# A Different Kinda Crash



## RatBikeRod (Jun 27, 2019)

I wanted to see about some advice from anyone who might have experienced what I did today. 

I went for a ride with a buddy and experienced what I think was a blood sugar crash that had me wiped out at the 6 mile mark. My buddy was kind and helped me limp back home but I felt really bad as I lost all stamina and had to keep stopping. 

Now I have been riding quite a lot up until a few weeks ago. I had a summer cold prior to that that had me slowed down and then it was just too bloody hot to ride here (Texas). So I have only ridden a few times in the past weeks prior to today. 

I know I am diabetic, although I have been able to handle it with diet mostly. However, I have let my self gain 30 extra pounds and have not been watching what I eat. I did not eat before the ride which was probably bad. I just had a Balance bar. I took a fruit bar and ate part of it when I started feeling bad. It helped but not enough. So I felt like crap the rest of the day. Very tired and weak. 

I suspect that it was a major drop in my glucose and that I probably need to watch it closer (no I do not test it). 

Anyhow, thought I would reach out and see what you fellows thought and what advice you could give. 

I want to get back at it, but I am now a bit fearful as I have experienced this a few times. I am not horribly over weight. I am 6’6” and weigh about 255. I should be 225 really. 

Also, my rides have been averaging 12-22 miles Up until today. 

Thoughts?


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## upstateSC-rider (Dec 25, 2003)

Think your suspicion is correct since you've been averaging at least twice as many miles. Can't really comment on the diabetic part of it but it sounds like you've been diagnosed as being pre-diabetic since you don't check your glucose but you have to take care of yourself, have a buddy that has a lot complications from routine hernia surgery due to being diabetic and it's changed my outlook for sure.


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## bitflogger (Jan 12, 2004)

Being diabetic I suggest you get professional advice.

From having a pancreas issue that requires a good diet I can offer this . I always need to eat well balanced meals and eat something in a reasonable amount of time before I ride. It seems like snacks during bigger rides are more important for me than others. I will eat sports bars but it also seems like I do better with whole foods. A banana, dried fruit, cheese and nuts are activity snacks that work out well. 

The low fat and low alcohol diet prescribed for the pancreas condition seems beneficial for all of life. A few associates with manageable diabetes say the same. It was kind of like learning a musical instrument, sport or language taking 1-2 years for better diet habits to be easy. 

On weight, age also got me the degenerative disc disease in my family. Whether for good bloodwork results or my back, more than I like to admit keeping my weight down seems to cut the aggravation with blood sugar and back. When I am at an ideal weight the eating and exercise balance seems even more important.

Sleep: Being 6+ decades into bad at it I also know sleep helps everything work better.

Good luck!


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## Fairbanks007 (Sep 5, 2009)

Hard to say definitively why you crashed without more specifics, but low blood glucose is a reasonable guess. It would be a good idea to take a snack with you when you ride - ideally some simple carbs to boost your glucose quickly followed by some protein to keep it elevated long enough to keep you out of serious trouble. Peanut butter crackers work well for this if you're not allergic.

I know you know this, but losing that extra 30 pounds is only going to help increase your insulin sensitivity and would go a long way towards minimizing these type of events. 

Keep riding, carry some food, and best wishes for your health.


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## 411898 (Nov 5, 2008)

The best thing you can do is improve your diet and lose weight. Best wishes.


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## RatBikeRod (Jun 27, 2019)

Thanks all. Yea, I need to suck it up and go get checked out. As one of you said I have been pre-diabetic and have been edging into fully diabetic for some time. I know it is not something to play with, especially at 59. I probably needed yesterday’s kick in the butt. 

I feel better this morning but know too that I need to be careful of a second crash in the 24 hours after the first. I read that I am more susceptible. 

I only last year got back into riding MTB’s. I got hit with COVID late last year and I do not think my lungs ever fully recovered. I still have a periodic cough. Otherwise I feel pretty healthy. 

Thanks for the advice.


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## RhB HJ (May 20, 2020)

As far as I'aware my bloodwork is OK. BUT to prevent those "*other crashes*" I carry two 21oz (620mL) bottles. One with peach flavoured water,. the other with defizzed Classic Coke. My body tells me when it's time for which.
Back in the "good old" days (in muggy Southern Ontario) I would be running - mostly on dusty, hilly country roads - up to 15 miles without liquids, longer than that I needed water stops.

