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  1. #1
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    Type 1 diabetes and burning amino acids

    I am type 1 diabetic (the "juvenile" kind in old school parlance) and keep my glucose close to 100-120 most of the time (essentially always below 150-160). I have noticed a very strong ammonia smell from my sweat on moderate-hard rides.

    After firing up the trusty google I gather that this is because I'm running too low on glucose, so to preserve it for brain functioning and what-not, the body puts amino acids into short-term energy use (rather than long-term anabolic muscle building use). A byproduct of this is a nitrogen molecule peeled off the amino acid, which binds to hydrogen and comes out as ammonia in sweat.

    This of course is bad news for fitness aspects of riding; it means that anabolic/muscle building effects of it are stunted, and I am burning protein and muscle building compounds just in order to power the ride I'm on. I couldn't care much less about the nasty ammonia smell itself, though the mrs. is not entirely thrilled about it. But I'd like to make the fitness aspect of the training more effective and not counter-productive.

    This ammonia-sweat/amino acid burn thing not unique to diabetics; it seems to pop up for lots of people with very low carb diets who do intense sweat-inducing training of any kind. But the usual remedy for 'normal' people is to eat more carbs, esp. simple sugars right before training, and diabetes can certainly complicate the wisdom of that strategy.

    So I'm wondering if other type 1 diabetics out there with reasonably well controlled sugar have had the same issue, and what you've done about it. And, more generally, how do you balance the need to make enough sugar available to train effectively on your mtb, vs. keeping your glucose levels in check?

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    I'm in Canada, so my meter units are different than yours, but I'm not familiar with an ammonia sweat when my blood sugar is high, or goes too low, during a ride/run.
    I have to wonder if it's more a long-term effect if you're on a low-carb diet, than a temporary result of exercise.

    I understand we have to maintain a "goal range" of blood sugar, but before, during and after a ride/run, I intentionally raise my blood sugar with extra food/fuel (since my body is using more energy than usual) rather than risk the short-term danger of a low.

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    Not sure if you found this group but I thought I would throw it out there...they are generally a roadie group but they sweat just the same.

    Team Type 1 ::: Striving to instill hope and inspiration for people around the world affected by diabetes

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    Thanks. I'd heard of team type 1 but forgot their name.

    fsrxc, what units do you use? Ours are mg/dl. How awesome if you used stones/gallon or something.

    From what little I know it has to do with glucose availability right before and during the workout. So, I'll just try slugging full sugar gatorade and see what happens.

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    Quote Originally Posted by slacker666 View Post
    Thanks. I'd heard of team type 1 but forgot their name.

    fsrxc, what units do you use? Ours are mg/dl. How awesome if you used stones/gallon or something.

    From what little I know it has to do with glucose availability right before and during the workout. So, I'll just try slugging full sugar gatorade and see what happens.
    We use mmol/L, and our "healthy" range is 4-8, which coincides with A1c targets.

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    That's handy. I always wonder/forget where the cutoff is for mg/dl to be raising or lowering A1C on average.

  7. #7
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    I've had this crap for only 6 years(im 30) a1c has been in the 6's but recently was 5.9 and although I have neve experienced the "stinky sweat" I found on my first tough ride that I need to carb up to 160-175 pre ride and once we roll I generally eat a gel or 3 shot bloks every 30-40 minutes and after a 2 hour/20mile ride i check at the car and im at or around 100.
    I try to eat wheat toast with peanut butter and a banana with 1cup of light n fit yogurt (85-90carbs)pre ride and it works well for me. I keep hydrated with water, but on 85* or warmer i will change up to gatorade for the electrolytes/carbs
    best thing is to try different things and find what works best....trial and unfortunately error
    09' Fuji Tahoe Pro 29er
    03' Giant Warp DS3

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    Had a couple of endo's confirm that it's about low glycogen stores in muscle, and burning amino/protein preferentially. I have been rolling with gatorade in my camelbak (so far no issues of it being moldy or grimy, I rinse it out well with water and flush the hose after each ride), and that hasn't helped. Endo's say it's probably not just due to carbs right before or during a workout, but more about general diet issues and balance. So I have an endo telling me, a t1d, to eat more carbs...

