# Sport & Exercise Weekend, Loughborough Uni



## Julia

I heard about this and thought I would share...

*Sports and Exercise Weekend*, Loughborough University
11,12&13th May

**Hear from Dr Ian Gallen *- consultant physician and endocrinologist as he presents on diabetes, exercise and sports, improving performance and glucose control
**Participate in practical exercise workshops*  - choose from football, swimming, cycling (gym based) & fitness (gym based)
**Share your experiences *- and learn from others in a workshop setting
**Meet the healthcare professionals *- the team will be there to assist and guide you in theory and practical sessions
**Be inspired by our motivational speaker* - Hear Claire Duncan's story; Iron Man competitor and channel swimmer and living with Type 1 diabetes

?100. Email sportsday@its.jnj.com for more information and to reserve your place

(Participation is open to people with type 1 diabetes only, aged 18 and over)


I tried to attach the agenda, flyer and registration form but they were too big and I'm not clever enough with computers to work out how to compress pdfs. I think I'm probably going to go...?100 is a lot of money but it seems good value (includes 2 nights accom, all food etc)


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## Northerner

Sounds excellent Julia, you'll have to let us know how it goes


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## trophywench

It's the Runsweet people - great!


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## Northerner

Are you there this weekend Julia?


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## Julia

Yes, it is amazing!!!!!!!!!! The best diabetes-related thing I've ever done (apart from join this forum of course!) 

The talks have been brilliant, but the main thing is to meet 50 ish other active type 1s from professional athletes to people just trying to keep fit and everyone in between. So many inspiring people. Today has all been about trying out different strategies (two exercise sessions) and then analysing what worked/didn't for different people in small group sessions.

Anyway will try and summarise Ian Gallen and Alistair Lumb's advice and what we have discussed as a group, when I get back tomorrow. The bar and a three course dinner is calling...... (this weekend is _heavily_ subsidised by animas - amazing value!!!!

  

P.S. I wanted to put a row of smiley faces to summarise my feelings about this course but can't put that many!


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## Northerner

Excellent! Sounds terrific Julia! Will look forward to your review, hope you have another good day tomorrow


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## HOBIE

A GOOD Thing to read !!!!


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## Julia

I?m not sure I can put into words and do the weekend justice, but I will try and summarise my understanding of the key points. If there are any lurkers out there, that also attended, please add what I?ve missed and correct me if I?ve misunderstood anything! 

Dr Gallen talked quite a bit about ?fuel regulation? during exercise in both people with diabetes and without. In non-diabetic people, the main source of fuel for the muscles is initially glucose, but then switches (after approx 50mins) to fatty acids and ketones. In non-diabetic people the level of insulin when exercising dramatically falls to facilitate this. In diabetics if insulin levels are not reduced enough or blood glucose is too high, there will be poor performance and fatigue because the muscles are burning the wrong fuels. This is most easily achieved using a pump and it was interesting that, bar a few exceptions, everyone on the course was already using a pump. 

Also people with diabetes have a poor glucagon and adrenaline response to exercise. He talked a lot about counterregulatory hormones and how to switch these on to reduce blood sugar drops. He also discussed how the counterregulatory hormone response is not instantly switched off at the end of the exercise in diabetics and how it is very common to get post-exercise highs immediately at the end of exercise (followed by lows later).

They gave us some strategies to try as starting points. Dr Ian Gallen said that these were based on working with and listening diabetic athletes for over 10 years. He and Dr Alistair Lumb have been testing these in a lab situation and presented some interesting and exciting data that is about to be published to the scientific community. 

*The Possible Strategies*

*1. Extra Carbohydrate*
Sipping glucose drinks up to 60g glucose/hr.
If >12mmol/l, delay carbs for 20 mins
If <7mmol/l at start, have 20g at start of exercise. 

This is quite a lot and quite hard to achieve. The dietition said you have to train your stomach to do this.
If exercising longer than an hour, you can use complex carbohydrate e.g. cereal bars, but not in last hour of exercise. 
He and the dietition in her nutrition talk also discussed isomaltulose (palatinose) as a slow release carbohydrate energy drink for longer races. 

*2. Reducing Bolus if exercising within 60-90mins of meal*
Reduce by 25% for 30mins light exercise
Reduce by 50% for 30mins moderate exercise or 30mins light exercise
Reduce by 75% for 30mins hard exercise or 60mins moderate exercise
Give NO bolus for 60mins of hard exercise (whatever amount of carbs).
One of the key points he stressed was that unlike resting muscle, exercising muscle does not require insulin to take up glucose.

*3. Reduce Basal* (on pump)
Reduce to 20%* (by 80%) 30-45 mins before start exercise. Restart 15 mins before finish. 
Ideally don?t stop completely, because of kinetics of restarting and something to do with size of ?little puddle? at infusion site. They presented a lot of data collected in kids and the advice for kids is different. 
* suggestion for exercise at 50% VO2max. This is a more severe reduction than most healthcare professionals currently recommend.

*4. Maximal Sprint*
30sec-1min sprint or squats/star jumps (Dr Gallen recommends 30-60secs which is longer than 10s recommended elsewhere)
To kick body into stress response and turn on counterrregulatory response to reduce blood sugar drops

*5. Caffeine*
2.5mg/kg e.g. 3-4 proplus tablets 30 mins before exercise to reduce blood sugar drops and increase performance
He did say he didn?t recommend this if you had diabetes for longer than 15 years or were over 40years old.