BTW getting back on the bike, after two weeks without because of all the smoke, I'll take it easy to test how it goes.


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## EpicTC (Jun 28, 2009)

bitflogger said:


> Being diabetic I suggest you get professional advice.


I agree with this. 
I'm not diabetic but I'm hypoglycemic and have passed out twice while riding my bike because I wasn't paying attention to the signs. The second time I crashed it was bad, 11 fractures in 8 ribs and a broken clavicle. 
I never go riding without a power snack, and I NEVER skip a meal.

You may need to have a glucose tolerance test to determine your personal needs.


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## Fairbanks007 (Sep 5, 2009)

EpicTC said:


> You may need to have a glucose tolerance test to determine your personal needs.


^ Clinical Exercise Physiologist approved.


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## EpicTC (Jun 28, 2009)

Fairbanks007 said:


> ^ Clinical Exercise Physiologist approved.


Awe shucks.
FWIW, the girlfriend I ride with frequently is a T1 diabetic with a glucometer and insulin pump.
In the beginning of a ride we make frequent stops to allow her to get her insulin in balance, then we're good to go.
She works at a hospital and has had to seek her doctor's advice on how to change her habits during riding season.

Its a tricky balance.

One of the times I had a glucose bonk and passed out, I had a friend with me on the ride who rushed me to the ER. They checked my levels when I was admitted into ER. It was 29!!


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## TheBaldBlur (Jan 13, 2014)

For me, this has become one of the adjustments that goes along with getting older - I used to just hop on the bike and ride, now I have to plan ahead on WHAT and WHEN I eat before a ride and, depending on the duration, what I'm refueling with during the ride.


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## RatBikeRod (Jun 27, 2019)

TheBaldBlur said:


> For me, this has become one of the adjustments that goes along with getting older - I used to just hop on the bike and ride, now I have to plan ahead on WHAT and WHEN I eat before a ride and, depending on the duration, what I'm refueling with during the ride.


I think this is the big adjustment I need to make....along with a doctor's visit.


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## cyclelicious (Oct 7, 2008)

Your symptoms could possibly be related to blood sugar but also consider the effects of heat exhaustion. The symptoms of heat exhaustion are similar to hypoglycemia (low blood glucose): dizziness, fainting, confusion, and for some people, excessive sweating.

Studies have found that extreme heat of summer affects blood sugar levels. How the heat affects your levels depends on what you've eaten, whether you're well-hydrated and your activity level. If the heat and your activity makes you sweat a lot, you may become dehydrated, leading to a rise in glucose levels.


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## 127.0.0.1 (Nov 19, 2013)

why are you guessing ?

*get your meter and test strips and use them,

bring on all rides until your sort yourself out
test every 30 minutes

type 1 here and I know what is what nearly 100% the time, got it dialed*

I don't use a pump I don't use a continuous glucose meter, don't need it. but I burn
6-8 test strips per day. can usually start a 40 mile dirt hammer fest at 140 and end at 99

---------------------------------------------
for this
RE: _I know I am diabetic,_
although I have been able to handle it with diet mostly.
<snip>
I suspect that it was a major drop in my glucose and that I probably need to watch it closer *(no I do not test it).*

--
_you don't know anything unless you test your blood._ I do know blindness and peripheral neuropathy can cramp riding....none if which happens to me since....I test. kidney failure is a real possibility if you are diabetic and just 'wing it' guessing about blood sugar levels

ffs, low salt can do what you describe


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## Brules (Jul 10, 2021)

Wait so are you a diagnosed diabetic - ie: been to the doctor and been tested etc and on active meds etc to treat? Or just think you are? If it’s the latter, get to a Dr stat and don’t screw around. Late onset T2 beetus can go south quickly.

If you are diabetic you should have better control of it at your age vs what it seems like you are doing. Any additional info?


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## EpicTC (Jun 28, 2009)

Brules said:


> Wait so are you a diagnosed diabetic - ie: been to the doctor and been tested etc and on active meds etc to treat? Or just think you are? If it's the latter, get to a Dr stat and don't screw around. Late onset T2 beetus can go south quickly.
> 
> If you are diabetic you should have better control of it at your age vs what it seems like you are doing. Any additional info?


