This content material initially appeared on diaTribe. Republished with permission.
By Ezra Ward-Packard
Former Team Novo Nordisk bike owner Ezra Ward-Packard shares how he manages his diabetes whereas endurance coaching, all the pieces he’s realized during the last 12 years, and his recommendation for aspiring endurance athletes.
Disclaimer: The coaching routine and weight-reduction plan mentioned on this article are particularly tailor-made for an elite skilled athlete. Do not try this stage of coaching or the particular weight-reduction plan suggestions with out speaking to your healthcare group.
My expertise as an endurance athlete with kind 1 diabetes has been remarkably diverse and numerous. I’ve competed in near 400 biking races over 12 years, and the correlation is evident: cautious diabetes administration results in higher coaching and higher race outcomes. But a tough diabetes day doesn’t essentially imply a failed day on the bike.
As an endurance athlete with kind 1 diabetes, each time I line up for the beginning of a race, I intention to restrict the detrimental negative effects that mismanagement of my glucose ranges might doubtlessly have on my athletic efficiency. Just as I spend months coaching my physique, I additionally practice my diabetes administration in order that I can carry out at my highest potential stage on race day.
I’ve completed bike races with blood glucose ranges within the 50s and within the 300s. But on this planet of aggressive endurance athletics, marginal beneficial properties are sometimes the distinction between successful and dropping, and that’s why diabetes administration is a central a part of my total coaching program.
I used to be recognized with kind 1 diabetes in 2005, on the age of 11. As a toddler, I used to be extraordinarily energetic and concerned in quite a few sports activities, however on the time of my analysis, I lived and breathed soccer. When I wasn’t at an organized apply or recreation, you’ll discover my older brother and me taking part in hours upon hours of pick-up soccer in our small yard in Lake Geneva, Wisconsin. My first query after being recognized was whether or not I’d be capable to proceed taking part in soccer. When my mother reassured me that I might and all the pieces appeared prefer it was going to be okay.
In 2008, my ardour for endurance athletics started. Long-distance working allowed me to push my physique and thoughts and endurance athletics grew to become a central a part of my life and diabetes administration.
Managing my kind 1 diabetes is one thing that has by no means come straightforward. Adolescence was an particularly difficult time in my diabetes administration. When I began to take part in endurance athletics, I rapidly realized simply how essential diabetes administration was in relation to efficiency. The higher my blood sugars, the higher I’d carry out throughout coaching and racing.
Cycling began as a approach for me to cross practice after I had a working harm, however quickly biking grew to become a separate pursuit. Then I realized about Team Type 1 (now generally known as Team Novo Nordisk). I all the time dreamed of someday changing into an expert athlete, however after I was recognized with diabetes, I feared it will be inconceivable. Team Type 1 confirmed me that I might compete on the highest stage, even with kind 1 diabetes. In my first bike race I wore a Team Type 1 jersey that my mother had purchased me. I completed third place and was hooked.
A couple of years later, Team Novo Nordisk posted on its Facebook web page that it was on the lookout for up and coming cyclists with kind 1 diabetes. I submitted a resume with my race outcomes and what I believed was my finest biking motion picture, after which carried on with my life, which on the time consisted of numerous school functions. The day I acquired the provide remains to be among the finest and proudest days of my life.
During my three years with Team Novo Nordisk, I primarily competed in two sorts of races: quick, technical races round a brief circuit, known as criteriums, which final about 60 minutes, and longer highway races that would last as long as 5 hours, relying on the course. In order to be aggressive each in criteriums and highway races, the group’s coaching plan balanced brief, intense efforts with longer days on the bike. A typical coaching week often included two or three intense coaching days, two or three restoration days, and two days of racing on the weekend. These exercises included energy, pace, and endurance coaching.
The three years I spent racing with Team Novo Nordisk have been memorable. I noticed a lot of the nation and the world from the saddle of my bicycle, however these years weren’t with out battle. After three years of racing full-time, I used to be burnt out from the singular pursuit of athletic efficiency and desired a life with extra selection.
So, from 2016 to 2020, I attended Carleton College in Northfield, Minn., the place I served as a captain for the Carleton College Cycling Team, and labored as a motorcycle mechanic at Northfield’s native bike store. I rediscovered my love of racing within the quickly increasing genres of gravel and bikepack racing (a type of ultra-off-road endurance racing the place you might be fully self-supported and infrequently have to hold sufficient meals and water to final for tons of of miles).
