Type 1 diabetes, two wheels and 222 miles in Switzerland! By Mark Straw

From a medical point of view, I faced 3 challenges

1. Type 1 diabetes.

2. Coeliac disease, meaning a strict gluten Free diet.

3. A recently discovered hole in my heart that when I do vigorous exercise, opens up and

de-oxygenated blood flows from the right side to the oxygenated side.

This reduces the available oxygen in my blood. Don’t worry, my heart consultant said.

It is safe for me to exercise with one exception – just don’t go scuba diving!

Getting myself prepared

Training in earnest started in February. I’m already fairly active – competitive swimming and training 3-4 times a week, bike rides 3 times a week, dog walking every day, badminton and the occasional gym session.

Through my trainer at the gym, I was shown the specific leg training exercises, squats with weights, goblet squats, walking lunges and dumbbell dead lifts. All new to me, as a swimmer I had concentrated on upper body strength exercises.

On the cycling front I increased the length of rides from 30 miles to 40-48 miles and with the “speedsters” on a Sunday morning I increase my speed.

The challenges of T1 diabetes

The main challenge is with blood glucose levels varying day by day. On one day they will be fairly consistent for the whole day with the occasional “too low” alert, then I will do the same ride on another day with the same amount of carbs and insulin but that ride results in my blood glucose crashing.

Hot weather is a hindrance with glucose levels lower than on a cooler day.

I’m lucky to have the Tandem t:slim X2 insulin pump with Control-IQ technology. When I first got the pump, I was put in touch with a highly qualified sports nurse at Air Liquide (Kathryn Fraser) who I chatted to a lot and she gave me some valuable tips on the pump use with sport. The key ones are to alter basal levels dramatically from say .75 units per hour to 0.15 units per hour or nil plus also increasing the correction factor to 1u:7.5mmol.

Lessons learned during training

(a) Monitoring blood glucose (BG) levels whilst riding for 4-6 hours per day.

Initially I would check levels by stopping, getting my phone out of my back pocket and checking Dexcom levels on the phone. However, when you are in a large group this is not always convenient. Dexcom can set an alarm at 5.5 but by the time you’ve stopped at the alarm it takes another 15-30 minutes to top up glucose levels. However, purely by chance and through a contact at Garmin, I found out that certain Garmin watches and cycle computers can link to Dexcom readings. With fantastic help from the Garmin Helpdesk, I have set this up and for the majority of the ride I can view my BG levels, occasionally when signal is poor, the reading drops out. This benefit has made a fantastic difference to the way I ride.

b) My top tips to boost your glucose levels

For years at both swimming and cycling I have used a glucose drink made from orange squash, sugar and water, supplemented by Jelly Babies, however especially on cycling the amount of sugar in the drink has increased and the thought of taking 3 kgs of sugar in my pannier was just not going to work. Luckily, I read an article by a Type 1 in the United States who recommended Dextro tablets as they get into the system much quicker. The modern Dextro tablets are now much tastier with a multiple array of flavours. I have converted and they are great.

To conclude, the challenge was still daunting, but I was as fit as I could have ever been at the age of 67 and the 4 friends (not living with T1 diabetes) I did the ride with supported me all the way.

So, on with the tour!

Day 1 Monday, travel day.. Car, plane, bus, train, airport lounge.

A long day of travel but we got to the beautiful medieval city of Luzern and had time to explore. Medieval buildings, pretty fountains (safe water to drink) & a unique medieval bridge.

A great start to the tour.

Day 2 Tuesday - Luzern to Gurtnellen - 48 miles and 740m ascent

A fantastic introduction with amazing views across Lake Lucerne, a ferry crossing and trip on a lorry for 2 miles on a road that was too dangerous to ride. Also a close call with disaster! A split second lack of concentration led to right arm injury. But no broken bones and the bike was undamaged. The tour can continue…

Day 3 Wednesday - Gurtnellen to Disentis - 29 miles and 1344m ascent 874m descent
Proper climbing now, but the result was spectacular scenery, the Schollenen Gorge that climbs up to the Devils Bridge where we stopped to admire the bridges. From there it was a short ride into Andermatt . Steeper climbing now up  to the top of the Oberalppass, stopping occasionally for a drink, or to top up the sunscreen. The 7 mile climb took just over an hour.  The cafe at the top provided a non-alcoholic cider and fantastic views including a lighthouse! Yes, a lighthouse!

Day 4 Thursday  - Disentis to Chur 44.37 miles, 730m of ascent

The worst day weatherwise and the only time in the whole tour that I needed my rain jacket.

Despite the rain and having at one point to shelter in a barn, stopping for lunch in Ilanz we carried on, the roads were wet as we descended down through the hairpin bends of the Versam Gorge, stopping to admire the view from the old bridge over the ravine. After this we rode on the minor road along the edge of the spectacular Ruinalta Gorge [called the Swiss Grand Canyon] where it was cut into the steep cliffs that rise from the river far below. 

Eventually we arrived at our hotel stop in Chur, wet and cold, but pleased that we had seen the spectacular views.

Day 5 Friday - Chur to Medels im Rheinwald - 35 miles and 1142m ascent

For me this was the best day of the tour,  the group split into my group of 5 "Mountains and Lakes" and the other 6 doing the "Rivers and lakes."

Great views through "Polenweg" a mountainous forest trail and after some miles on the flat  we got to  a very steep climb up the old road,  (not open to traffic now).

"Viamalweg" with views of Viamala ,"Via mala", Romansh for "evil road". Yes it was hard going with a few potholes, but we made it.

Our hotel in Medels im Rheinwad was very remote but the Swiss/ Italian couple looked after us very well.

Day 6 Saturday - Medels in Rheinwald to Bellinzona - 51 miles and 901m ascent

A very hot day, starting at 8:30 it was 25C and it got hotter. The object of the day was to climb up to the top of the "San Bernadino pass".

I felt strong and led the other 4 up the 26 hairpin bends to the cafe at the summit . We were a long way up and it was 40 miles down to Bellinzona.

Started with 85 hairpin bends, not sure of that number, but there were a lot!

A luxurious and mega expensive hotel on the outskirts of Bellinzona was at the end of a hard day’s riding. Air conditioning in the room was most welcome.

Day 7 Sunday - Bellizona to Schauffhausen via Goschenen - 24 miles and 1010m ascent

We saved the most difficult climb until the last ride. Lots of hairpins up and most of the way on cobbles, I know now how the Tour De France riders feel.

Climb was an average of 7.25 % with the steepest at 11.3%.

I wasn't expecting cobbles on the way down, but yes at the start they were there, then we  got onto the busier roads to the bottom, we were faced with a strong head/cross wind . With heavy panniers this caused my bike to shimmy. A bit frightening, but I survived.

Lunch in the cafe used by the workers who are working on a second Gotthard road tunnel , some time  to wait for the train and we explored more. Great views again.

Day 8 Monday - Schaffhausen to Basel and home - both groups together again

An unexpected treat, early breakfast and then one of the group said let’s walk to see the famous Rheinfall about 2.5 miles from the hotel. A hard slog , but well worth it. Then by train to Basel and a quick walking tour.

Home to Gatwick and a late drive home. A fantastic experience and Switzerland has some stunning views.