The way I understand it is that the OP is a "pre-diabetic" but not actually diabetic and is only recently experiencing these issues. 
My guess is that the OP is either trasnfering to being an actual diabetic or is in need of some medical assitence to figure out how to manage his/her issues.


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## Brules (Jul 10, 2021)

Gotcha. If that’s the case - OP go to a doctor immediately!!!!!

I am type II and it is not something to avoid/mess with/put off.


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## RatBikeRod (Jun 27, 2019)

EpicTC said:


> The way I understand it is that the OP is a "pre-diabetic" but not actually diabetic and is only recently experiencing these issues.
> My guess is that the OP is either trasnfering to being an actual diabetic or is in need of some medical assitence to figure out how to manage his/her issues.


Yes, I have never had to go on anything and have been diagnosed pre-diabetic. Glucose intolerant.

However, I have not had a recent check up. I know guys, I have been avoiding my growing state. But this time got my attention. Typically, I just feel "off" but this time I really bonked, hard.

So the key;

Go to the doctor to confirm where I stand! (damn it, dumb ass!)
Watch what I am eating and eat before I go for a ride.
Watch the heat and what it does to me (Texas August.....)
Take along a snack
Hydrate!

That about it?


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## 127.0.0.1 (Nov 19, 2013)

RatBikeRod said:


> Yes, I have never had to go on anything and have been diagnosed pre-diabetic. Glucose intolerant.
> 
> However, I have not had a recent check up. I know guys, I have been avoiding my growing state. But this time got my attention. Typically, I just feel "off" but this time I really bonked, hard.
> 
> ...


nope, you need to add: get a glucose monitor and use it. should be primary option.

I prick my fingers up to 8 times a day, and use needles 4-6 times a day.
piece of cake vs sitting home crippled from some problem I -could have done better about-

so I skip the bullshit and just take care of myself. no whingeing on about it.


"stop whingeing and get on with it!"


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## Brules (Jul 10, 2021)

Def see a Dr and get a glucose monitor. It’s cheaper if you go to Dr and they prescribe one. I’m type II and like 127 said - I’m doing everything I can to not end up with missing toes and organ failure. Get in to Dr and let them run a full blood panel and A1C etc. at our age (I’m 48 almost 49) it’s not worth putting it off. Get it figured out and get it corrected before permanent damage like unknown neuropathy etc. 

If I can do it (just getting my beetus under control I’ve lost 50lbs) anyone can lol! Good luck and let us know what Dr says.

Also get your T checked. I did at 47 and was WAY low. Been doing TRT as wel and I’m feeling like a million bucks with the weight loss, diabeetus under control and TRT.


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## EpicTC (Jun 28, 2009)

RatBikeRod said:


> Yes, I have never had to go on anything and have been diagnosed pre-diabetic. Glucose intolerant.
> 
> However, I have not had a recent check up. I know guys, I have been avoiding my growing state. But this time got my attention. Typically, I just feel "off" but this time I really bonked, hard.
> 
> ...


Add these: 

Monitor your glucose
Along with a water source(you listed hydrate) carry a bottle wtih juice for a quick shot of sugar _my friend who is a T1 diabetic has a hydration bladder back pack but also carries a water bottle with juice._


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## RatBikeRod (Jun 27, 2019)

EpicTC said:


> Add these:
> 
> Monitor your glucose
> Along with a water source(you listed hydrate) carry a bottle wtih juice for a quick shot of sugar _my friend who is a T1 diabetic has a hydration bladder back pack but also carries a water bottle with juice._


I did not know about the juice thing. Is there something specific, or just any juice?


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## Brules (Jul 10, 2021)

I think just a high sugar juice works. But I’m not type 1 so not 100%.


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## EpicTC (Jun 28, 2009)

RatBikeRod said:


> I did not know about the juice thing. Is there something specific, or just any juice?


I can ask my friend, but I think she uses something like a cranberry juice.


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## stripes (Sep 6, 2016)

Reactive hypoglycemic here. 

I have to be really careful on rides, even DH park rides to not let myself have a blood sugar crash. 

i am NOT a doctor, go see one. This is my personal experiences. I used to have your problems too. 

Working with a hypoglycemic trainer who understands this helps a lot. 

