Carb Loading With Type 1 Diabetes: 10 Tips Any Endurance Athlete With Type-1 Diabetes Should Consider For A Successful Tapering
Tapering days are weird.
You’re at the peak of your fitness, all you want to do is to get going, to move, you’re pumped to get after the race.
But all you have to do during a tapering is rest and preserve the energy for the big day.
Physical recovery is not all though! If you want to toe the starting line in peak shape you also must nail your nutrition and hydration. And depending on the duration, the length and the intensity of the upcoming race, you will have to eat more carbohydrates than usual. Those glycogen stores need be filled and ready to propel you.
While the idea of chilling and eating for a few days sounds like a dream, if you live with type 1 diabetes, carb loading is going to be a slight more complex affair.
Not only you’re eating more carbohydrates. Since you’re trying to avoid digestion issues on your big day, you’re also probably going to limit the amount of fibers by getting them from more refined sources (like white pasta, rice or bread), while also reducing the size of all the usual servings of vegetables you’d normally consume.
This is problem number one: fibers are essential to smooth the blood glucose curve and maintain its stability, and with them being momentarily out you have an additional degree of complexity to consider.
That is not everything! As the race approaches, you’re also resting and moving relatively less. And here comes problem number two: movement is another critical component of a successful glucose management, and it is especially important when your meals are rich in carbohydrates. Practices like walking after a meal and being active in general are superb advice.
So, isn’t it ironic that the few days we need to load ourselves with carbs coincide with our need to rest the body and limit our movement? How to manage our insulin and protect our time in range? And what are the best foods for carb loading?
It’s a tricky business for sure.
But there are great tactics to optimize both for performance and diabetes management.
Here are the ones that, with time and experience, have served me very well (and that you can download as a FREE PDF!😁).
1) The High-Carb Week
This has changed the game for me lately. Filling the glycogen stores during the week means I don’t have to exaggerate with carbs on pre-race day. I can keep portions relatively smaller, which helps to avoid hyperglycemias without putting me at risk of bonking during the race.
Say the run’s on Sunday. The idea is to gradually increase the carb intake from race week’s Monday in order to have my glycogen stores already filled by Saturday.
This is going to make Saturday (the day before the race) much easier to handle because while I’ll be moving and walking less, I won’t need an inundation of carbs either because the majority of the work has been done the days before.
And since on Saturday I am topping up my carb tank during the earlier hours of the day (from breakfast time until midafternoon, with a small snack in the early evening), I have time to catch any rise in blood sugar, fix it and hit the bed with no insulin and carbs on board.
2) Whole Carb-Rich Foods Throughout The Week For Stable Blood Sugars
The key word here is whole. Whole fruits, whole grains, legumes all the rest of it, always accompanied by greens and fiber reach foods, not only will maximize blood glucose stability but it is also going to create a layer of insulin sensitivity that will help you navigate the days when you’ll decide to cut the fibers and concentrate on carbohydrates.
Typical meals for me during the first three to four days of the week include abundant fruit salads, as well as meals based of grains and legumes (typically in a bowl with some sliced vegs of choice).
One additional reason to love fruits: they hydrate you, which brings me to the next point.
3) Drink Tons Of Water To Increase Insulin Sensitivity
I know, grandma’s advice. But the amount of people cramping or cutting short on the race due to dehydration tells me not everyone hydrates properly.
Drinking tons of water should be default behavior anyway (it is for me, I drink an average of three liters every day). But it is especially important before a long endurance effort, and especially if you live with type 1 diabetes.
Proper hydration will prevent cramps, dehydration and let the blood circulate seamlessly through your body on race day. But water is also essential to facilitate insulin circulation and increasing your insulin sensitivity. When you’re well hydrated, the insulin you inject will have a much easier time reaching all the nooks and crannies of your body and shipping the glucose it finds into the cells.
When insulin is stuck or slow to circulate, glucose will accumulate and generate hyperglycaemias.
Drink!
4) Annotate, Improve, Annotate, Improve
At the end of the day, type 1 diabetes is one big math equation with a lot of variables to consider (at least 42, if you are curious!).
It is much more complex than simply “eat X carbs, inject X insulin”. The same amount of carbs can have a widely different impact depending on the other 41 variables at play. If you’re not moving as much as usual (as it happens during a tapering week), your carb to insulin ratios will have to be adjusted and you’ll likely need more insulin. If you’re eating less fibers, those same carbs will make it into your bloodstream much faster. If it’s hot outside, your blood sugar is more likely to rise. If you are not sleeping enough, insulin resistance is going to increase.
You must keep track of these things in order to make sense of them, predict them and factor them into your equation.
Knowing that on Friday and Saturday you’re going to be less active and eating less fibers will enable more informed decisions when it comes to adjusting your boluses, your insulin timings and your meals.
The dose that worked yesterday might not work today, and you need to annotate the factors that have changed since yesterday to improve your equation and get the right result.
5) Keep Reviewing And Adjusting Your Carb-To-Insulin Ratios
As you start to decrease your physical activity and reduce your fiber intake, you should expect more insulin resistance and be ready for your blood glucose to rise a bit faster than normal.
