My Diabetes, Food and Training Regime

I had a great time at the diabetes and exercise conference on the weekend, and I was truly touched by the kind comments, tweets and emails that I received after the event. A few of the correspondences asked me about what I do to manage my diabetes and avoid hypos during and after my training sessions. So here we are a blog on just that! The aim of this blog is for me to be able to show and explain what I do. It is important to bare in mind however, that this blog is not meant to provide medical advice, as what works for one person with diabetes may not work for the next. But it is more designed to give an insight into what I find works for me, after years of training, monitoring and keeping training diaries.

This scenario is for a typical training session, that starts at 6:30pm, from when I was not using Enlite sensors for continuous glucose monitoring;

Breakfast 8:30am
E,g- Porridge -
Here I take on slow release carbohydrates, that get stored to fuel my training later. They also help provide me with a more even blood glucose reading through the morning, as does carb counting the value of the porridge and the other meals that I eat.

Snack 11am
Fruit - banana/ apple/ cereal bar

Lunch 1pm
Chicken, risotto, spinach and tomatoes - (protein, carbohydrate and vegetables)
Wholemeal bread, 2 egg omelette

Here, again I take on slow release carbohydrates with protein, which again helps maintain even blood glucose levels leading up to training. I try and fit in my 5 fruit and veg during the day to try and boost my immune system with all of the training that I do.

Snack 4:30pm
Depending on what my blood glucose levels are at this time before training, dictates what type of carbohydrate based snack that I might have. For example, if my blood glucose levels are dropping at this point during that day, I'll have a fast acting sugar snack such as a treat size chocolate bar (not to treat a hypo, but to increase BG levels slowly until training). I'll also consider whether I need to reduce my basal background insulin in my insulin pump. How much of a reduction, will depend on what my blood glucose levels are doing, and how strenuous the upcoming training session will be. The aim of this is to come into training on a stable blood glucose level, without too much insulin on board.

Pre-training 6pm
Snack in response to BG levels-
Half an hour before training, this is also an opportunity to do something about blood glucose levels if they're not looking like they'll be high enough, and to take on fast acting sugar. This might be a few jelly babies of some Lucozade energy, although I prefer the first option over the bubbles of the second.

Training at 6:30pm
This is another opportunity to check and respond to blood glucose levels, again taking on fast acting glucose if necessary. Also to adjust my basal rate if it is still delivering too much or not enough insulin. Please note that I never knowingly train with a hypo or with blood glucose levels that are heading that way. Safety is paramount with training and diabetes.

During the training session I will keep my temporary basal on, and take on glucose as necessary. Testing and listening to my body to provide it with what it needs.

Within the first half an hour after exercise I take on whey protein. The protein that I take has only 6g of carbohydrates in it and is approved by UK Sport, so that it does not contain any banned substances. The reason why I take on so few carbs in my protein is that there is often a slight adrenaline spike after exercise, and if I were to take on more glucose then, it would make my blood glucose levels even higher. The additional aim of the protein is to provide the necessary amino acids in order to help my body recover and rebuild from the training session quickly. Training 6 days a week can take a heavy toll on the body. Finally, I find that the protein also helps slow down the release/digestion of the carbohydrates I have in my evening meal (within an hour of training). As it's important to try and reduce the risk of night time hypos after training.

Evening meal 9pm
Salmon, mashed potato and vegetables
My evening meal is either already made or quick to prepare when I get home from training, because the affects of adrenaline will be starting to ware off and my blood glucose levels are dropping at this point. Here I try and eat clean carbohydrates such as potato, or pasta which is more complex. But with pasta I have to consider the slower digestion, and look to match my insulin release to its behaviour, for example with a split dose of insulin.

How much insulin that I decide to give for my evening meal depends on how strenuous the session has been. However, what I ALWAYS bare in mind, is that during prolonged physical activity such as the 2 or 3 hours I spend at training. I create a 'carbohydrate debt' that must be repaid, or I will be chasing low blood glucose levels for days to come. By this I mean that the training has made me burn off an amount of carbs that I have to put back in, or there will be a deficit for a period of time. Through careful recording and monitoring, I know that this value is about 25g of carbs for me, that I won't usually bolus for in my evening meal.

Bedtime BG check
I always check my blood glucose levels before I go to bed, as this is another opportunity to respond to blood glucose levels before sleeping. If they are below 7.0mmol, I like to have a snack and check again to make sure they're not dropping further.