Howdy again,
Training has been going good as of late. I have my system pretty down now, and am enjoying life. I wanted to give a post not so much about the wacky basal rate changes, but more about an actual bike ride.
Yesterday, on the phone by 8am doing the usual. At 9:30 eat breakfast (2 packs of oatmeal) with 3 units of Apidra. Apparently I misjudged as I went up a bit, and had to do a correction of 2 units, which at 11am had me dropping. I think at one point I was 142 with an arrow straight down, so I snacked on some juice, had an apple, and leveled off at 107 by 11:15. I had a conference call set up for 12, and then planned to hit the bike for a 4 hour training day immediately after. At 11:45 I had 2 more packets of Oatmeal (no bolus,) or 60 gms of carbs, and the arrow began to go up. By the time I left the house at 12:15, I was at 148 with an arrow pointed slightly up.
Quick arrow definitions:
If it is going straight up or down, it means blood sugar is change at least 2 points per minute, sometimes more.
If it is at a 45 degree angle, then it is changing at 1 point per minute. Very helpful to plan ahead.
I knew I was going up. I set out on the ride with 3 almond bars, at 160 calories each, a banana, a cliff bar, Dex4, 1 bottle of water, and 1 Gatorade.
25 minutes into the ride I was 160, with no arrow. This meant that I was leveling off, and I was thinking I would either flat line, or begin to drop. 15 minutes later, I checked the Navigator, and I was at 148, so the drop had begun. I drank some water (fluid before food helps digestion) and then ate the banana. 1 hour into the ride, I was at 118, so I ate a almond bar. 20 minutes later, was at 111, so I ate another almond bar, this time with Gatorade in advance. I am not riding a real fast pace right now, so I am very comfortable riding with a blood sugars between 90-160. If I were racing, I would want them higher, say 130-180. At 1.5 hours I was at 99, with flat arrow, but noticing a slight downward trend. I ate my last almond bar (these things are really good!!!) drank some Gatorade, and I knew I would be good. I did not look at Navigator until about 2 hours 20 minutes into the ride, when it got to 91. I stopped as I needed fluids, got a coke, and Gatorade. I drank about half the coke (40 gms carbs) on the spot, and then put the rest in my bottles. I rode the rest of the way without looking. I knew I was good, felt good, and continued to take a coke/Gatorade mix in for the last 1-1.5hrs. Should have had more though, as when I got home I was 88 with an arrow pointed straight down.
The recovery process: 88 arrow straight down: Went straight for about 45 gms carb/15 gm protein from Chocolate milk, then put 162 gms of pasta on the stove. This is about 120 gms of carbs. I ate the pasta, and then bolused 5 units of Apidra. Blood sugar went up to 148 before dropping, and 1.5 hours after my ride I had some Dex4, and an apple which leveled me out, before grabbing sushi with my brother Jack at 7:30, or 2.5 hrs after my ride. Typical dose for sushi would have been 5 units, but I did 2, and blood sugar was great!
Before ride carb/insulin ratio seemed to be about 15/1, and after ride 30/1.
Exercise does make a difference.
Last night continued on my split dose Lantus, with a 4 unit bolus of Lantus at 10pm.
Then Southpark, and asleep by 10:35...
That is a very typical day, and how "my" body works for training. I hope this helps.
Have a great day.
Phil
Team Type 1
Thursday, November 20, 2008
Tuesday, November 18, 2008
Platinum Baby!! a little diabetes stuff
Howdy again,
Platinum?? So today I hit the mark, 75,000 fly miles on Delta this year which is the mark to hit their Platinum status. I think I have been on 65 separate flights with them this year, and it gave me some time to reflect. What exactly do you do when on a plane this much. Let's look at some #'s: 65 flights with average of 1.5 hours on the runway per flight not counting fly time. =97.5 hours
Then 75,000 miles at 500mph = appx 150 hours of fly time.
Then time before check in: avg 1hr, and 45 minutes spent at airport after flight or 105 hours
for a grand estimated total of: 14.7 days spent at airports or on planes. Not factoring in delays, driving too, and from airport.
Which begs the question: What in the heck do you do? So I went and took a look at my book shelf, and counted 34 books read this year. Some great ones, some not so good ones, and some that just pass the time.
I really don't mind all of this fly time, as it does give me a chance to escape into the world of words. I have no contact with email/phone while flying, and I get to read, which I love to do. I am on book #35 right now, and kind of half-way reading 2 others, and have another 10 or so that I want to read before the year is out.
