Hypoglycemia and Spinning

[Catrin]

I have mild diabetes, or pre-diabetes (my specialist refuses to come down on either side). It actually doesn't matter which as the treatment for both is the same - a tightly controlled diet and lots and lots of exercise. No problem, we can do that

The problem is that things can get a little, dicey, after spinning class - even when I eat an hour or so prior My specialist wants me to get some sugar during the class, but the drinks such as Gatorade are just too sweet and have too many calories.

Does anyone else have this problem? How have others solved it? I am resistant to drinking anything other than water but if I can come up with something that I can add to it that won't be too sweet...

I guess it is time to figure this out now, before I get my bike out on the roads this spring.

[tulip]

You can dilute gatorade with water. G2 is their lower sugar drink. You can dilute that, too. Or dilute juice with water. Find what works for you.

[KnottedYet]

Unfortunately, the sugar you need to prevent hypoglycemia is going to be sweet and have calories. That's the nature of the beast...

I am finding that I do quite well snorfing down clif blocks during riding, and drinking water (or clif drink mix). They don't give the huge blood glucose spike and crash.

Maybe if you eat Blox, you would be better able to tolerate the brief burst of sweetness? Then you could drink just water.

Have you worked with a nutritionist yet? Mine was quite helpful.

[sarahspins]

even when I eat an hour or so prior

A couple of things here... first, timing a meal/snack that way before a workout can contribute to hypoglycemia if you have a delayed first phase insulin response... when you time that with increased glucose uptake by your muscles, it would not be a surprise at all if you go low. So I wouldn't recommend doing that... at most, have a light low-GI snack immediately *before* your workout or mid-way through. Like a Luna Mini or energy gel (you'd be surprised that most are relatively low GI, despite seeming like syrup), or something more protein heavy and light on the carbs.

Second, most type 2/pre diabetics who are not on diabetes medication such as insulin or sulfonylureas don't really need to worry about lows - and I don't say that to suggest that they CAN'T happen, more that it's just really unlikely unless you already had a documented medical history of hypoglycemia.

Third, 'dicey' feeling may not actually amount to any medical concern at all. Do you have a glucometer? Are you using it? Do you know if you legitimately 'low' during/after spin class or do you just think/feel like you are? Plain and simple, you can't rely on how you "feel" - you have to test, not guess. Low is <60 mg/dl. Anything higher is probably just fine. I often finish rides in the 70's and sometimes 60's and I don't worry about it at all. You might consider checking your blood pressure too. Mine is sometimes on the lowish side, and that can be really unsettling when on the bike... I will feel like I am going to black out and sometimes I have to stop until I feel better, but I've never been low when that has happened.

A true hypoglycemic event shares a few of the same hormones that are produced/used during exercise (in particular, adrenalin and endorphins, which is what actually contributes to many of the symptoms of being low, and glucagon, which is used by the body to release stored glycogen to fuel your muscles, can make you feel a little woozy on top of that). It's all a normal part of how the body works... so you may end up with 'low' symptoms when your blood glucose is really quite normal. I know it happens to my husband.. every time he's wanted to test because he feels "shaky" his blood glucose is in the 80's - totally normal.

I second the suggestion for some sort of diluted carb source during class. I usually alternate between diluted gatorate (some flavors are better than others when diluted, I prefer the "blue" one, whatever flavor that is - maybe glacier freeze?) and tri-berry nuun on my rides (I take plain water too, but rarely drink any unless it's super hot out). My gatorade is usually diluted more than half strength... it's probably like third strength so it's really not overly sweet.. nuun tastes sweeter, and that has no calories.

The only other advice I have, is that if you don't have a glucometer, get one, and use it. Test at 10 minute intervals until you have some reassurance that your body isn't doing anything crazy. You'll definitely want to have one when you're riding on the road, along with some kind of fast acting glucose if you did have a true low.

[Triskeliongirl]

I am a mild type I diabetic, so I understand what you are talking about.