These are two crucial pieces of information, two variables to incorporate into your blood sugar equation to fix your ratios.
I always track and review my ratios on a meal by meal basis to maximize my chances of nailing it and minimizing the risk of spikes. If my lunch ratio of 10:1 generated an after meal BG of 190, I will adjust my dinner ratio to, say, 8:1. Then I monitor what happens and iterate through the process.
This tip goes hand in hand with the next four.
6) Limit Refined Carbs To The Day Before The Race For “Damage Limitation”
This helps avoiding GI stress and means trading a part of vegetables and fruits for foods like potatoes, rice and whole bread. Definitely less blood glucose friendly, but functional given the circumstances.
I tend to limit my fiber intake and lean on carbohydrates that lower my risk of gastrointestinal problems in the 24 before a long run or race.
Eating more refined carbs with less fibers and while not moving is typically a recipe for a blood sugar roller coaster, and if roller coaster needs be, I’d like to have it for a bunch of hours instead of an entire week. That is why I have a high-carb week, and limit my fibers only for one day.
This doesn’t mean that I binge eat three tons of past, bread, pizza and drink gallons of juices for twenty-four hours straight.
It just means that I’ll trade some fruits, whole grains, legumes and vegs for some slices of whole bread, or some rice, or something of that nature. I still like to have some greens and a few pieces of fruits, but I tend to limit those at my breakfast to have a full day to digest them well and clear my gut.
7) Pre And Post Boluses: Time Your Insulin Like A Pro
You’re eating more refined carbs, you’re less active and the excitement for the race is starting to kick. All factors that alter your blood glucose stability.
And all reasons why you should be even more careful and considerate with your pre and post bolusing.
Insulin timing is key to avoid or contain blood glucose spikes, and you must ensure that by the time you start eating whatever source of carbs, there’s some insulin in your body ready for it. This is true in every day’s life, and even truer now during your tapering.
Make sure you keep a lag between the moment of your injection and the moment you start eating. And make sure you eat slowly and not overwhelm your bloodstream with a ton of carbohydrates in a few seconds. And, based on how your insulin-to-carb ratio is evolving (because you’re surely keeping track of it, right?), be ready to give some additional units one or two hours after your meal to contain a possible spike.
8) Eat The Bulk Of Carbs In The First Part Of The Day To Avoid Late Night Hyperglycemias
This has been very helpful for me the day before the race.
Under the assumption that I’ve done my carb-loading work during the week, Saturday is a mere carby “victory lap”. I just have to top up the stores for Sunday’s race, and I have the freedom to do that in a more blood glucose friendly way.
The last thing I want is a huge carb heavy dinner to spike my blood glucose during the late evening, over night or on race morning.
Adding corrective units can lead to insulin stacking and eventually to a blood glucose cliff. If the cliff happens during the evening or night, it will destroy sleep quality - making us more insulin resistant the day after and keeping us awake when all we’d want is a restful slumber.
To avoid late night problem, I simply move any carb heavier meal in the first part of the day and keep the afternoon and dinner for smaller snacks. By doing so I can catch any spikes in time, tame them with insulin or with some movement and preserve the quality of my sleep. Eating too late could alter blood glucose overnight, impacting the quality of our sleep and the stability of blood glucose during the race itself.
9) Keep Moving, In Shorter Bursts
We said movement is essential to foster blood glucose control. True, we can’t move much becase we’re tapering and it’s right that we rest more than usual. But there are many tricks we can use to still increase the efficiency of our insulin through movement.
Short five to ten minutes walks after eating are my favorite because they activate the legs and are virtually zero impact.
I also do house chores that involve some muscles, like moving boxes, mopping the floor, deep cleaning the kitchen. Possibly with some music that makes me dance.
Get creative! Unless you decide to climb a mountain or to attack the gym for the heaviest leg day in years, you should be safe. Common sense wins here.
10) Accept That Blood Glucose Could Be Less Smooth. It Happens!
You’ve done your best to make it right. Your race is approaching and you should rest and let any stress vanish.
If your blood glucose isn’t perfect, so be it! When you’re a master of blood glucose management, a couple of days are not going to be a problem.
As I said at the beginning, type 1 diabetes is one big math equation with more than 40 variables to take into consideration. You’re doing your best to crack the code, but controlling them all, all the time, is impossible. In fact, you shouldn’t aim at that at all.
Focus on the big ones, those that you know out of your own experience have the biggest impact on you. Things like moving, hydrating analysing your trends and adjusting ratios are big evergreen actions that will always help.
Then the equation is yours and even if for once you can’t solve it perfectly, be ok with it and enjoy your race.
This is all I do before a big race or a particularly long training session. I am aware that we all have unique. experiences and tackle situations from different angles, so I am definitely curious to hear if you do anything different and what has worked for you!
In any case, I do hope you found this helpful and interesting.
Let me know in the comments below, and feel free to share this with someone who you think might benefit from it!
