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The Question
Fri Aug 10 12:24:01 UTC 2012

I am planning on competing in a triathalon. Any advice on how to maintain my sugar level over a 2 hour period of intense exercise?
Asked By: mathisldm1  
Category: Exercise

Background Info Hide
I am type 2 and on insulin. I became diabetic after recieving an organ transplant although there are several diabetics in my family. My sugar is usually well controlled but I am worried about it going too low. It will take me at least 2 hours to complete the swim, bike run.
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Expert Answers (2)
2012-08-15 19:35:15.0

Dear mathisldm1,

Congratulations on making physical activity an integral part of your diabetes management! It certainly can be a bit perplexing to figure out how to alter your regimen for specific activities like a sprint triathlon.

One thing to keep in mind is that although you do need to have some insulin in your system during intense activities to counterbalance the glucose-raising hormones like adrenaline, you don't want to have too much as that is likely to cause hypoglycemia, or low blood glucose levels. Leading up to your triathlon event, you should practice doing that length of training (even if it's less intense) to see how your body responds. Minimally, you will likely need to cut back on the insulin that you normally take for any meals or food you eat beforehand. How much you need to cut back is an individual thing, but likely by at least 50% or more.

Intense activities can actually cause an increase in blood glucose levels (due to a greater release of glucose-raising hormones like adrenaline), so that is where a bit of practice comes in. If you can exercise for two hours, cut back your insulin some, and not get too low, then during the event you will be even less likely to develop hypoglycemia because your intensity will be higher.

For that duration of exercise, you will also likely be taking in some carbohydrates during the event, even if it's just sports drinks, which will help prevent a drop as well. If you consume too much, it is possible for your blood glucose to rise a bit at the end of the race, so it's important to use a blood glucose meter to watch it for several hours afterwards.

You'll also want to have a meter handy to use during the event (during transitions), as well as a ready supply of easily-absorbed carbs. Also, watch out for later-onset lows for up to 48 hours afterwards, during which time you may need less insulin as well. Check with your doctor for help. Good luck!

Accreditations: PhD, FACSM
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2012-08-14 19:51:22.0

Hello math
Thank you for bringing your concern to dLife.

First I must ask you a question. How have you been training for this event? You must be monitoring your glucose levels before training and then after training. I would suggest using this information to guide you as to the best glucose level to have at the start of this intense exercise. Please be sure you start around 150 - 200mg/dl. Please be sure you are carrying a source of easily ingested rapid carbohydrate such as glucose gel or tabs. I think that you should inform someone in charge of this event of your health history. Someone should have a glucose meter and possibly injectable glucagon in case you have an episode of hypoglycemia and are unable to ingest a rapid carbohydrate.

And, most importantly, get your physician's approval to do this race.

Answered By: Rita Juray
Accreditations: RN, MLT-ASCP, CCM, CDE
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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