  9. #9
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    Quote Originally Posted by slacker666 View Post
    Had a couple of endo's confirm that it's about low glycogen stores in muscle, and burning amino/protein preferentially. I have been rolling with gatorade in my camelbak (so far no issues of it being moldy or grimy, I rinse it out well with water and flush the hose after each ride), and that hasn't helped. Endo's say it's probably not just due to carbs right before or during a workout, but more about general diet issues and balance. So I have an endo telling me, a t1d, to eat more carbs...
    It would be interesting to test your blood sugar periodically during a ride to see where it's at and confirm how frequent/concentrated gatorade to drink.

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    I haven't tested during a ride lately, but since I started thinking about this a couple weeks ago, I try to head out with BG at about 130 mg/dl (that's about 7.2 mmol/l in Canadia). On a ~2 hour ride I might slurp through up to 1.5 liters of gatorade, for maybe 75 g carbs. That keeps my BG pretty stable, to about the same level on finishing. Naturally I ride with no basal drip going, and usually after the active window for any bolus is over.

  11. #11
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    Quote Originally Posted by slacker666 View Post
    I am type 1 diabetic (the "juvenile" kind in old school parlance) and keep my glucose close to 100-120 most of the time (essentially always below 150-160). I have noticed a very strong ammonia smell from my sweat on moderate-hard rides.

    After firing up the trusty google I gather that this is because I'm running too low on glucose, so to preserve it for brain functioning and what-not, the body puts amino acids into short-term energy use (rather than long-term anabolic muscle building use). A byproduct of this is a nitrogen molecule peeled off the amino acid, which binds to hydrogen and comes out as ammonia in sweat.

    This of course is bad news for fitness aspects of riding; it means that anabolic/muscle building effects of it are stunted, and I am burning protein and muscle building compounds just in order to power the ride I'm on. I couldn't care much less about the nasty ammonia smell itself, though the mrs. is not entirely thrilled about it. But I'd like to make the fitness aspect of the training more effective and not counter-productive.

    This ammonia-sweat/amino acid burn thing not unique to diabetics; it seems to pop up for lots of people with very low carb diets who do intense sweat-inducing training of any kind. But the usual remedy for 'normal' people is to eat more carbs, esp. simple sugars right before training, and diabetes can certainly complicate the wisdom of that strategy.

    So I'm wondering if other type 1 diabetics out there with reasonably well controlled sugar have had the same issue, and what you've done about it. And, more generally, how do you balance the need to make enough sugar available to train effectively on your mtb, vs. keeping your glucose levels in check?
    i'm t1 i was a full time road racer for a bit, until they stopped paying us! i'd say (and i've not read the other threads) that you're over insulinizing (yup thats a real word) you need to cut back a bit and run a bit sweeter. with too much insulin on board you cant mobilise glycogen or fat properly. what's your current regimen?

  12. #12
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    Non-diabetic here to take that into cosideration: I get the ammonia smell on occasion, generally only with a hard workout on the elliptical (the smell starts ~30 minutes in). Rarely get it when running, biking or lifting weights. Even with sugar loading (with the sole purpose of trying to prevent the loss of amino acids just like you're hoping to do), I still get it, right at the 30 minute mark again. So at least in my case, there's something else going on rather than a simple carb deficiency.

    Also, as far as building muscle goes, you should probably determine your body type (ecto, meso or endomorph) and your ability to add muscle size (poor for an ecto like me; at least without the roids). Also, adding size is oftentimes difficult without giving up the aerobic workout routine (which I was never willing to do). For me, busting my ass 6 days a week on the elliptical, bike, my feet and in the weightroom while not caring about nutrition (other than that it's healthy food in proper quantities) has yielded me better results than when I followed all the advise of the supplement pushers (and I tried just about every legal type there is). I think I went a bit off topic here; for a total heathen, I sure love to preach :|

    Steve
    Last edited by Mr. 68 Hundred; 02-10-2012 at 05:43 PM. Reason: :|

  13. #13
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    Don't use the "smell" method to gage what's going on. A small amount of amonia will be lost through sweat but most of that nitrogen is converted to amonia in the liver and filtered through your kidneys (so long story short: urine)
    Your body will use more protein as a source of energy when carbohydrate supply is low; that is because you body will uso those aminoacids to convert them to glucose in the liver (process is called gluconeogenesis) and to spare then carbohydrates for the central nervous system.
    During exercise your muscles are able to use the glucose, just like when you inyect yourself with insulin. Both (exercise and insulin) do this by increasing the glucose transporters in the muscle (called GLUT-4)
    You may need to increase your blood sugar before exercising and depending on what type of insulin (fast, short, etc) adjust it for exercise so you don't go too low and have a hypoglycemic event. Check your blood sugar before, during and after exercise to fine tune. Its a learning process.
    Are you aware of the diabetes.org website? (american diabetes assoc.) check it and try to meet with a Sports Registered Dietitian to help you plan your nutrition
    Cheers and good luck
    BBW. MS, RD