1. I second the recommendation to use a glucometer. I would get symptomatically hypoglycemic even if my blood sugar is in the normal range when I consumed a pre-ride meal with carbs, since our bodies can actutely sense the RATE of change of blood sugar. If you let it get too high at the ride start, and then you start exercising, exercise will cause a massive translocation of glucose transporters to the plasma membrane, which is a good thing, but if the blood sugar then clears too quickly you will feel hypoglycemic even if you are not.

2. The way I solved the problem, is to eat a high protein (but no carb) pre-ride meal, being sure that I start the ride with normal blood sugars, and then I use a drink called muscle milk light during my ride which, which I mix at 10g CHO, 25g protein per bottle. You can also metabolize protein for fuel on the bike (deaminate amino acids to carbon skeletons that feed into TCA cycle).

[KnottedYet]

Addendum: if you are truly going hypoglycemic, please get a medic alert bracelet or necklace. When I fall low (30-40) I get incredibly confused and agitated and don't even think of eating my emergency sugar, in fact I will resist eating.

If you get low enough to pass out or become confused, you want folks who find you to be able to figure out what's going on.

Mine say: HYPOGLYCEMIC Feed Me Sugar (never hurts to spell it right out!)

RoadID is my favorite, and they don't jerk you around like American Medical ID. www.roadid.com

[Becky]

+1 to all of the awesome info that the others have shared!

Vitalyte is a good, lightly-flavored electrolyte drink choice that's lower-carb - only about 10g CHO per serving, compared to 15-25g CHO for many of the other mixes. No need to dilute it and therefore alter its electrolyte concentrations.

If I need a lot of carbs at once, I prefer to eat solid food. Vitalyte is good for sipping throughout longer rides (alternating with water) to ensure that I'm getting some carbs in the whole time. I stick with Nuun or plain water for shorter rides.

Ask your doc for a glucose meter. Most docs seem to have a huge stash of meter samples- I haven't needed to pay for one yet.

[Catrin]

I do have a problem with hypoglycemia, and I use a meter regularly - my blood glucose has been as low as 29 and as high as 250, though things have stabilized quite a bit with rigid diet control and exercise.. I do generally have a light meal prior to spinning or other intensive exercise activities like when I work with my personal trainer. It has been a mixture of high protein and light carbs and I will consider if that is still an appropriate mix.

I thought that I needed to eat at least an hour before the class, and will experiment with eating immediately prior to it - there may well be a delayed insulin response (we have suspected this already). My specialist has encouraged me to experiment with the timing, as long is it is no longer than an hour prior - and she has told me more than once to drink something other than pure water when spinning...

Thankfully my trainer's wife was in the locker room with me last night and figured out what was wrong, bless her, and she got some orange juice and stood there and basically bullied me to drink it (which was a very, very good thing for her to do) Last night I did not have my meter with me, that will not happen again.

My trainer suggested today that I try one of those Gatorade powders so I can dilute it to my desire - will also check out the Nuun and other things that have been suggested.

Thanks to everyone

[Catrin]

I am a mild type I diabetic, so I understand what you are talking about.

1. I second the recommendation to use a glucometer. I would get symptomatically hypoglycemic even if my blood sugar is in the normal range when I consumed a pre-ride meal with carbs, since our bodies can actutely sense the RATE of change of blood sugar. If you let it get too high at the ride start, and then you start exercising, exercise will cause a massive translocation of glucose transporters to the plasma membrane, which is a good thing, but if the blood sugar then clears too quickly you will feel hypoglycemic even if you are not.

I just re-read your post, and I did not know this. I do get seriously low upon occasion, but have also noted feeling that way even when I wasn't. In my case I think it is totally related to what/when I eat...and it is difficult to judge when my glucose levels peak. Things have improved, but are still unstable - which is why they started my use of a meter last summer. I have had occasional problems with hypoglycemia since I was at least in my teens.

2. The way I solved the problem, is to eat a high protein (but no carb) pre-ride meal, being sure that I start the ride with normal blood sugars..

I guess I need to be more strict about when I test before spinning. I have learned that I can't change ANYTHING in diet or exercise without consequences - and am trying my best to avoid starting medication. My doctor has offered it, but it is currently only one option.

