 Poster: A snowHead
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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martinm,  Do hope she's alright.
I skiied with a diabetic who was having trouble regulating his insulin, a couple of years ago. It was quite frightening, although all was OK in the end, and he enjoyed himself. He was, however, with people he knew well all the time, so any signs that things were going awry were spotted quickly.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Hope everything is ok and that whatever went wrong with lesson was not diabetes related. My brother has T1 and I have had to deal with the fall out of him not adapting to new situations quite a few times and it is always very scary.
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Nope, not diabetes related, thanks. Basically, very unorganised, she was last up the 1st drag, and no-one was there when she got up!!
Cue extreme stress, tears etc., Ski school not very helpful. Would love to post more, but until they at least offer my money back, I'm not gonna drop it - and the TO rep will make sure none of his customers uses the school in the future (he came with me to the school and wasn't impressed either).....
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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martinm, what bad luck. Terrible start. Val D'Isere seems to have loads of good ski instructors (at least, judging by recommendations on here). Any chance of persuading her to give it another go? One to one.
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martinm, how awful. Not a good introduction at all.
pam w, Freestyle Lite test strips are almost exactly the same price as the One Touch Ultra ones.
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Helen Beaumont, thanks very much - sounds like that would be a good bet, then. Especially as I found a BOGOF offer for the metres.
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pam w, Helen Beaumont, I too use the One touch Ultras, and frankly, given the amount of money my family and I have passed over the counter to the HM Gov in our working life, have little or no time to worry about the cost of test strips to the NHS.
National Insurance payments are a social responsibility that covers those members of society unfortunate enough to require them- very left-wing, but hey, I can be as schizophrenic in my belief system as the next 
The same logic applies to health, car or building and contents insurance - the many (capable) pay, the few (needful) claim. Why should you worry about claiming against a policy you have been paying into?
My dad, before he passed on, commented - I hope flippantly! - that thank God someone in the family was ill, to get some value back from all the NI stamps we'd been paying in for the past 50 years... He didn't survive long enough to claim a state pension, so as for qualms - nope, can't find any around here.
PS Do you remember all the furore when they started giving out disposable plastic syringes to recovering junkies, but initially insisted that diabetics pay for their own, or remain on the old "glass and daily sterilise" regime? Hopefully things have moved on since those 'enlightened' times.
martinm, hope your wife recovers from the trauma and gets back on the horse. It may not feel like it to her at the moment, but it is truly , truly worth the effort, and she should not need to use the bad experience or her diabetes as an excuse not to continue.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Martin , really sorry to hear of your tribulations. I hope you get through them and your wife enjoys the holiday and skiing. I am a type one diabetic, on injections, and have been skiing abroad regularly since 1984. I am no doctor, but have climbed in teh alps above 4000m and managed to cope, but not without the odd hypo. One thing that maybe hasn't been posted by others here ( and there is plenty of good advice above re test strips and altitude, some are affected , but its usually over 3000m altitude) is that your blood chemistry does change even at Val D village. The air is drier and its easier to get dehydrated, this can thickens the blood, you loose more moisture because you are breathing more, and harder. Altitude affects everyone very differently, and fitness is no indicator of an improved response. Your blood also changes as it responds to the requirement to produce more blood cells to acclimatize, and also in response to the harder breathing you are doing. These may affect test strips also? Or the pump meter ( do pumps have an integral meter - I know nothing about them!!). Just out of interest there are several easy to understand books on acclimatization available and are a worthwhile read for any serious skier.
Finally if your wife was with the ESF , then I am not surprised by the problems she had. Try and get here some instruction with one of the other ski schools in Val D . They all seem to have good reputations( but I haven't used them). If it was an instructor from one of the "other" val D schools then I am very surprised.
Good luck.
Steve
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Hi There,
I can highly recommend the following website/organisation for anyone who has diabeties.
It was initially set up by Nikki Wallis and active female mountaineer and national parks warden.
The site has very good information and you can always ring Nikki up for a chat about medical issues etc.
http://www.mountain-mad.org/
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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Its worth watching the effect that fear/adrenalin can have on blood sugars too. I took my son down the ridge leading to the grand coulior in courchevel when he was 14. He was ok going down the ridge but by the time we reached the top of the coulior he was into his second worse hypo ever, many dextros and about half an hour later and i thought it was a helicopter job. then as quickly as it came on, he was fine again and skied down. only time its ever happened like that but it wasnt long since he had tested and it had been about 7 so i put it down to the adrenalin?
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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DaveMcSki, interesting. Any doctors/biochemists etc come up with any relationship between adrenalin and blood sugar levels?
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DaveMcSki, pam w, I'm not a doctor(yet) but i can tell you a bit about adrenalin. I take it you have heard about the flight/fight response, well this is triggered by the autonomic nervous system(the one we have no control over) causing te release of adrenalin amongst other things. Adrenalin causes many physiological changes, principally increasing heart and breathing rate. These both require an increase in Glucose to sustain this increased activity, perhaps causing his BG to fall, but i cant imagine it having too much of an effect.