When you’re producing that much output on a ride, I absolutely have to keep your carbohydrates and sugars up. I have to eat frequently, usually between 30-45 minutes and have protein and a carbohydrate. Fast digesting proteins and carbs, like Nugo Bars, make my life much easier. I also carry sour gummy bears and usually a gel packet for emergencies. I cannot have dairy, so i keep it to vegan bars and usually jerky. 

The protein prevents you from crashing, and evens out the sugar so you don’t spike. 

The other thing that helps: increase your fibre. If you’re not getting enough, that also will affect at how quickly sugar will go through your system. 

Also before a ride, i have a meal 1-2 hours before hand. If it’s longer, i have a vegan protein shake. This also means I start off right. Same thing after a ride: i eat sooo much, but i have to during a long ride (more than 2 hours). Otherwise, i cut back on sugar significantly. 

I’ve developed a feel for what i need over the years, and it took years to learn what works for me. But it sounds like you need a diabetic nutritionist to set you straight, as well as a doctor consult. 

Edit: removed random lol. Stupid autofill.


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## Brules (Jul 10, 2021)

Thanks for the tip on the nugo bars!


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## 127.0.0.1 (Nov 19, 2013)

you should just carry tube(s) of glucose tabs

1) they won't rot or mold, or make a mess, as juice can, and will
2) they store indefinitely
3) the fastest method to orally ingest carbs and convert to usable energy
4) wash down with water to make (3) true

juice works, or whatever you want that has a high glycemic index
(coca cola is great for this and for performance riding in general -feed stations-)
but glucose tabs, or liquid glucose 'shots' are the ultimate for chasing hypoglycemia

fwiw, _saltines_ can be faster at boosting blood sugar than some juices


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## stripes (Sep 6, 2016)

127.0.0.1 said:


> you should just carry tube(s) of glucose tabs
> 
> 1) they won't rot or mold, or make a mess, as juice can, and will
> 2) they store indefinitely
> ...


Glucose tabs will help you in a pinch, but you can still continue crashing unless you get some protein in you too.

They're definitely a good idea for emergencies (instead of fruit juice), but at the same time, if the OP is going for a long ride, they need to be better prepared with both protein AND carbs, or they'll get another crash again.


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## old_er (Dec 27, 2020)

I've had good success with Clif bars for dealing with hypoglycemia and general refueling for my normal rides (2 to 3 hours). I tried gummie bears, swedish fish, and gel blocks. They will get your blood sugar back up but will burn back off quickly without something to fuel you for the duration of the ride.


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## Brules (Jul 10, 2021)

Could carry some beef jerky with you as well for protein + carbs/sugars.


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## RatBikeRod (Jun 27, 2019)

Wow, you guys have blown me away with the great insight. I really, really appreciate it. I have been jotting down all of the advice and will definitely change my routine (Well, create a routine, since I did not have one). 

I also scheduled a full blood panel work up to finally accept where I am. I will work with the doctor on next steps and I am looking at test kits, but will wait until I talk to the doc. 

This helps so much and again, I really appreciate the input.


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## Brules (Jul 10, 2021)

Good to hear man. Having the beetus sucks but having it and not knowing/treating can go sideways quick! My neighbor just lost his big toe to it!!! Good luck sir!


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## EpicTC (Jun 28, 2009)

stripes said:


> Reactive hypoglycemic here.
> 
> I have to be really careful on rides, even DH park rides to not let myself have a blood sugar crash.
> 
> ...


My experience has been similar. 
It's interesting to see the difference between my glucose maintenance and my friend who is a T1. 
She tends to need juice or a glucose tab
I tend to need a protien snack. I often carry almonds.
The best thing about the two of us riding together, besides enjoying each other's company, is that we can often see signs of a bonk in each other before either of us feel it.


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## Xylx (Mar 18, 2005)

Here's one weird tip- stop drinking alcohol if you do drink. I was headed to Beetusland (pre-diabetic) for years with my A1C bumping up to 6.2 for a few. Last June a blood test sobered me up, literally. Kidneys were in trouble, liver was a problem and blood sugar was way up thanks to excessive alcohol consumption during the pandemic. I was at 215 lbs (overweight for 6' tall). Within three weeks of giving up the alcohol my kidneys were back to normal, liver was well on its way to normal and my blood sugar was 93. I lost ten pounds in three weeks. Mostly just from giving up spiritous liquors and carbs. Try some low glycemic index bread with an avocado for breakfast. I take a packet of double caffeine gel (Gu brand) with me on bike rides for emergencies. Never had to use it. But even a single shot Gu will get me home most times when I bonk. Set a weight loss goal then buy yourself a new lighter weight wheelset for the new lighter you when you make it. I did. Hope you can do the same.