Since graduating, bikepack racing has change into my predominant focus. Living in a self-converted van in Flagstaff, Arizona, I now work as a full-time bike mechanic for the native REI. This previous 12 months has been one in all my most profitable aggressive years on the bike. In May, I positioned second on the 302-mile Pinyons and Pines Bikepacking Race, which began and led to Flagstaff. Then, earlier this month, I gained the 530-mile North to South Colorado Bikepacking Race working from Fort Collins to Alamosa.
Training and racing with kind 1 diabetes isn’t straightforward, and it in all probability by no means shall be. Just like with on a regular basis diabetes administration, it requires numerous dedication, perseverance, and exhausting work. You’re going to have good days and also you’re going to have dangerous days. Enjoy the great days, and don’t let the dangerous days get in the best way.
I’m a particularly methodical and data-driven particular person, each when it comes to my coaching and my diabetes administration. I’ve a number of notebooks and too many Excel paperwork to depend. Want to know what number of miles I rode in August of 2015? Give me 30 seconds and I can let you know. (I rode 1,199.26 miles).
My coaching at the start of the season all the time consists of testing potential exercises. I’m at some extent in my biking profession the place I typically know what sort of coaching will finest enhance my efficiency, however I’m consistently refining these classes to maximise their results whereas additionally working inside different constraints in my life. For instance, throughout my time on Team Novo Nordisk, 20-plus-hour weeks on the bike have been customary. Now, working 40 hours every week as a motorcycle mechanic, 20-hour coaching weeks on the bike solely occur just a few instances all year long (and it often means I’ve to take day off of labor).
My physique and my blood glucose ranges reply very otherwise to completely different classes or exercises throughout a season. When I’m driving, I hate stopping to check my blood sugar. I’m working with my new insurance coverage firm and medical care to safe a steady glucose monitor (CGM), however in the intervening time I’m doing it the old style approach with lancets, check strips, and a blood glucose meter.
During my preliminary exercises, I cease on the finish of each interval to check my blood sugar. To measure persistently, I attempt to full these exercises on the identical time of day, after having eaten the identical pre-workout meal, whereas consuming the identical variety of carbohydrates throughout my exercise. I’ve discovered that these three elements (time of day, my pre-workout meal, and carbohydrate consumption) have the best impact on my blood glucose whereas coaching.
When I’m finishing my preliminary section of intense blood glucose testing, I work out throughout the identical time of the day, both earlier than or after work. I desire to do excessive depth exercises after work since I’m often exhausted and nugatory for just a few hours after these difficult exercises, and my boss doesn’t prefer it after I go to sleep whereas engaged on a buyer’s bike.
There are a limiteless variety of potential pre-workout meals, however for me there’s nothing higher than candy potatoes, eggs, spinach, a pinch of shredded cheese, and an aggressive quantity of salsa. If I do have a bit extra time earlier than my exercise, complete wheat pancakes with 100% actual maple syrup are one other go-to meal.
Both of those meals are very carbohydrate-centric and often find yourself being a majority of my carbohydrate consumption for the day. At this level, my physique is aware of that if I’m consuming both of those meals, it’s time to get able to put within the work.
My carbohydrate consumption on the bike additionally varies with the kind of exercise. During “endurance” rides (lasting longer than three hours), I intention to eat about 100 grams of carbohydrates every hour from a mixture of stable meals (like bars, rice desserts, and mini sandwiches) and liquids (sports activities hydration mixtures and, sure, the occasional fuel station Coca-Cola throughout these actually lengthy days on the bike).
Shorter rides are extra intense, however I nonetheless intention to eat about 100 grams of carbohydrate per hour. Getting meals down whereas exercising at larger intensities is more durable. I take advantage of much more fast-acting and concentrated carbohydrates reminiscent of power gels, power blocks, and better concentrations of sports activities hydration mixtures.
During restoration rides (shorter, low-intensity rides lasting lower than two hours), I usually don’t eat any carbohydrates, until it’s extraordinarily scorching – by which case I’ll sip on a low-concentrated sports activities hydration drink.
By finishing preliminary exercise assessments, you possibly can create a set of pointers on your diabetes administration. Every particular person with diabetes who’s on a basal-bolus insulin routine has an insulin-to-carb ratio and a correction issue, however these equations aren’t all the time excellent. I do know that after I’m going to be consuming pizza, I’ll must take extra insulin. The identical is true when coaching.