So I would say that if you tend to get stressed out when jumping on a plane, grab a book in the bookstore that every airport has. It really takes a lot of the stress out, and also makes it easier (for me) to fall asleep on the plane.
Now for diabetes... I am still splitting my doses of Lantus. Doing 5 in the am, and 4 at night. I didn't work out yesterday, and that was too little. Woke up a little elevated at 4 am, did a small correction and woke up at 78. Plan is to hit the gym, and then ride in the 45 degree weather, and will stick to 4 tonight thanks to the elevated metabolism.
Now, I know it seems like I make a lot of changes, but I think that is the bike racer in me doing it. If I did not change training every day, I would probably do the same amount of insulin give or take a few units of Apidra day after day. But when riding/racing a bike, you have to be on the lookout for new ways to improve, which is why I am always switching things up. It may seem from some of my last posts, that diabetes is the most complicated disease in the world (which it can be at times...) but to me I go by feel. I am CDE's worst nightmare, because I do not carb count, and I wing it every time. It just so happens that I can look at a plate of food and judge what I need, which I bet you can too.
My challenge to you: Before factoring carbs, correction, and bolus needed next time, take a guess at what you think you would do. Then compare to what the "real" calculations say. I would say you can probably do it by feel as well. At Camp Kudzu a few years ago, I worked with our clinician Susie Smith. She was cool with me not carb counting, and playing the guessing game, but she wanted to expirement. So I counted the carbs, told her what I ate, while giving the amount of insulin I thought I needed. It just so happened that 98% of camp I was on a carb/insulin ration of 18.75/1.
Internally I knew, and I bet you can too. Give it a try, and let me know what you think.
If you do this, please double check afterwards to ensure you did it right.
Thanks for reading!
Have a great day.
Philpott (yes, this is in fact my middle name. Thanks mom...)
www.teamtype1.org
Platinum?? So today I hit the mark, 75,000 fly miles on Delta this year which is the mark to hit their Platinum status. I think I have been on 65 separate flights with them this year, and it gave me some time to reflect. What exactly do you do when on a plane this much. Let's look at some #'s: 65 flights with average of 1.5 hours on the runway per flight not counting fly time. =97.5 hours
Then 75,000 miles at 500mph = appx 150 hours of fly time.
Then time before check in: avg 1hr, and 45 minutes spent at airport after flight or 105 hours
for a grand estimated total of: 14.7 days spent at airports or on planes. Not factoring in delays, driving too, and from airport.
Which begs the question: What in the heck do you do? So I went and took a look at my book shelf, and counted 34 books read this year. Some great ones, some not so good ones, and some that just pass the time.
I really don't mind all of this fly time, as it does give me a chance to escape into the world of words. I have no contact with email/phone while flying, and I get to read, which I love to do. I am on book #35 right now, and kind of half-way reading 2 others, and have another 10 or so that I want to read before the year is out.
So I would say that if you tend to get stressed out when jumping on a plane, grab a book in the bookstore that every airport has. It really takes a lot of the stress out, and also makes it easier (for me) to fall asleep on the plane.
Now for diabetes... I am still splitting my doses of Lantus. Doing 5 in the am, and 4 at night. I didn't work out yesterday, and that was too little. Woke up a little elevated at 4 am, did a small correction and woke up at 78. Plan is to hit the gym, and then ride in the 45 degree weather, and will stick to 4 tonight thanks to the elevated metabolism.
Now, I know it seems like I make a lot of changes, but I think that is the bike racer in me doing it. If I did not change training every day, I would probably do the same amount of insulin give or take a few units of Apidra day after day. But when riding/racing a bike, you have to be on the lookout for new ways to improve, which is why I am always switching things up. It may seem from some of my last posts, that diabetes is the most complicated disease in the world (which it can be at times...) but to me I go by feel. I am CDE's worst nightmare, because I do not carb count, and I wing it every time. It just so happens that I can look at a plate of food and judge what I need, which I bet you can too.
My challenge to you: Before factoring carbs, correction, and bolus needed next time, take a guess at what you think you would do. Then compare to what the "real" calculations say. I would say you can probably do it by feel as well. At Camp Kudzu a few years ago, I worked with our clinician Susie Smith. She was cool with me not carb counting, and playing the guessing game, but she wanted to expirement. So I counted the carbs, told her what I ate, while giving the amount of insulin I thought I needed. It just so happened that 98% of camp I was on a carb/insulin ration of 18.75/1.
