What to do with your insulin on a long bike ride? TeamWILD diabetic athletes answer this question!

Having diabetes that requires injecting insulin and going on a long bike ride (longer than 1. 5 hours) can be a challenge.  One such challenge is what to do about carrying extra insulin in the unlikely but possible (as you will read!) of pump failure or heat.

One of our TeamWILD athletes, Michelle, who trained using one of our cycling programs, is doing a long ride this coming weekend at the Tour de Cure Colorado and she asked a few questions about what she should do. Here at TeamWILD we like to support one another, and here are Michelle’s questions and several replies from experienced long distance cyclists who all have diabetes.

Dear TeamWILD,

I am on an insulin pump, and in my day to day life I carry an extra vial of insulin with me just in case I needed to change my cartridge or inject insulin if the pump failed.  Do any WILD cyclists carry extra insulin on them while biking?  I’m afraid if I leave it in the car it will get to warm (unless I pack it in a cooler or Frio case).  I could take it with me on the bike, but it might get warm and I am also already carrying a bit of “stuff.”  Do pumpers also carry back-up infusion sets when they ride?  Wondering what others do.

Just trying to be prepared as possible so I have less to worry about on ride day… the Tour de Cure Colorado on August 18!

Thanks,
Michelle

Dear Michelle,

I’m so excited for you! Your Tour day is going to be a wonderful day I’m sure!!! Thanks for asking your questions.

All of us handle these issues differently… here’s how I think about insulin and infusion sites, and how I plan for a long ride or long race day.

I wear a 2nd infusion site that I know is working. I wear this site as backup, as I’m generally more concerned that my infusion site will pull out or go bad than I am worried about “bad” insulin. I cap off the 2nd infusion site and it’s just “on my body” as backup. This way I don’t and wouldn’t have to try to actually put in an infusion site while doing my event.

I also put in a new infusion site early in the morning the day BEFORE my big ride/event. That way I can be 100% sure the site and the insulin are good. I will often use a very new bottle of insulin, also thus ensuring that all is functioning at top levels.

I also will almost always have with me in my car a cooler with lots of ice packs and in that cooler I will have extra insulin and even an extra vial of test strips as the strips can overheat too! I also have my recovery food in that cooler. I like to think of it as I have the cooler for the recovery food FIRST and then since I have diabetes I throw in the diabetes stuff too! (that’s the TeamWILD philosophy of  “athlete first, diabetes second” thing I do for my mental strategy about all this preparation and forethought!)

I’m very glad you are thinking about all this Michelle! This is the sort of detail that you can put into your Race Plan. Because you are absolutely right and brilliant to be making a plan to have less to worry about on Ride Day!!!

GO WILD and GO RED RIDER!!!

Mari, TeamWILD Director/Founder of the Red Rider Program

 

Dear Michelle,

Mari’s answer covered everything I would tell you! Have an amazing ride and remember, work your Race Plan! You did all the training you needed to do!!

GO WILD and Cheers,

Marcey, Diabetes & Nutrition Coach

 

Dear Michelle,

I wear an insulin pump and usually carry infusion sets, extra insulin and syringes.  However,  about a month ago during a long training ride, my pump completely failed.  I mean completely busted.  I was stuck about 50 miles in the middle of nowhere without backup supplies and my blood glucose level was over 400.  I had never had issues before, so I thought what the heck, I’m not going to carry any extra supplies.  My bad and I learned from it.

I have learned from that and will always have extra supplies on hand.  None-the-less, have a fabulous Tour de Cure!

GO WILD,

Lorrie, TeamWILD Ironman Team 2011

 

Dear Michelle,

I carry insulin with me as a backup & storage area is not plentiful.  I put the pen cartridge in my frio bag with my pump.  I prefer the cartridge compared to the pen due to size. It is a little harder to fill a pump reservoir from this but when I have prefilled a reservoir it ends up with air bubbles. I have also prefilled a reservoir & attached to back up tubing & manually primed to tubing & put that in my frio back too (but never had to use it).

Have a great ride and see you out there! (I’m doing the ride too!)

Mara, TeamWILD Special Projects Director
Dear Michelle,

I carry an extra vial of insulin and syringes for back up to my pump.  I typically carry it in my camelpack or bento box.  I also had a pump failure during a sprint triathlon a few years back.  I had my insulin in transition since it was a short race.  Best wishes in your training!

Kathy Z, TeamWILD Ironman Team 2011

 

Dear Michelle,

First, Go RED RIDER!

Even though I’ve done my share of biking in 90-100 degree heat, I’ve never had insulin degrade.  Both times I had pump failures were Friday nights resulting in no replacement pump until Tuesday; the first time it happened I was unprepared with a backup plan (but improvised) and the second time I was prepared.