I have an anatomy session in an hour or so, and one of the facilitators is a physiologist and knows his stuff so i will forward this Q and get back to you...
Just thinking about it tho, adrenalin is secreted in conjunction with noradrenalin. Noradrenalin causes glucose to be released from energy stores(in muscle and the liver) so i can imagine the 2 would balance out. Certainly they do in someone who is not diabetic???
Haha i think i have proposed more questions than answers there!
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You know it makes sense.
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Noradrenalin causes glucose to be released from energy stores(in muscle and the liver) so i can imagine the 2 would balance out.
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Maybe the mechanism of noradrenaline is different in diabetics somehow?
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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jwhiteley1,
Adrenaline causes your blood sugar to rise.
What actually hapens in the practical situation ofp eople skiing with various things such as vaying excercise differnt diets etc basically means in my experience as the father of a diabetic that you need to test more often and workn it out from there.
Don't think asking your doctor usually helps very much.
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Poster: A snowHead
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T Bar,
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Adrenaline causes your blood sugar to rise
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and then crash.!
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you need to test more often and work it out from there.
Don't think asking your doctor usually helps very much.
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yep, agree completely. Not their fault, as you said, there are so many factors interacting(change of diet exercise excitement etc) that it is very difficult to predict.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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DaveMcSki,
Well the withdrawal of the adrenaline may cause the sugar to crash or the other things that are happening, but the pure action of the adrenaline should cause the sugar to rise.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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T Bar, so where does this sugar come from? - and, since I have ingested the sugar to balance the insulin injected, if it is used up more quickly than anticipated (and assuming the insulin IS used to extract / convert the glucose from the storage areas under adrenaline fuelled conditions and is thus exhasuted) - then in the words of Question of Sport: what happens next?
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You need to Login to know who's really who.
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It's quite possible that when it expanded it pushed more insulin through the tube.
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Good observation Watson - this could have made a big difference in the first 24 hours but not since then. You might expect the converse when you get back to sea level. Looking forward to hearing your experiences in the fullness of time - good luck... 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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JimW,
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T Bar, so where does this sugar come from? - and, since I have ingested the sugar to balance the insulin injected, if it is used up more quickly than anticipated (and assuming the insulin IS used to extract / convert the glucose from the storage areas under adrenaline fuelled conditions and is thus exhasuted) - then in the words of Question of Sport: what happens next?
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Not quite sure what you mean here but the sugar comes form the glycogen stores.
'assuming the insulin IS used to extract / convert the glucose from the storage areas'
It isn't, Insulin causes the glucose levels to fall as I am sure you know, not quite sure what you mean. But the glycogen stores are unlikely to be exhausted however if you are still burning sugar and have Insulin on board your sugar levels can fall and you may have a hypo.
Edited a comma in
Last edited by Anyway, snowHeads is much more fun if you do. on Wed 3-02-10 10:16; edited 1 time in total
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| Mountain Haddock wrote: |
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It's quite possible that when it expanded it pushed more insulin through the tube.
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Good observation Watson - this could have made a big difference in the first 24 hours but not since then. ... |
Not to sure about this, the Insulin in the pump is short acting and the increase in the size of the bubble should be pretty quick, almost instantaneous the effect would be over in much less than 24 hrs I would have thought. Not saying it didn't happen but would be suprised if there was any effect more than a couple of hours after the ascent.
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Right, turns out my tutor is a Neuro-physiologist(handy seeing as we are doing the Neuro module:-p), hence he does not know much about endocrine-physiology...dead end.
T Bar,
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It isn't Insulin causes the glucose levels to fall
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Well it is actually it is, Insulin stimulates the entry of glucose into the muscle, adipose and liver. Thus reducing the concentration of glucose in the blood...
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T Bar, sorry, wasn't quite clear - a re-read will often point that out to me!
The insulin is the mechanism that converts the eaten carbohydrate into a useable form of energy... or so I've be led to believe these past 35 years ... and whereas a normal pancreas will produce the insulin necessary to match the sugar intake, for us T1s we put the insulin in, and match it with the sugar.
So, if the available sugar becomes execssive due to adrenaline pulling it from the body's stores for example, then the contention is that the insulin will get 'used up' converting it to a useable form, leaving a high level of sugar in the blood stream that has no reagent left to convert it, thus resulting in hyper, or high blood sugars.
Also btw, rendering the desired 'fight or flight' "strength plus" capability worthless - in fact worse than that, since the drowsiness you would normally associate with high blood sugar levels becomes a debilitator rather than an accelerator.
Yet experience suggests that a consistent level of medium to intense exercise (which ought to be a factor potentially unlocking the stored reserves) such as running 13 miles, or a days skiing at altitude has the opposite effect, and we should reduce the amount of insulin taken when indulging in an activity that would normally be associated with carbo burn. Hence my initial post including the word 'counter-intuitive'.
