and the variety of folks within the water can drastically change the depth of a surf session.
My methodology succeeds in conserving my blood sugar in vary more often than not. I normally find yourself round 75-85 mg/dl after a 2-3 hour session however there have been loads of occasions when I’ve felt sluggish from a excessive blood sugar or have needed to minimize a session brief resulting from hypoglycemia.
Watch out when adjusting your routine with the intention to surf. Make slight changes and are available to test your blood usually. Keep in mind chances are you’ll not at all times really feel the signs of a low.
Treating low blood sugars throughout & after browsing
Low blood sugar poses the very best threat whereas browsing with kind 1 diabetes. Even with cautious planning, all that paddling and wave driving can ship sugars spiraling down under 70 mg/dl with out you ever noticing the traditional signs of a low.
For that reason, I at all times carry a pack of fruit snacks or glucose gels in my board shorts pocket or within the leg or zipper of my wetsuit. This fashion I can fight a low if I really feel one approaching and keep out within the water longer.
When experiencing a low after browsing, I prefer to deal with it in two levels. First, I’ll eat/drink a fast-acting sugar consisting of 15-20 grams of carbs.
My favorites are Gatorade, juice containers corresponding to Hello-C, Sweetarts, or Mott’s fruit snacks (they don’t include gelatin, gelatin is gross). Then after round 10-Quarter-hour, I’ll eat one other 15-20 grams of slow-acting carbs corresponding to a granola or protein bar or a slice of bread with peanut butter.
The rationale for the two-stage therapy is that the results of intense train like browsing on blood sugar might be extended. Spacing out therapy of the low ensures you received’t simply drop once more after a snack.
Browsing with a pump and/or CGM
The apparent problem of browsing with diabetes expertise corresponding to insulin pumps and CGMs is that they aren’t waterproof, properly not all of them at the least. Let’s have a look at our choices.
CGMs – Carrying your CGM transmitter within the water is completely effective. You retain it on within the bathe proper? The issue is that the receiver will not be waterproof, and due to this fact the 2 gadgets shall be too far aside and the sign is misplaced when you hit the water.
Pumps – Most insulin pumps available on the market usually are not waterproof apart from a couple of. And even these which are waterproof nonetheless pose a threat of being ripped off by waves or from falling off the board.
Right here’s a record of waterproof pumps and their respective depth and length specs.
There are additionally waterproof instances that work with insulin pumps, however I wouldn’t absolutely belief them they usually look like they can be cumbersome within the water.
Insulin in waterproof pumps is extra inclined to wreck from excessive warmth or direct daylight. Many pumps’ adhesives are poor and may come unstuck in saltwater. In the event you select to remain in your pump and it comes off within the water, you run the danger of dropping it and now haven’t any insulin on board to fight excessive BGs.
Strive utilizing waterproof tape corresponding to Opsite flexifix to maintain pump insets and CGM transmitters in place.
Switching to a number of every day injections (MDI)
In the case of browsing, MDI makes essentially the most sense so far as insulin supply goes. There isn’t a concern of insulin overheating so long as your pens are saved someplace cool and protected corresponding to a fridge or Frio Cooling Sleeve.
You possibly can learn extra about conserving insulin cool in our evaluate of the very best moveable insulin fridges.
With MDI, it doesn’t matter what occurs within the water, you should have basal insulin on board. After analysis in 2013, I instantly acquired on an Omnipod pump and determined to ditch it after six months after I realized it simply wasn’t understanding whereas browsing.
High ideas for browsing with Type 1 Diabetes
Here’s a record of prime ideas to bear in mind when browsing with kind 1 diabetes
- All the time surf with a buddy in case of a extreme low
- Carb load proper earlier than paddling out and take into account reducing insulin doses
- Carry fast-acting sugars for low therapy in your swimsuit or wetsuit corresponding to fruit snacks or glucose gels (nothing water-soluble like sweet)
- Examine your BG usually. Don’t surf for greater than 2-3 hours with out checking
- Contemplate taking a pump break whereas browsing and switching to MDI
- Preserve CGM and pump websites in place with waterproof tape like Opsite flexifix
- Taking a surf lesson? Inform your teacher that you’re T1D and the way that will help you in case you want it
- Browsing for the primary time shortly or ever? Put together your physique, prepare, go swimming, do push-ups. Browsing is much more bodily demanding than many assume
Most significantly, HAVE FUN! Browsing is completely addicting. What different exercise lets you experience and categorical your self on a fleeting type of vitality created by mom nature?
Don’t let diabetes preserve you out of the water. In the event you comply with the data above, I promise you should have the time of your life!