Hiking with Diabetes

September is here and fall weather is upon us.  Here in Washington DC, that means the humidity has lifted!  (I hope.) Fall is a great time for walks and weekend hikes. They are enjoyable, relaxing and healthy, but especially for the most seasoned athlete with diabetes, hiking can be a sneaky culprit to blood sugar control.  Its time to put the ego aside and accept even the most leisurely hike will in-fact effect your blood sugar management.  Some of you egomaniac ironman triathletes might be rolling your eyes—I used to be one of you.  Then I got sick of my dad—type 1 patient, 50 years old, sits behind a desk all day (“twirling in his chair” my brothers joke)—waiting on me, the young buck, the “athlete” in the family, recovering from a low blood sugar in the middle of a leisurely family hike.

A hike probably includes more hills than you realize and use the large muscle groups directly affecting your blood sugar. How? I thought you would never ask!

Today’s science lesson:
When you were diagnosed with diabetes, your doctor or educator taught you that insulin, the “key,” binds with a “lock” (the tyrosine kinase receptor) on the membrane of a cell unlocking he “door” (GLUT4) that allows glucose to enter the cell.  When muscles cells are in use, their affinity for accepting glucose drastically increases. That means less insulin or more glucose is needed to sustain a level blood sugar level. 



What to do:
If this is a spontaneous hike or you are on medication or long acting insulin, bring extra glucose with you.  I typically bring 3 packets of fruit snacks each containing 20g of carb with me.  If I have recently eaten and have active short acting insulin on board, I eat 15 grams of fast acting carb 10 minutes into the walk. This helps me avoid a low blood sugar.
If this hike is planned hike and you have an insulin pump, decrease your basal rate 45 minutes before the hike.  The basal rate should be decreased between 10-20% for a leisurely hike, and more than 50% for a strenuous hike such as a backpacking trip through the mountains.  These values are guidelines, not absolutes.  Every one’s body is different, and your own body is divergent of past performance.  It is important to check your blood sugar whenever there is doubt to where your levels are heading.

There is some great information regarding advanced level hiking and backpacking on the web.  The links below have been helpful for my adventures.