So: we use up what we eat, the body reacts by opening up the storage areas to give more "energy", we have less conversion capability injected, and yet people still seem to suffer hypos or low blood sugars in the mountains.
It doesn't make sense, IF the assumptions about the mechanisms are correct. So either
1) I've been keeping myself alive under a false premise for these past 35 years, or
2) there's another mechanism at work under certain circumstances, of which I / we understand little.
I hope it's not (1) !, but am asking to see if medical science has any theories about (2)
(such as the adrenaline/noradrenaline itself being able to converst stored glygogen to a useable form without the use of insulin, for example).
Hope this makes more sense,
J
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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jwhiteley1,
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T Bar, Quote:
It isn't Insulin causes the glucose levels to fall
Well it is actually it is,
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Oops, missed a comma between isn't and Insulin.
JimW,
Don't claim to have specialised knowledge about Insulin/diabetes but my understanding is:
Although Insulin is necessary for the uptake of sugar into cells and its utilisation, it is not 'used up' by that though but is steadily metabolised. The rate at which the carbs enter cells is not dependant solely on Insulin but also the metabolic rate of the cell. Thus if you are excercising hard although you need a smalll amount of insulin you need far less as the cells are pulling the sugar in.
If you put in the usual amount of Insulin and carbohydrate when excercising you will go hypo as the body does not need this amount of Insulin to utilise the carbs. So you have to either decrease the Insulin or increase the carbs or frequently both.
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JimW, In a normal pancreas. Insulin secretion drops and glucose regulating hormone levels increase once exercise starts,then the muscles change from using muscle glycogen to free fatty acids and liver glycogen as its fuel source.
In a diabetic, Insulin levels do not drop with exercise and the glucose counterregulatory hormone reaction may well be reduced by previous exercise or hypos, so the liver doesnt get the same command to produce glucose. Also, the the blood flow around the injection site and the muscles increases so you get faster absorption of the insulin, and during exercise the muscles greatly increase the amount of glucose they can use without insulin. Thus Hypo.
However
High intensity exercise can increase BG, probably due to insufficient insulin to counter the ketones etc which are produced at this intensity and the increased levels of counterregulatory hormones, In my experience insulin taken at this stage to bring BG down leads to a almost certain Hypo 40 mins to an hour later
Proviso: Im not a doctor, This is just what i learned/absorbed over many years trying, (and failing) to train a T1 diabetic to be a competition tennis player
Conclusion, As has been said before. You need to test lots and see if you can work out whats going on from there.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| increase the carbs |
Now that sounds more like a holiday!
But thanks: makes sense, and fits the observed conditions.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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| martinm wrote: |
| Well, very bad lesson experience, no more skiing for her ever, and I'm about to visit the Ski schoolwith 2 resort reps...... More to follow depending on the outcome. |
Don't know if this will be any help at all, but back in November my chum, a nervous one week skier, had a complete and utter wobble on the glacier at Tignes. Tears, snot, shaking and paralysis..I think right then and there she hated me (& we've been very good friends for years) and swore that she would never ski again. I left her with Rorie from Abraskidabra (he posts here) and after a fw hours returned to find her smiling, happy and confidently snow ploughing down an easy red (the only slope open that remotely resembled anything easy).
If you've time and inclination get hold of a private instructor and see if you can get her some confidence.
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If you've time and inclination get hold of a private instructor and see if you can get her some confidence
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Absolutely. I have sometimes spent ages, pleading with people to take a lesson, or bullying/threatening/bribing etc etc. On every single occasion they've come back smiling and elated, on a real high.
But you need to get the right instructor - plenty of recommendations available here. And preferably nice weather, and preferably an unthreatening environment. Has to be said that Val d'Isere is not good nervous beginner territory, especially in cold weather.
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You know it makes sense.
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For a British private instructor in Val'd I suggest you contact Nick at www.skiencore.com - I had a private lesson last week and one last year, better than any previous lessons.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Well, went to a quiet learner slope today (by Funival in Daille), where my friend got her down twice - a bit of ski tip holding etc., - she did well, and the TO Rep has arranged a 2hr private lesson tomorrow, and he and the instructor know the situation!!
plus it's warm today (has been -20ish, above 0 today) so had a nice time in the sun eating and drinking - she's actually enjoying hereslf anyway which helps. 
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Poster: A snowHead
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martinm, I'm pleased she has the nerve to try again.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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martinm, brilliant. Hope the weather and the confidence both hold.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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martinm, that is good news 
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You need to Login to know who's really who.
You need to Login to know who's really who.
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martinm, great news. Yes, the warmer weather is very pleasant.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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You'll need to Register first of course.
You'll need to Register first of course.
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melissagwen
melissagwen
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From what I know, the altitude have not an effect on the insulin pump.
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