*After exercise*
It is normal for BGs to rise at end of exercise. This can be offset by a bolus (typically 0.5-2 units) at end of exercise. 
If blood sugars always fall after end of exercise, they suggest doing maximal sprint at end of exercise. 

Reduce basal rate overnight by 20% (to 80%) if unaccustomed exercise or exercising less than every 3 days. 


So in our small groups and for two practical exercise sessions we tried the various strategies. Some of the strategies worked beautifully for some and not for others, so, as always, it?s all a case of trial and error. One young lady had perfect blood sugars all afternoon and evening, but was wired on the caffeine!!! The things that worked for me that I have taken away are reducing my basal more (e.g. to 20%, rather than 40-60%), reducing it only 30-45mins before exercise (compared to 60-90mins). Not worrying about the bolus dose if meal is more than 90mins before (previously thought 3-4hours). 
I have been putting on 200% basal at end of exercise to try and stop post exercise highs (and had previously wrongly thought this was due to too much carb intake), but am now going to experiment with bolus doses. I tried 1.0iu but it wasn?t quite enough. 

Sorry that this is a massive essay. Spending the weekend with other type 1 athletes and fitness fanatics, was enlightening, inspiring and empowering! I can?t praise this weekend enough and recommend anyone who ever breaks a sweat to go next year if possible! Everyone was so friendly and it was so much fun! Excellent value for money. The food was amazing too. 

Right off for a run?.


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## Northerner

Wow Julia, thank you for writing this  I will take my time to absorb all the wisdom - I hope you enjoy your run!


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## HOBIE

Pleased you had such a good time Julia !  Like northy it will take me some time to go through info. Well done for post !


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## Cumbrianlass

Hi Julia - thank you so much for writing this - you have written about some of the many things I experience when exercising - it's great to have some really practical tips to try with my pump. Can't wait until my next spinning class


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## Northerner

Another write up about the weekend, from Anna on Shootuporputup:

http://www.shootuporputup.co.uk/2012/05/animas-sport-exercise-weekend-part-two/


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## Julia

And here is a short video of the weekend
http://www.youtube.com/watch?v=6YlThZfux1U&feature=youtu.be

I hope they run another weekend next year!


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## Julia

Registration open for the 2013 weekend. 10-12th May, Loughborough, ?100 (heavily subsidised!)

Moral dilemma....on the one hand this weekend is so brilliant I think everyone* should go, so I should spread the word...on the other hand, I want to go again and they give priority to people who haven't been before, so I don't want anyone to know how brilliant it is! No, seriously, I cannot recommend this weekend enough!

To register your interest, email sportsday@its.jnj.com

And have a look at Anna's blog here (with more details too)
http://insulinindependent.blogspot.co.uk/2013/01/animas-sports-day-event-do-it.html

*everyone unfortunately means type 1 over 18s only


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## Northerner

Thanks for letting us know Julia, hope you manage to get in again


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## Pigeon

Do you think it would be of use to people not on a pump? 

Also, how fitness fanaticky was everyone? I've done a few half marathons and sprint triathlons but I'm not at all competitive or that fit really..... Just wondering how I'd fit in!


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## HOBIE

Looks good Julia. I might try next year but have got some heavy things to do this year.


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## VanessaK

Hi pigeon I have e-mailed them to ask your questions as they were the same as mine lol.... will let you know if I hear of anything. Also you sound miles fitter than me I have only done one half to date !  Must get a wriggle on for the next half this year..


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## Dory

Hi Julia, thanks for this - I'm really interested so have emailed them asking for further details and an agenda.  Once I get that I'll post it here for everyone.

I'm definitely going to go so if anyone wants to come along to I'd appreciate the company!


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## Julia

There were people of all fitnesses, shapes and sizes there last year, ranging from professional athletes and ironmen competitors to people who wanted to start exercising but were scared to. Lots of people were on pumps, but many weren't and all sorts of different ways of managing exercise were discussed.

I think it's only natural to be slightly apprehensive going to something like this where nobody knows anyone else, but there was no need! Everyone was so friendly. People from all walks of life were united by sport and diabetes. Looking at how much fun people were having you would never have guessed people had only just met!

And don't worry about fitness and the different sports. Last year most of the people who did football had never played football before but they had a great time! (This year the choice of practical sessions are spinning, circuits, badminton or volleyball). 

I don't know how to attach pdf of the fliers but they're on this blog http://insulinindependent.blogspot.co.uk/2013/01/animas-sports-day-event-do-it.html

Hope this doesn't encourage too many of you to go!!!  (only joking!)


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## Dory

woo hoo! place confirmed (with a badminton session which I asked for - happy me!)

if anyone else has signed up and is going, would be great to meet up!


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## AlexisB

*Start/finish times*

Does anyone who went last year know what time the event started on Friday and finished on Sunday? I've asked the organisers who said that I'll get an information pack nearer the time but I need to know now so I can book time off work and trains. Thanks


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## Copepod

Welcome to the forum, AlexisB.

I hope that someone who attended last year will able to reply soon.


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## AlexisB

Thanks. I wish I'd never booked on to the weekend now. If they organisers can't even tell me what time it starts and finishes so I can book time off work and get my train tickets, they can't be very organised!


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## Dory

Alexis - yes they do give you a LOT of detail about times to arrive, start times of events over the weekend etc.  I can't get access to my emails at the moment.  It did take a few weeks between me sending my cheque and getting the information.

Given the scale of the event, be patient with them.  You could always give them a call if you sent your cheque off a while ago and haven't heard from them.


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## AlexisB

I've already called and emailed twice but they won't tell me anything. Oh well, thanks anyway.


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