  14. #14
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    Im a MTBer that has insulin dependent diabetes. Its a challenge to balance the sport and health requirements - but far from impossible. Ive never had problems with smelly perspiration ... well, i generally have a off smell anyhow! coupla hours of sweating in mtb shorts with liners and merino baselayers = pretty filthy stench, add mud and a well sweaty helmet = gah!

    As said above, smells are useless - if your BSL is within the target levels then you have nothing wrong. If however BSLs are running low, here are a few tips i follow.

    Fueling up before a ride = Low GI carbs = sustained energy release & better BSL control. However, if you ride like me, this will only take you so far - i always carry extra Low GI fuel in my camelback so i can top up wherever iam. sure, it is extra weight, but i like the security. A brown rice salad loaded with dried fruits / red kidney beans (LOADED with protien) / mushrooms / shallots ect makes a perfect riding meal. (chuck some bananas in ya pack too - 1banana = equal amount of energy / carbo from those revolting sports gels - and the natural fructose pawns that artificial crap)

    2 - Carrying a meter vs. Added weight...? - METER they are so small and light these days - and gives you reassurance out in the trails

    3 - Insulin dosages: (*disclaimer* - you need to discuss changes to insulin regimes with health care professionals) The intelligent reduction of insulin post ride and during the ride will give alot of BSL leeway. Before the ride and during less insulin is needed than in comparison to a afternoon on the couch due to the benefits of exercise and insulin behavior.

    4 - hypos. they will happen even with the best control. dextrose canisters are light and efficient in raising BSL - follow with some fruit to regain control

    i happen to live in tas, out my window is australias 3rd hardest hill climb and a wealth of trails all around. i put in up to 5 hours in the saddle at times - and generally have not too many problems. i carry more weight than most other MTB riders, but i see jealousy in their eyes when ive parked my ass on a log and are munging through some delicious food, and all they have a revolting snot like sport gels.

    this year im pushing further into enduro riding, with events like the blue dragon challenge - and while i have alot more to consider and moderate, there aint no reason that we cant do what other riders can.

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    ** The intelligent reduction of insulin post ride and during the ride will give alot of BSL leeway ... should have been

    'The intelligent reduction of insulin pre/ during / and to a lesser degree after a ride will give alot of BSL leeway

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    it's worth noting that you don't HAVE to eat low GI carbs and that doing so will not necessarily improve exercise performance. It's an option and if it makes you happy then go for it but there is no need to "carry more weight" nor to stop on rides and eat brown rice. certainly i know i couldn't really get away with that in a belgian kermesse or a UCI road race!

    not saying this is bad advice i'm just saying there are more options out there and the whole low gi thing is a bubble which needs bursting. another one is that fructose is any use at all during exercise.

    Quote Originally Posted by seaweeding View Post
    Im a MTBer that has insulin dependent diabetes. Its a challenge to balance the sport and health requirements - but far from impossible. Ive never had problems with smelly perspiration ... well, i generally have a off smell anyhow! coupla hours of sweating in mtb shorts with liners and merino baselayers = pretty filthy stench, add mud and a well sweaty helmet = gah!

    As said above, smells are useless - if your BSL is within the target levels then you have nothing wrong. If however BSLs are running low, here are a few tips i follow.

    Fueling up before a ride = Low GI carbs = sustained energy release & better BSL control. However, if you ride like me, this will only take you so far - i always carry extra Low GI fuel in my camelback so i can top up wherever iam. sure, it is extra weight, but i like the security. A brown rice salad loaded with dried fruits / red kidney beans (LOADED with protien) / mushrooms / shallots ect makes a perfect riding meal. (chuck some bananas in ya pack too - 1banana = equal amount of energy / carbo from those revolting sports gels - and the natural fructose pawns that artificial crap)

    2 - Carrying a meter vs. Added weight...? - METER they are so small and light these days - and gives you reassurance out in the trails

    3 - Insulin dosages: (*disclaimer* - you need to discuss changes to insulin regimes with health care professionals) The intelligent reduction of insulin post ride and during the ride will give alot of BSL leeway. Before the ride and during less insulin is needed than in comparison to a afternoon on the couch due to the benefits of exercise and insulin behavior.