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## Brules (Jul 10, 2021)

That’s super impressive. I too quit drinking (thank goodness for medical mmj lol) and noticed a big difference on blood work etc too.


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## plummet (Jul 8, 2005)

Ok, I'm not a doctor... seek professional advice...... disclaimer out of the way. 

You bonked or hit the wall.... I think pretty much all of us have done that multiple times over the years.

Key factors leading to the aforementioned Bonk.

Lack of Fitness, over training, sleep, diet (lack of long chain carbs in the tank), distance compared to normal riding, heat, hydration level (or lack of), mental state (being mentally drained), riding too hard and fast.

Analyse the event and you will discover several of the above factors combining together to reach a bonk.

For you I think a diet induced wall hitting could be quite common. So make sure you have those looong chain carbs in the tank. Examine those fruit bars/balance bars you are eating. Most mas produced stuff us laced with refined sugars.... not good for you. 

If you ensure good sleep, good hydration and a tank of slow releasing long chain carbs you should negate a good portion of wall hittings.


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## RatBikeRod (Jun 27, 2019)

So, I thought I would follow up on this after my doctor visit. 

My test in 2019 showed my A1C at a 7, the test this week has me at an 8. So the Doc is putting me on a couple of meds. One for the Diabetes and the other to keep the first med from wrecking my kidneys.

He did not say anything about testing my sugars so I have a call back in on that. But I suspect I need to. 

Now is the work of figuring out how to adjust my eating and what to do from a riding standpoint. I am thinking I will try to ride every other day if I can and maybe do a battle bag workout on off riding days, then take one day off on the weekends. I am not sure if that is realistic. They have someone calling me about that aspect. 

I have really noticed a reduction in my endurance since the event that spurred this thread. I can make 5-8 mile rides easily enough, but anything over 10 is causing me some difficulty. Of course some of that could be the stifling summer heat in Texas right now. 

Anyhow, I am going to be pouring back through this thread for all of the good tips you guys gave me. 

Thanks again for responding.


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## Brules (Jul 10, 2021)

Type II guy here, best diet recommendation I can make is: drop all or as much sugars and carbs as possible. If it’s white and not meat - don’t eat it. I do 30-40g of carbs a day max. Lots of protein and vegetables. I prefer IF 16/8 as well (intermittent fasting). I eat between 11/12 and 7/8pm. No liquor / beer as I don’t like to drink anymore (got my fill in college and before kids lol).

I don’t count calories or anything (true keto was too hard with as much as I travel and counting macros sucks) so I just do carb/sugar restrictions and a ton of water. I allow one diet soda a day. I’m down 50lbs in 2 years with almost no real exercise, just diet.

At the pint now where I have a lot more energy so I’m picking up MTBing and working out 3-4 days a week.

If they didn’t do a testosterone test with blood panels, I’d ask your doc to do it. That was one of my biggest issues as I was at 200 (normal is 600-1000). Been on TRT a year and it’s made a HUGE difference in energy levels, recovery, losing fat but I can again build and maintain muscle. I do a low dose per my Dr, he prefers 600-700 MAX or else above 700 you can have severe issues (stroke, aneurysm etc from blood too thick). I feel Like my 30s again. At 285 now and have about 30lbs to go to my goal.

What meds are they using? I do metformin in am (500mg) and Trulicity shot once a week. Just had labs Friday and will see where they are at tomorrow. Should be down around 5.5-6 A1C.

Hoping to be off meds by end of 21 as my BP is on point now 120/73 and if I can lose more weight with more exercise I should be off beetus meds at some point. I’ll be doing TRT forever though. Definitely worth it.


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## RatBikeRod (Jun 27, 2019)

He is putting me on Metformin HCL and Lisinopril. I am going to look those up to see what the side effects might be. I will pick them up tomorrow.


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## Brules (Jul 10, 2021)

The metformin - you’ll be on the pot a lot lol. 🤣


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## stripes (Sep 6, 2016)

@RatBikeRod glad you got a medical diagnosis.