I haven't started riding more than an hour as I am still practicing in parking lots, but I need to get as much of the nutrition thing figured out before I start riding Stella down back roads by myself....

All of the other advice is helpful as well. I picked up some Clif Blocs and will check out Nuun and Vitalyte in the near future. I strongly dislike the taste of Gatorade, even diluted, so that is the last choice in my list. Obviously spinning class, while intense, is of lower duration than a good ride, but this is a start.

Thanks again!

[Triskeliongirl]

I control my diabetes with diet and exercise. Its taken me a few years to understand it all. I found it most helpful to keep a notebook, and write down everything, time, food, exercise, blood sugar, etc. That is how I worked out a regimine that works for me. What works for me, is to choose food/exercise combos that never let my blood sugar go above 120 (peak at ~1hour post meal) and be back under 100 by the 2 hour mark). On the bike I feel best in the 100-120 range.

I also found it very helpful to read the book Dr. Bernstein's Diabetes Solution. You also want to enlist the help of a good endrocinologist, especially one that supports diet/exercise control, with medication as a last (but sometimes necessary) resort, if that is what you seem to want.

[Catrin]

Thankfully my specialist is being very supportive about my efforts to control by diet/exercise. I document all of my intake and exercise, I need to be more consistent about testing my glucose. I need to develop a specific schedule for testing, but the problem is my activities are timed differently throughout the week so it doesn't make sense to test at the same time every day.

Sometimes my glucose runs quite high, other times I can't seem to get it over 68 - but all in all things seem to becoming more balanced so my efforts seem to be paying off. It is finding the right combination of things...

[Eden]

Just a note NUUN is electrolyte only - no carbs, no sugars. It is good when you do not want calories in your drink (I generally carry a bottle of NUUN and a bottle of Cytomax).

Go to a bike shop and experiment around with drink mixes - you can generally get small packets and there's certainly more out there than Gatorade. Gatorade is probably the least thought out formulation of everything out there. It has lots of plain old sugar and high fructose corn syrup, lots of sodium and not a whole lot else. The brands you can get in sports stores usually have rice syrup, maltodextrin, dextrose and not HFC's. Some contain some protein as well as sugar. I think they also contain better thought out mixtures of electrolytes.

[softthings]

i am type 2 pre-diabetic. i found this article the other day, and it is pretty helpful for type 1s as well.http://www.insulinfactor.com/graphic...ng_article.pdf

also, make sure you don't eat or drink anything, ANYTHING with high fructose corn syrup. it is the worst type of sweetener for diabetics. check the gatorade for that, i have found that their "lighter" version contains hfcs as well.

that being said. you need to carb up before you ride, play around with the amounts. drink water or low car drink during. if you still feel wonky after, then fruit. natures' candy or some slow releasing carbs such as whole grains are going to be your best bet. after i ride i do a fruit and yogurt or milk smoothie. milk and chocolate milk are great for post ride. just make sure it is low fat. also, if you feel like you are having a dip, and you need some sugar, make sure whatever you eat doesn't have a high fat content, it slows the release of the sugars into your body. so, no chocolate or things with nuts or nut butters in them if you need something quick. hope that helps, if you have any more questions, feel free to pm me! good luck!

[softthings]

also......http://www.myra-simon.com/bike/bike-food.html

[Triskeliongirl]

Thankfully my specialist is being very supportive about my efforts to control by diet/exercise. I document all of my intake and exercise, I need to be more consistent about testing my glucose. I need to develop a specific schedule for testing, but the problem is my activities are timed differently throughout the week so it doesn't make sense to test at the same time every day.

Sometimes my glucose runs quite high, other times I can't seem to get it over 68 - but all in all things seem to becoming more balanced so my efforts seem to be paying off. It is finding the right combination of things...

You want to be testing ~30 min and 120 min. post prandial, and recording the details of food consumed and exercise performed. There is a nice form you can copy from Bernstein's book, that lets you record food, activity and blood sugars, and bring to your doctor for review.