    4 - hypos. they will happen even with the best control. dextrose canisters are light and efficient in raising BSL - follow with some fruit to regain control

    i happen to live in tas, out my window is australias 3rd hardest hill climb and a wealth of trails all around. i put in up to 5 hours in the saddle at times - and generally have not too many problems. i carry more weight than most other MTB riders, but i see jealousy in their eyes when ive parked my ass on a log and are munging through some delicious food, and all they have a revolting snot like sport gels.

    this year im pushing further into enduro riding, with events like the blue dragon challenge - and while i have alot more to consider and moderate, there aint no reason that we cant do what other riders can.

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    This isnt a thread on general exercise performance, it is related solely to BSL control for those that ride with insulin dependent diabetes.

    Low GI based meals are what should be eaten prior to moderate riding. It is slow release carbohydrate which can often cover the whole window of the short acting insulin (that which is taken at meals). The original poster was looking for tips so he can experience smoother BSL control while riding.

    Now - 'there is no need to "carry more weight" nor to stop on rides and eat brown rice. certainly i know i couldn't really get away with that in a belgian kermesse or a UCI road race!

    - So the original poster is experiencing a hypo while MTBing. He has treated it with a glucose based energy source, raising the BSL temp to a safe level. Following this - what do you suggest? It is commonplace knowledge that a hypoglycemia event must be treated with fast acting glucose - then reinforced with long lasting carbohydrates to prevent another hypo 10minutes down the trail.

    Im sorry, this thread really does need advice from those who have experience with the condition.

  18. #18
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    I'm with Seaweeding to an extend. Not only advice from people that has the condition but from the specialists that help to manage it. low GI or high GI doesn't matter WHILE exercising since catecolamines supress insulin. Doesn't matter
    BBW. MS, RD

  19. #19
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    Quote Originally Posted by seaweeding View Post
    This isnt a thread on general exercise performance, it is related solely to BSL control for those that ride with insulin dependent diabetes.

    Low GI based meals are what should be eaten prior to moderate riding. It is slow release carbohydrate which can often cover the whole window of the short acting insulin (that which is taken at meals). The original poster was looking for tips so he can experience smoother BSL control while riding.

    Now - 'there is no need to "carry more weight" nor to stop on rides and eat brown rice. certainly i know i couldn't really get away with that in a belgian kermesse or a UCI road race!

    - So the original poster is experiencing a hypo while MTBing. He has treated it with a glucose based energy source, raising the BSL temp to a safe level. Following this - what do you suggest? It is commonplace knowledge that a hypoglycemia event must be treated with fast acting glucose - then reinforced with long lasting carbohydrates to prevent another hypo 10minutes down the trail.

    Im sorry, this thread really does need advice from those who have experience with the condition.
    nice try buddy, i'm type one diabetic. I've raced professionally in Europe. and id id it without eating brown rice in the middle of races.

    what would i do if i went hypo in a race, i'd eat glucose then i would eat something starchy, not necessarily low gi. maybe a bar or a bottle of mix. or i'd suspend my pump. what i categorically would not do is let it end my race or let my diabetes make me give up or fail at what i'd set out to achieve.

    I didn't say your advice was BAD what i said was that it wasn't the only option. I don't think that as a type one diabetic i have to act any differently i'm not disabled and don't want any special treatment.

    on a side note why on earth would one want to take carbs to cover short acting insulin before a ride when you could just take less short acting insulin? eat because you need to eat, not to feed your insulin. that's the a rapid route to weight gain.

  20. #20
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    Good stuff here, thanks for the feedback.

    An update on my experience...as I said above I was heading out with BG about 130-140 mg/dl (so, a shade above normal for the mmol types), with a camelbak full of gatorade, about 80-100 g of carbs (high gi) for a 90-120 minute ride. But this wasn't really helping the situation.

    Since then I've started eating about 1-1.5 cups of oatmeal with maple syrup on it, about an hour before I ride. No insulin coverage (I never ride inside the active window of fast acting insulin). So, a mix of low and high gi carbs, and they sit easily in stomach while riding. AND I roll with gatorade in the camelbak, and also often eat a clif bar etc. midway through the ride. So this puts my BG at 200-250 when I hit the trailhead -- way above normal. And, with all those carbs ingested before and during the ride, I am finishing at about 120-150. Then, after rides I'm eating a lot more carbs to replenish glycogen in the short window when carbs get converted to glycogen quickly.

