La Marmotte – a guest post by John Grumitt


We have a guest post today from John Grumitt, one of our Vice Presidents (he was also on our Board of Trustees for over nine years). John likes cycling. He likes cycling a lot… In the past he’s cycled from John O’Groats to Land’s End to help raise vital funds for Diabetes UK, and if that wasn’t enough, he’s recently undertaken the rather gruelling La Marmotte – a 174km ride taking in 4 of the biggest climbs in the Alps. And John’s done all this whilst expertly managing his Type 1 diabetes.

Here’s John’s story about how he got on…

“An ordinary bloke, with Type 1 diabetes completed one of the big cycling challenges, La Marmotte, in the French Alps. To hopefully give credence to the idea (almost) anything’s possible, here’s how it was done.

First, a little by way of background. Soon after 7am on Saturday 7th July, 7,000 brave/foolhardy people from numerous countries set off on a 174km ride taking in 4 of the biggest climbs: Glandon, Telegraph, Galibier and Alpe d’Huez. This meant peddling up well over 5,000 vertical metres before completing the journey just over 10 hours later (11 hours if you include stops for food and water).

In preparation I got expert advice from the sports team under Ian Gallen at High Wycombe Hospital. Although this meant some travel, getting expert advice on how the body responds to such challenges gave me confidence and avoided unnecessary complications. Alistair Lumb and Carin Hume in his team were superb in telling me how and when to adjust my insulin dose (to roughly 20% of normal) and what, how much and when to eat before, during and after. It became absolutely clear that the fittest person on the best bike would not finish without getting this right.

As for the bike, yes, you need a reasonable bit of kit but there is also an expression: “all the gear and no idea” and there was plenty of evidence of that. I had my bike serviced the week before to ensure that absolutely everything was in tip top condition. After all, you don’t want a mechanical failure as you descend from a mountain top.

I had a great coach at my local gym who created a schedule that enabled me to train without completely destroying my family and work commitments. We trained and monitored performance every step of the way. This together with a long ride over one morning at the weekend built the endurance and strength fitness.

Stephanie Amiel’s the team at King’s College Hospital had me very well set up with a pump and a CGM (continuous blood monitor) which with my hypo unawareness gave me valuable data on which to make decisions. The graphs from the monitor allowed me to spot the blood glucose trends and adjust accordingly.

Fueled by a hearty low GI breakfast about 2 hours before, we set off. The buzz of being in such a large group with mountains towering all around set the adrenalin running. I had a very clear idea of what to do: not to set off too fast, regular intake of water and carbs and to keep an eye on the blood glucose trends. Oh, and concentrate a bit on the cycling too.

The climbs were tough but that detailed preparation allowed me to keep peddling at a steady pace. After the toughest climb of all, Galibier (2,642m), we decended 40km and 2,200m before the final climbing the legendary 21 switchbacks up to Alpe d’Huez.

After a really good day, I failed to take enough insulin with my food at the top of Galibier and on the long decent was not using much energy. As a result my blood glucose rocketed to over 20mmol in under an hour. Ahead lay a 1,000m climb and with bloods over 12 I knew my power would be severely limited. I took a corrective dose, made sure I had a glucose gel ready and set off. After about 3km painful cramp set in forcing me to walk for about 500m. I drank lots of water with added electrolytes but no sugar.

I should add at this stage, as well as the uber fit racing up the hills, lots of mere mortals were finding things tough. Rapidly my blood glucose fell towards normal and with it the feeling of fatigue and cramps seemed to go. Almost without realizing it I found I had renewed energy and started enjoying the final climb. I checked my monitor which read 6.1. Elated, I pushed myself to the top and onto the finish in the ski resort.

To others contemplating such adventures my tips would be:

– Get the experts to help you. They are out there, and all available to you as part of your treatment.

– Having friends and family alongside spurs you along and, if your lucky, as I was, will offer valuable support.

– Have a detailed plan and stick to it.”

Thinking about doing something similar, or just starting to do more exercise? Speak to your healthcare team to let them know what you’re planning and they can help you manage your diabetes every step (or kilometre) of the way. You can also get in touch with our Careline who can offer some great support and advice. Good luck!

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Just read your “Tackling La Marmotte” which I found very interesting. I have been diabetic for about 30 years now (I am 40) and have been into triathlon for the past 6 years. This year I was hoping to step it up and do longer distances however chicken pox and another viral infection has left me feeling currently awful so 2013 is not my year. It is good to know people like us are out there in the semi-competitive world of sport – just wish there were more doctors aware of the specifics of competing and adjustments which need to take place.
Thanks again for your article – just wish I was well enough to do more at the moment but 2013 is a rest year for me now.
AJ