Having been through all of this ourselves, we have put together a few tips to help make trying new activities easier.

 

1. High is your friend! If you are going to try anything new that involves being outdoors and possibly away from help and civilisation it is safer to err on the side of caution and keep your blood sugars slightly high. While running high all the time isn’t a good place to be during your first foray in the outdoors, running higher for that day is by far a better option than running too low (especially if you are far from the nearest café!).  

                 

2. If you take basal insulin, consider reducing your dose. This will help you run a little higher and helps reduce the chance of hypo massively. How much you reduce it by will be dependent on your individual insulin needs but making that reduction can be very beneficial. I like to think that having basal insulin onboard during a hike is a bit like having a sugar hoover running full speed in your bloodstream! It is scary how quickly a hypo can creep up on you even if you have eaten way more carb than normal and taken less fast-acting insulin. The culprit here is almost always basal insulin.

                                                            

3. Consider taking less insulin for your carbs. This one is obvious but very important. Remember to change your insulin-to-carb ratio and take less than normal for aerobic activities. You might need to reduce this a lot and it will take a bit of time to figure out what is right for you, but if in doubt less is more, you can always take more insulin later if you need to.  

                               

4. 5 mmol/L is a magic number. In the UK to drive a car, blood sugars should be above 5mmol/L. This number applies (unofficially) at The Diabetic Outdoors too. Aiming to keep blood sugar above 5mmol/L helps to reduce the chance of hypos and lets your time outdoors flow better. If bloods are under 5mmol/L, treat this as a hypo and eat your standard hypo cure. You don’t necessarily have to stop doing your activity, so long as you feel good, just keep a close eye on blood sugars until they go back up.

                                       

5. CGM alarms are amazing tools. CGMs (continuous glucose meters) are pretty life-changing bits of kit and if you can get one, do! They give you way more information than a finger prick meter would and if you have alarms use them! In terms of setting alarms, a hypo alarm is far more useful if it tells you that you are going low before you have a hypo. For that reason, setting the alarm at 5 mmol/L provides an early warning when you are starting to trend low and allows you to act before becoming medically hypo.

             

6. Take many types of sugar. Having lots of options for carbs and sugar means you can choose the right thing for your blood sugars at the time. I have found that sweets, juice and glucose tabs raise blood sugars very quickly whilst fruit and nut pressed bars can act semi quickly but also hang about in the bloodstream longer. Finally, starchy carbs take longer to take effect but keep you on an even keel for a few hours which can be beneficial during a long active day. Make sure you have a variety of carbs and experiment to find which works best for you. I would recommend keeping at least some of your sugar in easy-to-access locations like waist pockets on backpacks or top flaps, so it is always on hand when you need it. Most importantly, make sure you won’t run out of hypo cures!                                                                                                           

7. Let other people know you're diabetic! If you are out with a guide you will need to fill in a medical form, and always declare your diabetes. A good guide won't use it to stop you from coming but it will mean they can bring some extra sweet snacks in their bag and will know to look out for you. Have a chat with them at the start of the day to let them know how you look after yourself too. If you are out with friends make sure they know your blood sugars might get low and you will need to deal with this as soon as it happens not in 15 minutes time when there is a good view or a nicer place to shelter. Do not allow yourself to be pushed into not looking after yourself. It can also be useful to let people know where you keep your sugar stash just in case you need help accessing it.

     

8. If everything is going wrong, turn back! As much as this isn’t a nice thing to have to do, the safety of you and the people you are with is the most important thing. If your blood sugars are in a world of their own and refusing to play ball, turning back is always the best and safest option. This is nothing to be ashamed of, it is simply a learning opportunity where you can figure out how to get your blood sugars to behave and prevent this happening again. It's better to turn back than become a mountain rescue call-out! The outdoors will still be there for next time.    

 

                                                                                                             

As with all things diabetes, this is a guide only and is based entirely on our personal experiences. Everyone is different and what might work for one person won't always work for another. It takes time to get things right sometimes but hopefully, these tips will serve as a leg up!                                                                                                                      

 

This page serves as a general guide, with more detailed information about how blood sugars are affected by different activities on the relevant specific page. If you have any concerns, chat with your diabetes nurse and any questions get in touch via the contact page where we will be happy to help if we can!