Short, intense intervals virtually all the time trigger my blood sugar to extend. This has been true ever since I used to be a highschool long-distance runner. Longer, decrease depth efforts have the alternative impact on my blood sugar. On rides that last more than three hours, I’m in a position to eat just about something and keep in my desired glucose vary.
I additionally expertise a compounding impact. In school, I led summer time bike touring journeys for youngsters. In 2018 and 2019, I led “America Coast to Coast,” which ran about 2,700 miles from Charleston, S.C., to San Diego, Calif. At the tip of this journey, after averaging 80 miles a day, my basal insulin would lower by half of what I’d take throughout the faculty 12 months. The identical is now true for me with bikepacking races.
This previous spring, after I accomplished the Pinyons and Pines Bikepacking Race by way of the mountains of northern Arizona, I began the 302-mile race at 80% of my standard basal fee and ended up at half on the second day. In phrases of bolus insulin, my insulin-to-carb ratio went from one unit to 10 grams to at least one unit to about 15 grams. My blood sugars have been remarkably constant – till the second evening of driving, after I began to hallucinate on account of solely napping for 10 minutes.
This was my first time pushing my physique to this excessive stage, and my intense give attention to staying awake (and staying upright) meant I uncared for to adequately check my blood sugar ranges. After main for the primary 200 miles of the race, I in the end completed in second place with a time of 48 hours, 25 minutes. The hallucinations continued on previous the end line, and solely subsided after an extended nap and some thousand energy (which I dosed for utilizing round 75% of my regular bolus ratio).
I all the time carry my testing provides, insulin, and additional carbohydrates on bike rides. Over the previous twelve years, I’ve developed an excellent sense of the place my blood sugars are whereas biking. Usually, if my legs really feel good, my blood glucose ranges are inside my desired vary.
If you might be an inexperienced endurance athlete, growing this sense on your personal blood glucose ranges is vital. Test your blood sugar earlier than you practice, begin the coaching session, guess what your blood sugar is everytime you check throughout coaching, affirm with a fast blood glucose verify, and see how correct you might be. This is a helpful ability to have throughout crunch time in the midst of a race, however proceed with warning. If you are feeling like you might want to check or verify your CGM, all the time accomplish that.
As you change into stronger, extra environment friendly, and able to coaching more durable for an extended time frame, your diabetes administration can be going to vary. I’m now assured in my talents to make the mandatory modifications, however that is solely after years of trial and error and dealing carefully with my endocrinologist.
For years, racing was tense for me, largely as a result of managing my kind 1 diabetes. I’d battle to sleep the evening earlier than, fret over each single element, and begin each race with my coronary heart pounding out of my chest. My method now’s way more managed. I view racing as a chance to indicate off all of the preparation and coaching I’ve accomplished. I’m all the time nervous to get began, however these nerves are actually constructive.
Your exercises ought to mirror what the race shall be like. For my bikepacking races, the exercise consisted of finishing exhausting intervals at first of my trip to be able to fatigue my legs to simulate what it will really feel like as soon as I rode longer than six hours. Then, I’d full as many hours as I might at endurance tempo. Bikepack racing isn’t nearly driving your bike, it’s additionally about your potential to eat whereas driving for prolonged durations of time; so throughout these coaching rides I’d additionally try to eat as many carbohydrates as I might (aiming for 100 grams per hour).
On race day, there are numerous elements that may are available in the best way of you attaining your purpose. For athletes with diabetes, managing your diabetes is among the hardest. Despite this, athletes with kind 1 have accomplished and succeeded on the highest ranges of athletics for years now.
In the North to South Colorado Bikepacking Race earlier this month, over the 76 hours, 530-mile journey from Fort Collins to Alamosa, I confronted fixed challenges, each diabetes-related and non-diabetes-related, together with a number of damaged spokes, dehydration, and excessive hyperglycemia. There was a time in my profession the place I’d have known as it quits. But over the previous dozen years I’ve developed the abilities and mindset to beat such challenges, and in Colorado I gained the race by a margin of greater than 5 hours.
I’ve by no means let diabetes gradual me down, and hope you gained’t both.
Read extra about bike race, steady glucose monitor (CGM), biking, insulin, Intensive administration, Novo Nordisk, racing, Team Novo Nordisk, coaching.