    Most importantly, I feel much better on this regimen during rides. The tell tale ammonia sometimes still arrives, but later in the ride and not like all over. And BG is easy to keep in check the rest of the day & the next day before I ride.

    So, that's consistent with a lot of what was said here.

    One thing I don't agree with is that odors and what have you are irrelevant/should be ignored. That was the very thing that tipped me off that something was up. My BG numbers didn't tip me off that anything was wrong; if anything they looked normal for anyone and amazing for a T1D. The way stuff smells is a signal of what/how well it is doing. It may not be dispositive by itself, but it's a tip off and it's important to put it in context to figure out what's going on. It seems to me they don't just randomly undergo persistent changes that are unrelated to the functioning of other systems.

  21. #21
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    Quote Originally Posted by slacker666 View Post
    I am type 1 diabetic (the "juvenile" kind in old school parlance) and keep my glucose close to 100-120 most of the time (essentially always below 150-160)...
    Man you should really give yourself a pat on the back. Your BS is wonderful. My daughter is Type-1 and just turned 13. I wish we could say her BS is in-line (last week avg = 163 but some ups and downs. I will ask her about the ammonia smell. She has been exercising quite a bit.

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    It's waaaaaaaay easier to control as an adult than as a kid. I was actually diagnosed as an adult (still type 1 regardless of age at diagnosis), and for some reason those cases are even easier to control for several years. All 3 of my kids have it too (yeah we really won the genetic lottery) and they are all over the map with bg and a1c. Your daughter will get it straightened out in a few years. Honestly I understand that teens often have a hard time with it, so if management is merely tricky for your daughter you're ahead of the game.

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    What you may want to look in to is getting a Dexcom. Between the Dexcom and insulin pump I've gotten my A1C's from 9's down to 6.0 (according to my endo visit 2 days ago).

    I've been a T1 diabetic for 20 years (I'm 27 now) and quite a bit overweight. I just bought a bike last week to get in shape (tired of having a beer belly, plus my wife is 7 months preggo). Anywho, I've been slowing working my endurance/stamina up so I can't exactly give advice for extended rides (especially because every diabetic is different) but I will say the Dexcom is an invaluable tool because it tracks trends.

    As far as going hyperglycemic prior to exercising, I'm not sure about anyone else, but if my BG is above 160 I'm already starting to feel dehydrated and weak. Nevermind 200+.. I doubt I'd be able to go more than 10 minutes... but again, I'm still quite out of shape...

    Quote Originally Posted by Fishermikel View Post
    Man you should really give yourself a pat on the back. Your BS is wonderful. My daughter is Type-1 and just turned 13. I wish we could say her BS is in-line (last week avg = 163 but some ups and downs. I will ask her about the ammonia smell. She has been exercising quite a bit.
    I probably averaged over 200 for most of my teen years. I really didn't work on getting it down until about 2 years ago. I now suffer from retinopathy . With her changing hormones she's going to have constant ups and downs...

    Quote Originally Posted by slacker666 View Post
    It's waaaaaaaay easier to control as an adult than as a kid. I was actually diagnosed as an adult (still type 1 regardless of age at diagnosis), and for some reason those cases are even easier to control for several years. All 3 of my kids have it too (yeah we really won the genetic lottery) and they are all over the map with bg and a1c. Your daughter will get it straightened out in a few years. Honestly I understand that teens often have a hard time with it, so if management is merely tricky for your daughter you're ahead of the game.
    I couldn't imagine having 3 kids with diabetes. On the other hand, I feel that if any of my kids are diagnosed with it, I will be much more able to handle it than my parents were when I was diagnosed....

  24. #24
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    I was just diagnosed type 1, I went to the hospital with 1057 BS. Right after that I decided to get a bike. This information is very good for me since I'm still learning to deal with the ups and downs. I will start monitoring my BS before and after each training session. Thanks guys. Slacker I hope you get to manage your situation.

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    Quote Originally Posted by kevingp View Post
    I was just diagnosed type 1, I went to the hospital with 1057 BS. Right after that I decided to get a bike. This information is very good for me since I'm still learning to deal with the ups and downs. I will start monitoring my BS before and after each training session. Thanks guys. Slacker I hope you get to manage your situation.
    What are you using to manage your diabetes? pump? MDI?

    you should also test DURING the workout as well
    -Scott

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