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wsgalinaitis
August 19th, 2012, 09:00 PM
Is there anyone out there that can say something about maintaining blood sugar levels during OW swims? I am only a type II (no longer on insulin) diabetic and my only problem (so far) is my sugar level dropping such that I start having problems. Mainly with the brain getting fuzzy and that results in poor decision making.

aqueoushumor
August 20th, 2012, 06:56 PM
That sounds like a big problem. Would your doctor, or if you have a diabetic educator/RD, be able to help you with this? Otherwise I would say to take in simple carbs (Gatoradish stuff) early and often. Have you taken your BS before and after (and during) to see where you stand? OW swimming is great for your diabetes, so managing this issue would be a good thing. Any RDs or DM professionals out there that understand endurance athletics?

fatboy
August 21st, 2012, 06:46 PM
Consult your doctor and let him help you make a plan.

I have some friends that have put some Gu energy gel packets under their caps during open water swims. As far as they know the do not have diabetes. But they seem to need the calories. Maybe you can try it during training swims.

I have not tried this myself, as I have not done any swims over two hours.

How long do you think you can swim safely without experiencing low blood sugar?

wsgalinaitis
August 22nd, 2012, 08:44 PM
My readings before swimming 2K are usually 130 to 180. Depends on how many and type of carbs that I ingest. After a 2K lap swim it can drop to 60-90 range if I don't ingest anything. For me, hitting 70 is a low and I start getting dizzy and have some large bright spots in my vision. Below 70, I just start to shut down mentally.

During my normal daily training ( 2K to 3K sessions) I drink G2 or use glucose tablets. Small mouthfuls taken at regular intervals seem to keep things in the 90-110 range and I don't have any intestinal cramping.

I attempting a OW 4K on Sunday (Noblesville,IN). I emailed the event manager (Dick Sidnor) and he said that eating/drinking is within the rules. I am looking into some type of gel pack or bottle that I can use during the swim.

My doctors basically are happy that I have a normal A1c and I have no major complications yet. Beyond that they are not really interested in my effort to do long distance swimming.

aquageek
August 23rd, 2012, 03:47 PM
If you aren't on insulin how are you going low? Are you on other medications for your diabetes? I think you need to talk to your endocrinologist. There are many good books out there, such as this one.

I have a T1 in our family and we have elaborate and complicated plans for workouts and races but none of that would really pertain to you I don't think. I will say in our experience it is a ton of trial and error.

My only advice is don't leave it to chance or roll the dice. Going low in any water is very very dangerous. Or, just eat pizza, that always screws up blood sugar (while true, that is not advice).

Best of luck to you.

Kevin in MD
August 23rd, 2012, 04:16 PM
Can't speak specifically to your issue but there are any number of energy gels available some with high GI sugars, some with mixtures of low and high GI carbohydrates.

You can easily slip gel packets under your suit as you swim. On long swims I even use a gel flask in my suit, it holds up to 6 ounces of gels, that's more than plenty. Your local running store should have the assortment of gels and the flasks as well.

wsgalinaitis
August 25th, 2012, 01:27 AM
Thanks. I have found some gel packs that will work. One is actually a tube (like a toothpaste tube) of baby food that is basically all fructose sugar. I can put it in my suit.

wsgalinaitis
August 25th, 2012, 01:36 AM
I don't know why it drops. Today I did not take my metformin at breakfast and went swimming an hour later. My BS reading was 128. After swimming 1K (yards) I took a reading and my BS was 74. I was swimming at an aerobic pace so I was not pushing it. I drank a mixture of water and sucrose that gave me about 15g of carbs. I swam another 500 yards and BS was 85.

Now 74 is not a dangerous low for me but as I said I start to get fuzzy below this level.

My doctor says it should not happen and that was it.

grumpytuna
August 25th, 2012, 07:44 PM
Diabetes is a very complex diesease as I'm sure you have come to realize. It is not a simple problem of ingesting a certain number of carbs to hold your BG level where you want it or to arrive at a particular level. Your body makes sugar during times you are not eating, its called gluconeogenisis and is responsible for most of your fasting glucose level. It may be that because of the type II diabetes your liver may not be producing glucose sufficiently using this pathway, leaving your body to use the ingested available carbohydrates. Glycogen stores in your muscle and liver could also be affected and could contribute to falling circulating BG during exercise. I'm sure you have heard it before but be very carefull and test often during exercise until you are very comfortable. I would rather read about a lot of useless testing than a serious problem.

Please keep posting I think this journey you have started would be very helpfull and encouraging to many other diabetics who may be working out the same issues as you but not willing to do so openly.

Willie

aquageek
August 26th, 2012, 08:41 AM
As you get more and more fit your medication requirements might change, along with how your body utilizes your medication. Have you considered getting a CGM? It is a very valuable device. Obviously it doesn't work in the water but can help you see your trends over the day(s).

For us, and this may not pertain to you, and probably doesn't, getting ready to exercise at 128 is scary. We know that 2-3 hours of heavy swimming beginning at 128 is going to be a problem. I don't know how TIIs like yourself manage these numbers. I'd really like you to continue to write about your experiences.

wsgalinaitis
August 27th, 2012, 01:05 PM
Diabetes is a very complex diesease as I'm sure you have come to realize. It is not a simple problem of ingesting a certain number of carbs to hold your BG level where you want it or to arrive at a particular level. Your body makes sugar during times you are not eating, its called gluconeogenisis and is responsible for most of your fasting glucose level. It may be that because of the type II diabetes your liver may not be producing glucose sufficiently using this pathway, leaving your body to use the ingested available carbohydrates. Glycogen stores in your muscle and liver could also be affected and could contribute to falling circulating BG during exercise. I'm sure you have heard it before but be very carefull and test often during exercise until you are very comfortable. I would rather read about a lot of useless testing than a serious problem.

Please keep posting I think this journey you have started would be very helpfull and encouraging to many other diabetics who may be working out the same issues as you but not willing to do so openly.

Willie
You hit it on the head when you indicated that diabetes affects the whole process.

I am ordering a book on Diabetes and athletes, the one recommended above.

An article in American Physiology showed that ingesting carbs during strenuous exercise will compensate for depletion of muscle glycogen and extend performance. That is for a trained athlete, what about an amateur diabetic athlete?


Just for info, I have been reading a a few references to learn the basics about human metabolism: " Principles of anatomy and physiology,Totora , Anagnistakos" and " General organic and biological chemistry, Solomon". I am still piecing together what source is used and when for energy production (ATP).

Also did a 4K open water swim on sunday. At 2K my body told me to ingest some carbs so I consumed two energy gel packs that I had stored in my suit. Seemed to help. I finished and felt mentally alert when I exited the water. No symptoms of low sugar. I was so happy that I forgot to take my BS. THat was unfortunate.

Thanks for all the info so far.

grumpytuna
August 28th, 2012, 02:58 PM
Pay particular attention to insulin and how insulin resistence affects the production of glugogen. You always use ATP, it is the source of the glucose your body is using that will effect how you feel when exercising. Remember also, your brain only uses glucose your BG directly effects your level of conciousness. Therefore when you go low you are taking a huge risk that you will bonk fast and hard, so I hope you have someone keeping a very close eye on you.