HypoActive

Simon Bennett is a 25 year old cyclist from Bendigo in central Victoria.  He has had type one diabetes since 1994.  A former swimmer, in 2009 he is learning to race with the Team Type 1 Development Squad.  For eight months he will be based on the east coast of the US in Richmond, Virginia, working with Team Type 1 coaching staff, racing, and promoting awareness of good management of type one diabetes.  Here is some background on his journey towards finding an ideal insulin regime to meet his needs.

I have been cycling for a year now.  Prior to this I came from an elite swimming background, training and racing with World and Olympic Champions. This is my story and what currently works for my diabetes management.

When I swam at the Open National/ International level I use to take 1 shot of Lantus every 12 hours. I was taking Novo Rapid 15 minutes prior to eating my main meals.  This routine worked for me while I was swimming 9 times a week and I had a set routine. At the time my HbA1c was in the non diabetic range.  Prior to using Lantus I was on Protophane and Act Rapid.

I finished swimming and went straight into coaching.  The coaching I was doing was strength and conditioning for swimming clubs, head coach of a triathlon club, sports science coach for Altona State League netball team, swimming coach and personal training throughout the day.  Coaching was a lot of fun and I loved helping people and seeing what they could achieve. While coaching I found that I was looking after the client or the athlete and not myself.  As a result my levels were all over the place.  It sounds bad but i wasn't too worried about where they were as I could still feel my highs and lows.  I continued to carry jelly beans on me at all times. 

Through the triathlon coaching I would take a group of corporate clients on a bike ride every Saturday.  On the third Saturday of doing this I had a low blood sugar.  Not concentrating, I wasn't holding on to the handle bars tight and hit a big rock .  I hit the deck and broke my collarbone.

I now have 7 pins and a plate in my collar bone but to me this was a blessing in disguise.

I left Melbourne and returned home to Bendigo to live with my family while my collarbone healed.  While it was healing I tried some running and swimming but both were no good so i started cycling.

I wanted my collarbone to heal quickly and i knew that if I was to stay on top of my sugar levels then the healing process would be faster.

When i was swimming I was 105kg and my riding weight is now in the 80s.  I went from taking 32 units of Lantus to 11 units and my Novo Rapid dose came down slightly too.

I heard about this cycling team called Team Type 1 and followed it up speaking to different riders and seeing how they controlled their blood sugars while riding.

When I ride I make sure I have plenty of food on board.  1 bottle of water and 1 bottle of Powerade.  For me i found there is too much salt in Gatorade.  I have a muesli bar around every hour of my ride.

I stayed on the Lantus and changed my Novo Rapid to Apidra insulin and for me i found that Apidra stayed in my system for an extra half hour and had a bit of a kick at the end.

Now cycling in the USA with Team Type 1 I changed my insulin regime to all Apidra and was on the Omni Pod. The main reason for this was to get rid of the spikes I was waking up with.  I was having a spike in the morning from the hormones been released while I was sleeping.

I found the Omni Pod great and this was to be the first pump I've used.  However, I didn't like the idea of the pump being attached to me all the time. It would deliver a basal rate and I could bolus with it when ever I needed to and it's wireless.  But i wanted to have more control.  I am now back on to Lantus, having 2 Lantus doses instead of what I did previously so that I can get rid of that spike when I wake up.

So this is where I'm at now:

For me, I will always test twice before I ride and I have my Apidra 3-3.5 hours before I exercise so the only insulin that I have on while riding is my basal.  I usually consume 15-20 grams of carbs every 50 minutes.  Off the bike I use Lantus, 1 shot at 7am and 1 shot at 7pm as well as Apidra 15 minutes before my meals.

I find it's a trial and error process.  I rode 4 hours today with efforts every 20 minutes for 10 minutes and I had a low blood sugar 4 times. I treated my low sugar with fast acting glucose (dex4).   Today i had 10 units of Lantus at 7am which was too much for a long day on the bike and I'll cut this to 8 units for a hard day next time and 9 on all the other days maybe even 8 for a race day - I'll see how it plays out. For my night time Lantus dose tonight I had 12 units after having 10 last night and finding it wasn't enough. I woke up this morning with a sugar of 324 (18mmol/L).

As I go to sleep right now i have a blood sugar of 119 (6.6mmol/L).

Simon Bennett, 25yrs old
Type 1 since 1994