What is it like to be a bike commuter with type-1 diabetes?
Well, I have a bike, I have a helmet, and I have a water bottle. I have tools in case I blow a tire (although, I don’t really know how to use said tools), a bike lock so no one steals my precious Holly Go Quickly, and a fancy commuter backpack.
All things most bike commuters have.
I also have pockets full of simple sugar snacks in case my blood sugars go low.
I’ve got Swedish Berries, applesauce pouches, fruit leathers, sometimes ½ a peanut butter and honey sandwich, sometimes blueberry pancakes.
I have my Freestyle Libre scanner and my Omnipod PDM.
And recently, I also started carrying a vial of insulin and a spare pod for just in case, which I hadn’t done for any ride previously in the 10 years I’ve been a proud pumper.
Last week I officially became a bike commuter. I’ve accomplished 3 rides, plus 2 practice rides to date.
I decided to become a bike commuter for a few reasons.
When my practicum was halted 3 months ago, my UPass (discounted transit fare) was also halted and has yet to be reinstated and likely won’t be reinstated, meaning if I took transit daily my costs would significantly go up.
Plus, I’m still pretty wary about using public transit anyway. Even though the trains are currently pretty empty, I expect they will start filling up again shortly and social distancing may be an issue.
My commute is 25 km, and it takes me approximately 1 hour 24 minutes give or take.
That means I have to leave the house by 6:30 a.m. to make it to the hospital by 8 a.m.
For those of you who’ve been following me for awhile, you know that I don’t like to run or ride with much insulin on board. You also know that I don’t like to start my days without having breakfast first.
But one of those has to give in my current situation.
Normally, for morning sessions I wake up at least 3 hours before my exercise to dose my insulin and eat my breakfast and then wait for the insulin to dissipate before heading out. But, if I were to do that now, I’d be getting up at 3 a.m.
That is NOT happening.
So, like all things sport and T1D, I’ve had to re-strategize.
It took about 3 rides to figure out a pattern that works for me; it would have been 2 if I didn’t have stress hormones activated one day messing with all things blood sugar related.
The recommended guidelines suggest reducing bolus insulin by 25-75% and potentially a basal reduction between 50-80%.
The strategy that seems to be working for me for right now is a 50% bolus reduction taken with my meal about 30 minutes prior to leaving, plus a 75% basal reduction at the start of the ride that goes for 1 hour. The final 30 minutes of the ride I’m back to full basal in an effort to mitigate post-ride hyperglycemia.
I check my blood sugars about 30-40 minutes in. If they’re below 7 with an angled arrowed down, I’ll have an applesauce pouch, which gets me through the rest of the ride.
Post ride, I jack my basal up by 75% for 1 hour, and make any other necessary carbohydrate, insulin correction adjustments as needed.
The commute home I’m still trying to figure out.
The last ride I did was pretty successful, but I’ve only achieved that success once so I’m not yet 100% solid on it.
I had ½ a PB and honey sandwich, whole grain bread, no bolus, about 30 minutes prior to starting with my BG at 7.1 mmol/L.
I decreased my basal by 50% for 1 hour during the ride, similar to my morning strategy. I didn’t consume anything more during the ride.
My finish BG was 8.1. I increased my basal by 95% for 1 hour. Two hours later my blood sugars were 5.6.
All in all, pretty decent, but still a work in progress.
Are you a bike commuter?
How do you manage commuting with type-1 diabetes?