Howdy From Atlanta,
The game has taken a twist. If you recall, about 10 days ago I would have to eat everything in site, and then some on rides. Insulin was being cut drastically. I think that was my body being inefficient at fueling on the bike, as a major switch has happened.
I have had to increase basal a touch, and think I am going to get it up some more. The past 3 rides I have done, eating the normal goods before hand, oatmeal, my blood sugars have skyrocketed. I have been getting up to 250 on the rides, and then a slow drop down to the 180's, and if I eat, BS goes right back up. Yesterday for example, I had a total of 40 grams of carbs on a 3 hour ride.
I think my body is now becoming more efficient, and I may be able to add some additional basal, or I may need a very small bolus (.5 unit of Apidra) with meal before ride. Today I am driving home to see mom, and should be on the bike by 11am for a 4hour ride. I am going to eat my oatmeal, with .5 units, and see what the reaction is. I do enjoy not having to stuff my face on the rides, however, I would much rather be between 140-180, than 180-220.
It is great having the FreeStyle Navigator, so I can really monitor these adjustments, and know immediately if I made the right call.
Although, I initially thought this is crazy, thinking back it happens every year. Insulin drop, drop, drop, and then all the sudden, add, add, add... If I can keep the training going without interruption this will be very helpful for racing, as I won't be stressing about low's.
It is also good for training, and my pockets won't be so stuffed full of food, and bars for my rides.
This is the start of week 4 of training post hamstring break. It took 2.5 weeks for the switch to happen. Could this be the same for non-diabetic metabolism? Has anyone out there with diabetes had similar experience with fueling?
Also, working with some top docs on potential research studies, and trying to find out more info for you. More details to come!!!
Very exciting step for me here, now time to fine tune it a little more to ensure I am at the best on the bike with both legs, and blood sugars.
Have a great day.
Merry Christmas, Happy Holiday, and Happy New Year to ALL!!!
Phil
Wednesday, December 24, 2008
Sunday, December 21, 2008
Diabetes Game- closer to the solution
Howdy from Atlanta,
How is everyone doing? Great question from Stella's mom, about why I wasn't back on the pump. In diabetes, there are a million ways to skin the cat. I had raced for 6 years on Lantus, and made a lot of mistakes, but more importantly learned a lot of lessons. So when I was on the pump, I found I was having a lot more lows on the bike, and then off the bike too which was causing me to eat way too much food. With Lantus, by making a 1 unit adjustment of Lantus/day, I can essentially make a .05 unit/hr basal adjustment, which is a big deal. I change my basal daily, and doing this on the pump for me is too much manual labor. I have done over 50,000 injections in my life, so 5-7 more a day, to me, is no big deal.
Also, why does exercise = less insulin: When exercising, the muscles become more sensitive to insulin, both basal and bolus. The body will naturally burn more calories per day, which means less basal needed, and the muscles are much more sensitive to insulin post exercise which = less bolus/meal. Not sure if there has been a science experiment, and I could be wrong, but that is my guess, and I have not had a doctor argue yet...
So the diabetes game: Last weekend I cut it a bit, and on Sunday was good. Blood sugars were up in the 200's, and I was eating a bit, but felt good. I have decided to start doing my 2nd shot of Lantus after my rides. So it is kind of a temp basal. Lately I have been doing 6 at night, and 3 in the afternoon. Tuesday I did that, and went pretty high on the ride up to 257, before I started trending down. I only had to eat about 400 calories on a 3 hour ride, and I was flying. Wed, I had a bit more basal, 7 units night, 3 in am. I went up to 220, before dropping to 150, and was eating a bit more. 800 calories on a 4 hour ride. After that ride I kept dropping, so I that night I dropped Lantus dose again to 6 units. Had to do a small bolus of .5 unit of Apidra in the middle of the night. Thursday was a 3 hour ride, and I can't really remember what was going on...ha Lots of activity this week. I have done yoga on Tues-Thurs, and Sunday this week. Stretching every am. Friday I only road for 1.5 hrs and was real tired, then Saturday did a mountain bike ride with my buddy John Martin!!! I figured this was going to be hard, and slowly rose my BG to 200 at the start. Within 20 minutes I ate a king size snickers, and 15 minutes later some other bar. Blood sugar was 220 trending up said the Navigator! So I began to drink water, until at some point I saw 287. For the last 2 hours, I did nothing but drink water, and dropped to 215. These #'s are a bit higher than I would like. I am obviously under insulinized, so I think the switch needs to be 7 units at night, and then 3 after ride of Lantus.
