During the summer months I seem to lose all sense of logic and decide to “enjoy” open water swimming. Not only do I face hypothermia, risk of contracting unknown water bourne diseases and grumpy geese on a weekly basis I have to ensure that my blood sugars behave. Open water swimming is requiring quite an intense level of diabetes organisation.
There are certain rules to adhere to when open water swimming. We are tagged in and out of the water. If you leave the water, then you cannot re-enter the water. You must follow the course round and swim continuously: once the course has been started you can’t touch the bottom, or turn back, and it is usually a 500m to 600m lap. Already this raises a few problems… Furthermore the water has been anywhere from 12 degrees to a toasty 15 degrees. Getting into the cold water causes an adrenalin spike!
Suddenly open water swimming has started to become a university level mathematical algorithm. How much active insulin do I have? What is my current blood sugar? Which way is it trending? Do I need to take on carbohydrate? If so how much? Will my blood sugar drop in the water? How cold is the water and by how much will this affect me? How much wind resistance is there and how hard will it be to swim? How much energy will I need for the conditions today? How many laps will I be able to manage before I need to get out to test or eat? What time did I start a temporary basal rate?
So far I have found that if I aim to start around 12mmol, having reduced my basal by 90% 45 minutes before, and take on 10g of carbs as I enter the water (as long as it isn’t too cold), I should be ok to swim a mile (three laps round) and finish at around 6mmol. However, if the water is really cold this seems to reduce the drop in blood sugar due to the adrenalin boost. I ensure I leave my insulin pump safely in my car and keep my testing kit on the water edge, in a zip-lock bag, with a bottle of lucozade. As I’ve swum with the swimming club since being a child they are all aware that I have diabetes and can consume massive amounts of lucozade! No one bats an eye at my infusion sets, apart from to ask me where it is if it is under my swimsuit!
Next on to my inability to keep my feet and hands warm. Currently, I am the only person who is allowed in with neoprene booties and gloves – apparently it hinders your swimming. Even when it is swimsuit temperate (17 degrees) I still wear my booties. I know that in a swimming pool I struggle to keep my feet warm, so I won’t risk freezing my toes or damaging my feet. I’m not sure swimsuit and booties is the best look though…!
Finally, my post swim routine. Once I leave the water I am able to test and re-connect my pump. I enjoy a nice warm towel and warm clothes thanks to my hot water bottle keeping them warm. Once I’m home, I ensure I change my infusion set in case anything unsavoury has some how made its way inside and because if I leave it then it becomes very itchy! My friend who is an iron-man triathlete swears by diet coke post open water, or sea swimming, to keep the tummy bugs at bay. I always have a can in the car ready for on my way home.
I am now preparing to complete the Great North Swim in Salford Quays. Fingers crossed I can manage a bag drop 30 minutes before the swim time, warm up swim and the 1 mile swim all without my testing equipment or pump. Then manage to collect my bag from bag drop. I’ve a feeling I will be very happy to see my testing equipment at that point!