Now that I use the Omnipod pump, I carry an insulin pen and a small frio case – takes up much less space than carrying a new pod and insulin vial, but those would be in the car in a cooler.  I also use a Camelbak for extra water and keeping supplies I don’t need right away more secure.  I’m always afraid I’ll reach in a jersey pocket and pull out and drop something.

From a psychological standpoint I’m more secure and relaxed when I have what I need with me and that applies to more than just pump supplies.  Not every ride has great sag support and not every sag vehicle is going to have your supplies (unless you’ve prearranged) so all they can do is give you a ride back to the finish and that’s not much fun.

Best wishes for a great and successful Tour de Cure ride.

WILDly,

Karen R., lives in Arizona where it gets REALLY HOT!

 

Dear Michelle,

I travel with a Lantus vial.  For the actual races/rides I typically have a pre-fill syringe with a few units in my bento box.  You can put about 3 units in a syringe and then put the caps back on.  They also make little cases that will let you fill them with more and carry that around.  Kind of bulky from what I have seen but not a bad idea.  I do have Humalog pens that I have left in Frios at transition.  I also typically leave my infusion sets in transition.  For a ride I might shove one an infusion set in my shirt.  I always have one in the car and in my little bag with my meter.  I too carry a vial and needle every day.  I’ve been known to run out of insulin in my pump- I get low reservoir confused with empty reservoir- and have used a needle to re-fill the cartridge so I can eat cake.  Seriously.

Hope that helps,

Alex, TeamWILD Membership Site Coordinator & Multiple Time Ironman Finisher

 

Dear Michelle,

I feel so out of it – don’t have a frio (but I do have cold packs), have never used a pen.

Sometimes I resent the fact that diabetes must take up so much extra thought process and real estate in my luggage/jersey pockets/etc.  And then it often affects my performance (this season, anyway), too.  Shitty diabetes.  Sorry – it’s been a real challenge, especially this season, and I’m sitting here waiting for UPS to deliver me a new pump today because I thought _maybe_ the reason I’m running so high might be because my pump is having problems, rather than the seemingly unlikely conclusion that my insulin needs have gone up across the board with IM training, even though they didn’t last year.

Anyway, for a long ride I typically don’t bother to bring extra insulin.  The only time I’ve definitely had insulin degrade was racing a 70.3 in Lubbock, and it was 111 degrees that day and on the run we were racing on black road (with tar bubbles, yum).  For Ironman day ( a LONG,LONG day), I think I’ll do what I did last year, which is to have a little baggie that I put in my pocket after the swim that contains small things that I want with me at all times in case they’re needed: insulin, syringe, Immodium, Pepto, ibuprofen, bandaid, hmmm, that may be all.

When I’m doing a long ride I’m often alone, but there’s only me, and I have a phone (and am not afraid to use my thumb for a ride if I need one).  You’re often out riding with someone who’s depending on you, and I’d totally understand if that makes you a little more conservative in your diabetes management.

For long races (although I forgot about this at last weekend’s 70.3), I usually have two infusion sites in my body.  Will definitely be doing that for IM MOO.  I also will be putting infusion sets in both my transition bags.  Since it’s my goal race, I’ll be more cautious that I’d otherwise be.

Hmmm…I have to think about my close-up vision.  Can I change an infusion set or fill a syringe without my old lady glasses?  Probably not well.  I have telescoping reader glasses that live in my Bento – maybe I need to remember to take those out and have them in a pocket on the run just in case.

Thanks, Michelle, for making me think about these things.  And sorry, all, for the navel-gazing.  It’s that time in my training to start obsessing even further…

Karen, TeamWILD Operations Director, Captain of the WILD Iron Team 2011 & Doing IMWI 2012 in a few weeks (send KarenL a BIG WOOSH everyone!)

 

Dear Michelle,

Not sure mine is the best strategy & since I’ve never tried to do this, I don’t know if it works, but… For long rides, I make sure I’ve got enough insulin in the pump for the time & any impromptu ice cream stops, etc. and I carry a syringe. I figure if my pump fails, I can pull insulin from the cartridge & inject periodically. On my century, I also stuck an infusion set in my seat bag (pretty large) in case I ripped out my set at a rest stop.

When it’s a hot day, I put my pump in a small Frio pump wallet in my jersey pocket and run the tubing through a button hole in the pocket (WILD jerseys come that way & now I cut them into my others).

Heather, TeamWILD 100 mile cyclist & Director of Communications

 

And, finally, from Michelle after getting all this advice:

Wow- this is all really helpful and gives me a lot to think about!  Thank you for the suggestions.  I love hearing other people’s strategies and stories.

GO WILD everyone!