During my recent trip back to the states visiting family and friends I had the goal of spending some time outdoors (an admirable one given the Mrs and I were taking our first US trip with the 7 month old). Ever since living in St. John’s Portland (2015) walking the entirety of Portland’s Wildwood Trail has been on my radar as an interesting challenge. Since the Wildwood is close to town it seemed like the right time to finally take it on.
On August 17th some friends and I set out early in the morning with the hope of conquering the entire 30 mile trail. This post should hopefully provide some insights for anyone looking to take on a similar challenge with Type 1 diabetes. It won’t be as personal as my previous post on the Yorkshire three peaks.
You can see my previous long hike taking on the Yorkshire three peaks here.
The route
The Wildwood Trail winds through the beautiful Forest park. Which is known for being one of the largest urban forests in the United States. The trail is well marked and maintained, making it a great choice for a long hike.
The crew started at the south end of the trail in-order to avoid the elevation gain at Pittock Mansion being the last major obstacle (overall this trail really does not have that much elevation to it, so this wasn’t super necessary). Our ideal pace was 20min/mile to make sure we finished in a reasonable amount of time.
The culmination
As with any long hike an early start was essential. We began our trek at 6:00am walking a pace of a around 20min/mi, finishing just before 6:00pm.
It went well! My blood sugar wasn’t quite as good as the Three Peaks hike but I felt much less anxious. Its not easy to see in the charts but I didn’t have to panic eat as much to keep my blood sugar elevated. I still would have done things slightly differently, lets go over that below.
What I learned
The main thing I wanted to try differently this time around was to not take any bolus insulin with breakfast (during the Three Peaks I saw pretty steep drops in my blood sugar right off the bat which I did not enjoy.)
I took my normal dosage of basal on the day of. You can expect this amount of basal will drop your blood sugar while hiking a decent length but I also found last time around that the blood sugar drop fairly closely matched my hunger and need for energy.
I did eat a low carb, high protein breakfast (I can’t remember exactly what) before getting in the car. In the car park I had a typical fruit based energy bar. As you can see this didn’t go super well 😂.
Learning #1: it takes about an hour for the hiking to start dropping my blood sugar from basal alone.
We ate lunch a little after noon. I was hungry at this point even though I’d been snacking most of the way. I decided to take 1 unit (about 1/4 of my normal dosage for the carbs I ate). I think next time I’ll skip the bolus / lunch break. You’ll see after lunch I had a little spike, but after the initial carb load my blood sugar was a bit of roller coaster. It doesn’t look that bad but it did take quite a lot to keep from dropping low. I think being a little hungry and continuing to snack would have been better. I do even wonder if upping my basal by 10% would have been a better choice. Just a little more carbs needed, spread out but less chance of a meal / post-meal roller coaster.
Learning #2: Bolus will hit you hard. 1/4 your normal bolus is still too much.
Overall I was pretty happy with how things went. For this adventure I ended up eating 410g of carbs over the course of the hike in-order to keep my blood sugar elevated. I would have preferred to have a slightly lower average but all things considered this wasn’t too bad, especially when you consider this was just a single day.
The practical bits
Thinking of doing your own big hike? Here’s what I would suggest:
Safety first
Talk to your hiking buddies before you begin. Show them where your glucagon kit is and make sure you have the instruction pamphlet in the kit (they don’t need the full run down of how it works, they can figure it out in the moment if need be). Tell them about the signs of hypoglycemia. Make sure they understand to call emergency services if you are incoherent or unconscious.
If you start to run low on carbs, bail. There’s no shame in it. You’ll know better for next time.
Energy
Choose how much you’re going to eat. Look up how many calories you’re going to burn and decide whether you’re going to attempt to match that or be in a calorie deficit.
Perhaps due to being a fairly skinny fella I don’t like the feeling of being in a calorie deficit.
Basal
Therefore I choose to use my normal basal dose, and eat enough to prevent my blood sugar from dropping too low.
If you want to be in a calorie deficit you may want to reduce your basal insulin dose. (my guess would be reduce by anywhere from 20-50% but every body is different, you’ll need to find what works for you.)
Bolus
Seriously. It’s pretty amazing how much a small amount of bolus insulin will try and drop your blood sugar. I could see maybe doing half units ~10 minutes before a bigger scran but prebolusing much longer than that could get sketchy, and bolusing more than that will cause some major drops.
If you do have a pump you may be able to dial in bolus better with a much much higher I:C ratio, but that would take some experimenting and practice. Once I’m on a pump I’ll probably attempt a lower basal with a MUCH lower bolus ratio. I’ll report back how that goes some day.
fin
Anyhow, that’s all I have this time around. I am so very grateful for my friends and family for supporting me doing things like this. Hopefully it’s a little bit helpful if you’re on a similar journey. Enjoy some other pics of the hike while you’re here.
