In terms of mountaineering, scrambling is perhaps that hardest of the disciplines to get right when it comes to blood sugar management.

 

When we walk we know there will be a constant steady effort and that the main changes we experience will be the speed we are moving and the angle of the ground we are covering. We are in aerobic effort and blood sugars tend to react accordingly. Similarly, when we rock climb, once the walk in is complete we know that we will be moving slowly up the rock face and, while climbing is great exercise, it is normally necessary to do quite a lot for it to have a big impact on blood sugars. Scrambling is where these two disciplines mix and as a result it can be much harder to know how best to look after yourself.

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Those people who have scrambled for a while are likely to have found a solution that works for them, probably based on a mix of guide book information and simply knowing how their body reacts in these situations. But for people entering this world for the first time predicting the impact on blood sugars can be tricky.

 

There are a few things that must be considered when trying to predict blood sugars on the scramble.

These are:

-distance to the start and from the end of the scramble

-height gain on the scramble

-grade of the scramble

-use of ropes

 

Most UK scrambles take a bit of walking to get to. Some, like the north ridge of Tryfan in north Wales, have a very short walk in and so this can pretty much be ignored as a consideration. A scramble on the north face of Ben Nevis, however, has a two hour walk in, so making sure blood sugars behave on this part of the day is important. For longer, steeper walks in, check out the information on the hill walking page for ideas on keeping your blood sugars stable!

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Another big variation with scrambles is the height gain achieved. As speed of movement tends to decrease when scrambling, knowing how long you are going for is important. A short scramble you can treat in a very similar way to a walk, but on a long scramble you are likely to need to treat it like a multipitch climb. For those who want information about how climbing can affect blood sugars, visit the climbing pages.

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The next two elements often tie together. On easy scrambles you are less likely to use a rope and so move faster; on a harder scramble you will probably be roped up and so the speed of movement is reduced, meaning blood sugars may go down more slowly or even possibly rise if there is not enough insulin in the bloodstream. This means it can often be safe to take close to a normal quantity of insulin before a long, harder scramble, provided you know how your body tends to react to either easy climbing or you have noticed that your blood sugars tend to rise when scrambling.

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As with all adventurous activities, it is much safer to err on the side of being slightly high when scrambling, especially when soloing as a hypo in this situation is potentially life threatening.  

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If you're planning your own scramble, it makes sense to use your guide book and map to assess the walk in and scrambling terrain in advance to get an idea of the difficulty and potential impact on your blood sugars before you set out. For those new to scrambling and going with an instructor/guide, it’s a good idea to chat to them about what to expect on the day. Most guides won’t know how to predict the effects on blood sugar levels but will be able to give you an overview of what you should expect, including distances of walking, rope usage and timings for the day, helping you make informed decisions about blood sugar management.

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For those using CGMs, it is also worth considering setting a higher than normal low alarm. This will warn you that you are getting low before you become hypo. Treating potential hypos early is the best way to avoid them happening at all and is by far the safest course of action in the scrambling environment.

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As with all outdoor activities, getting to know how your body reacts will take some time. For those coming from hiking or climbing backgrounds, bringing the knowledge of those other activities with you is invaluable. But for everyone, it’s always best to start conservatively and learn from your own personal experiences.

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We hope the information given here will help you make a positive start on your journey.