Do you do other exercises besides mountain biking? I found that I have to every day, even 20-30 minutes of walking, rowing, strength training, yoga, etc helps keep my blood sugar in check.

The other thing that's supposed to help is increasing fiber, and man, do I need to add that type of bulk to my diet.

I'm working on eating better, but after a very unexpected layoff four weeks ago, I need to recheck my eating habits.


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## RatBikeRod (Jun 27, 2019)

stripes said:


> @RatBikeRod glad you got a medical diagnosis.
> 
> Do you do other exercises besides mountain biking? I found that I have to every day, even 20-30 minutes of walking, rowing, strength training, yoga, etc helps keep my blood sugar in check.
> 
> ...


Yes, I do, I either walk or I typically work out with a battle bag. So I am going to try to alternate days between riding and the battle bag workouts. I also have some other gear here at the house to work out with.

I too am out of work for I feel ya. I am going to have to begin managing this at a time when funds are tight. Let me know about your ******* eating habits, my neck is pretty red as my wife reminds me reguarly.


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## 127.0.0.1 (Nov 19, 2013)

RatBikeRod said:


> So, I thought I would follow up on this after my doctor visit.
> 
> My test in 2019 showed my A1C at a 7, the test this week has me at an 8. So the Doc is putting me on a couple of meds. One for the Diabetes and the other to keep the first med from wrecking my kidneys.
> 
> ...


here is the best possible advice.

*start testing.*

and switch to insulin injections to manage being diabetic. if you can get your a1c down without meds that really should be the end goal if you are a true type II.

insulin is a thousand times better than any other medicine method as far as health of your body...but you have to step up and manage it well. otherwise it is super duper clean to your body. risky if you mess up and take too much....it is like handing someone a loaded gun. you need smarts to use it properly.

stick to common type II meds, actos, metformin, or a host of others, they all have odd side effects that need to be managed somehow. insulin is -clean- you just have to test and watch how much and study how you react...but for the body, insulin is super duper clean.

actos is really good too, but expensive, but less side effects. good for a hammer pilot you won't be shitting yourself on hard rides like can happen some other 'things' you can take

or don't listen.

*
switch doctors, if he did not prescribe test strips and a meter, he failed you.*


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## stripes (Sep 6, 2016)

127.0.0.1 said:


> here is the best possible advice.
> 
> *start testing.*
> 
> ...


Listen to this guy. Get a second opinion


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## RatBikeRod (Jun 27, 2019)

The other part of this, aside from the incident that happened that began this thread, is that I was at an A1C of 7 in mid-2019. I have not really felt bad or had episodes other that periodically knowing that I needed to eat something to help how I feel. 

It makes me want to drop 30 lbs and work out a bunch to see if my numbers would right themselves. 

I have probably waited too long for that though.


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## 33red (Jan 5, 2016)

RatBikeRod said:


> I wanted to see about some advice from anyone who might have experienced what I did today.
> 
> I went for a ride with a buddy and experienced what I think was a blood sugar crash that had me wiped out at the 6 mile mark. My buddy was kind and helped me limp back home but I felt really bad as I lost all stamina and had to keep stopping.
> 
> ...


It might be 2 problems like sugar drop added to heat or cold that made it worst.


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## RatBikeRod (Jun 27, 2019)

33red said:


> It might be 2 problems like sugar drop added to heat or cold that made it worst.


Yea, i am noticing that heat is really having a pretty massive effect on me this year.


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## stripes (Sep 6, 2016)

RatBikeRod said:


> Yea, i am noticing that heat is really having a pretty massive effect on me this year.


OMFG the heat just kills me. I have to ride earlier in the day (my friends aren't happy about that, so I end up taking a few more solo rides than planned), or I can't ride at all.

I'm hoping that taking off weight will help. I've started using MFP to keep logging my food, and hopefully get myself out of trouble. Because everything adds up.


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## BansheeRune (Nov 27, 2011)

For me, heat is one thing. I can usually deal with it but humidity is the killer.


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## RatBikeRod (Jun 27, 2019)

BansheeRune said:


> For me, heat is one thing. I can usually deal with it but humidity is the killer.


We have been having a run of both. High 90's and pretty high humidity. Hard to breath in that. Definitely having an impact.


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