I’ve been biking to work about 14 miles round trip for the past six years, and I was diagnosed T1d diagnosis just over a year ago at 38 yo (largely due to noticeable increase in effort while cycling, combined with weight loss). I am hoping someone here might be able to suggest some strategies for handling meals right before my morning commute.
While I have a good handle on exercise in general, the challenge with the bike commute is that I need to eat breakfast before leaving. For about a year after diagnosis, this didn’t appear to be a problem. I would eat breakfast around 6:30a, bolus (injection) at that time, and then bike to work at about 7:30. I never had a low on my way to work, but I also didn’t have a CGM.
I moved to a Dexcom G5 in January, and Tandem T:slim x2 in March. With the Dexcom, my BG was dropping considerably on my way to work–often with false lows, but other times I found I actually was getting fairly low (suggesting that I probably was in my 60s occasionally before I had a CGM).
My strategy now is the following: reduce basal 50% at 6:00a; eat breakfast around 7:00a (no bolus); bike at 7:30a; bolus at work at about 8:00a, and resume normal basal rate. This works in that my BG drops very little on the way to work. The downfall is that (a) I sometimes I arrive higher than I’d like (but not worrisome high); (b) I have to remember to bolus shortly after I arrive (I occasionally forget until I notice my BG rising); and © I get false occlusion alarms on the Tandem because of the temperature change from being outdoors to indoors. The lattermost is most frustrating, especially when it cannot determine how much insulin it gave during the bolus.
Does anyone have alternative strategies that might work?