Internally I knew, and I bet you can too. Give it a try, and let me know what you think.
If you do this, please double check afterwards to ensure you did it right.
Thanks for reading!
Have a great day.
Philpott (yes, this is in fact my middle name. Thanks mom...)
www.teamtype1.org
Sunday, November 16, 2008
split dose basal- Diabetes game again...
Howdy from Atlanta,
I like saying "from Atlanta!!!" As of tomorrow night, it will be 2 full weeks, yes 14 days that I have not stepped on an airplane. I believe this is the single longest stretch since mid February, and it rocks. It is good to be home, see friends, and have a semblance of a schedule. Life is good, and biking is great!!
So last time, I think I made the cut to 9 units Lantus. That was a bit too much still for the early part of the night, but a touch too little for the night. When my metabolism is going, it goes, and a bigger dose almost feels like rapid acting insulin plus. So about 4 am, I saw 155 with an arrow trending up, did a .5 unit of Apidra, and woke up at 80. I decided it was time (thanks Dr. Howard Zisser) to go to split dose. I did 3 units the next morning, and had a good day. Friday was I able to train for 2 hrs, and felt decent. Then Friday night, laid low, and did 6 units for a total of 9 units of basal. Had to eat extra at night due to the pop. Saturday went for 4 units in the am, had a big bowl of oatmeal, with no bolus, and then hit the road for 4.5 hours. Got lost, which added the extra hour. Blood sugar went up to 220 in the early part of the ride, but 2 hours in I began dropping, and eating. Stabalized at 110, and kept eating and eating. Got home with a bg of 77, did 5 units Apidra, and had 160 gms of carbs (pasta and chocolate milk) and 40 gms protein. After 1 hour, I began to drop again, so ate some fruit. Dinner consisted of a salad, fruit, and steak.
Last night I went to 5 units, still having the 9 units of basal, but thanks to the split dose, I have had no hypo's. This morning, it was 5 units of Lantus, and tonight I will do 3-4. It has been a slow transition, but I think I have finally found the sweet spot. Curious to see if with the split dose, my basal will decrease much more??? The lowest I have ever gotten was 6 units of Lantus split 3 in am, 3u pm.
Today is another 4 hour day on the bike, and tomorrow a day off! Time to get dressed, and see if I guessed right today!
I hope all is well.
Have a great day.
Philpott
www.teamtype1.org
I like saying "from Atlanta!!!" As of tomorrow night, it will be 2 full weeks, yes 14 days that I have not stepped on an airplane. I believe this is the single longest stretch since mid February, and it rocks. It is good to be home, see friends, and have a semblance of a schedule. Life is good, and biking is great!!
So last time, I think I made the cut to 9 units Lantus. That was a bit too much still for the early part of the night, but a touch too little for the night. When my metabolism is going, it goes, and a bigger dose almost feels like rapid acting insulin plus. So about 4 am, I saw 155 with an arrow trending up, did a .5 unit of Apidra, and woke up at 80. I decided it was time (thanks Dr. Howard Zisser) to go to split dose. I did 3 units the next morning, and had a good day. Friday was I able to train for 2 hrs, and felt decent. Then Friday night, laid low, and did 6 units for a total of 9 units of basal. Had to eat extra at night due to the pop. Saturday went for 4 units in the am, had a big bowl of oatmeal, with no bolus, and then hit the road for 4.5 hours. Got lost, which added the extra hour. Blood sugar went up to 220 in the early part of the ride, but 2 hours in I began dropping, and eating. Stabalized at 110, and kept eating and eating. Got home with a bg of 77, did 5 units Apidra, and had 160 gms of carbs (pasta and chocolate milk) and 40 gms protein. After 1 hour, I began to drop again, so ate some fruit. Dinner consisted of a salad, fruit, and steak.
Last night I went to 5 units, still having the 9 units of basal, but thanks to the split dose, I have had no hypo's. This morning, it was 5 units of Lantus, and tonight I will do 3-4. It has been a slow transition, but I think I have finally found the sweet spot. Curious to see if with the split dose, my basal will decrease much more??? The lowest I have ever gotten was 6 units of Lantus split 3 in am, 3u pm.
Today is another 4 hour day on the bike, and tomorrow a day off! Time to get dressed, and see if I guessed right today!
I hope all is well.
Have a great day.
Philpott
www.teamtype1.org
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