But the higher blood sugars are making me feel very, very good on the bike. But I don't want to completely sacrifice a good A1C for performance. If I could raise it to 5.8-6.0, I would be happy. Higher... not so sure. But that is me.
Yesterday a good friend got some great news, and I am happy for her. I got some bad news, and it was a rough day. All will be ok in the long run... The work week was pretty stressed. But the thing is, making time every day to ride, really, really helps. No matter how much crap is piled on, I have not given an inch when it comes to my riding, and yoga. So for anyone out there if the stress seems to pile up, I would encourage you to get out and ride a bike, take a walk, or bit the gym, as it puts everything else at ease.
Thanks for reading, and sorry for the jumble of #'s.
Have a great night, and Happy Holidays!!!
Phil
How is everyone doing? Great question from Stella's mom, about why I wasn't back on the pump. In diabetes, there are a million ways to skin the cat. I had raced for 6 years on Lantus, and made a lot of mistakes, but more importantly learned a lot of lessons. So when I was on the pump, I found I was having a lot more lows on the bike, and then off the bike too which was causing me to eat way too much food. With Lantus, by making a 1 unit adjustment of Lantus/day, I can essentially make a .05 unit/hr basal adjustment, which is a big deal. I change my basal daily, and doing this on the pump for me is too much manual labor. I have done over 50,000 injections in my life, so 5-7 more a day, to me, is no big deal.
Also, why does exercise = less insulin: When exercising, the muscles become more sensitive to insulin, both basal and bolus. The body will naturally burn more calories per day, which means less basal needed, and the muscles are much more sensitive to insulin post exercise which = less bolus/meal. Not sure if there has been a science experiment, and I could be wrong, but that is my guess, and I have not had a doctor argue yet...
So the diabetes game: Last weekend I cut it a bit, and on Sunday was good. Blood sugars were up in the 200's, and I was eating a bit, but felt good. I have decided to start doing my 2nd shot of Lantus after my rides. So it is kind of a temp basal. Lately I have been doing 6 at night, and 3 in the afternoon. Tuesday I did that, and went pretty high on the ride up to 257, before I started trending down. I only had to eat about 400 calories on a 3 hour ride, and I was flying. Wed, I had a bit more basal, 7 units night, 3 in am. I went up to 220, before dropping to 150, and was eating a bit more. 800 calories on a 4 hour ride. After that ride I kept dropping, so I that night I dropped Lantus dose again to 6 units. Had to do a small bolus of .5 unit of Apidra in the middle of the night. Thursday was a 3 hour ride, and I can't really remember what was going on...ha Lots of activity this week. I have done yoga on Tues-Thurs, and Sunday this week. Stretching every am. Friday I only road for 1.5 hrs and was real tired, then Saturday did a mountain bike ride with my buddy John Martin!!! I figured this was going to be hard, and slowly rose my BG to 200 at the start. Within 20 minutes I ate a king size snickers, and 15 minutes later some other bar. Blood sugar was 220 trending up said the Navigator! So I began to drink water, until at some point I saw 287. For the last 2 hours, I did nothing but drink water, and dropped to 215. These #'s are a bit higher than I would like. I am obviously under insulinized, so I think the switch needs to be 7 units at night, and then 3 after ride of Lantus.
But the higher blood sugars are making me feel very, very good on the bike. But I don't want to completely sacrifice a good A1C for performance. If I could raise it to 5.8-6.0, I would be happy. Higher... not so sure. But that is me.
Yesterday a good friend got some great news, and I am happy for her. I got some bad news, and it was a rough day. All will be ok in the long run... The work week was pretty stressed. But the thing is, making time every day to ride, really, really helps. No matter how much crap is piled on, I have not given an inch when it comes to my riding, and yoga. So for anyone out there if the stress seems to pile up, I would encourage you to get out and ride a bike, take a walk, or bit the gym, as it puts everything else at ease.
Thanks for reading, and sorry for the jumble of #'s.
Have a great night, and Happy Holidays!!!
Phil
Subscribe to:
Posts (Atom)