Just wondering if i could get some advice and opinions. I am finding im getting low rather easily and quickly when i train in cycling, sometimes running and ALWAYS when swimming. I have tried numerous combinations including:
1) 0.5 unit bolus (and minor basal reductions the night before exercise) for breakfast/lunch or whichever prior to exercise. The result= no power and didn’t train well. Its as if i need my normal 1 unit bolus to shuttle that glucose into muscles. (1 unit is what i have at lunch and breakfast because both meals have 30gms of carbs)
2) I have tried low GI carbs and waiting around 1-2 hours prior to exercise. I have also tried high GI carbs about 15mins prior to exercise. The result= Still get very sharp drops in bs within 30 mins.
What was worked for my triathlon races is this: 1 unit bolus in the morning 2-3hours out from the start to cover around 55gms of carbs. It usually gets me to around 10mmol which is great (if it doesnt i just have to have a few jellybeans to top it off). I do a 300m swim (yes, 300m only!) and have a Gatorade prime in the first transition (30gms of quick acting carbs), ride 15km while drinking a powerade along the way, and finish the 3km run. I finish back on 10mmols. It goes down after that over a fairly short time, if it doesn’t i bolus but usually don’t have to. Anyway for an event that lasts all of about 45 mins, i need 55gms carbs for breakfast + 30gms in transition + 15gms on the ride. 45mins of exercise and i need around 100 grams of carbs just to get through! These feels crazy to me. I feel like im sucking down carbs just to stay afloat.
Ill give you another example. Today i got up, had a banana and 30gms of oats and 1 unit (to cover the oats, the banana to try and spike me a bit). I got to 7mmols before i took off for a run (in about an hour after taking food and insulin). Now perhaps i needed to wait more because i had full effects on insulin on board. But in only 4kms i was down to 3.1. I took glucose tabs and jelly beans to see out 10kms. It was at moderate pace. At lunch i had 1 unit to cover lunch (30gs of carbs), 2 hours later went to the gym and lifted weights. Finished that about 2hrs later with bloods at 5mmol (weights slightly spike me then level out). I then had a powerbar with 40gms of carbs in it before i went for a swim after weights. I waited about 15 mins and my bs got up to 7.5mmols. The powerbar was working and my sugars were seemingly on the way up. I swam 35 laps of a 25m pool and lost my power and technique went to crap so i knew i must be getting a bit low. Jumped out and i was 3.3mmol.
Does anybody else feel like their really sucking down alot of carbs to keep afloat with exercise? Sorry for the long post, but does anyone have any suggestions. I have tried to spike with larger amounts of most things from brown rice to energy gels, often with insulin still ‘fresh’ in the system and often when its well out (eg 4 hours like my swim today). Im at a bit of a loss in trying to maintain high bsugars for any length of time during exercise, intense or not, stopping short of becoming a carb addict. I assume the honeymoon period may have something to do with it. I think when im off my honeymoon and my insulin needs increase i think i might get a pump.
I have been in that situation, before I got my pump, the Tae Kwon Do classes I was taking would drop me 80-150 points. We had a Friday evening class, at which I'd lose 4-5 lbs (water weight, I know but still...) and have pretty much an entire Gatorade for.
I don't swim much but the last time I did, maybe 2007 or 8, when MrsAcidRock had a broken toe and couldn't do any impact workouts, I noted that it killed my BG too. I haven't exactly avoided it but it doesn't come up that much. Eventually, the up and down of TKD (not to mention my A1C had drifted up into the 7s, at least partially from running up to 180 6 days/ week to work out...it adds up I think?) made me decide I want a pump.
It sounds like you are working out a lot more than I am as well. There's a few people at the "diabetics who run marathons" who do a lot of workouts. Do you know Heidi Jane James? She's from NZ and is an avid competitive triathlete. http://www.t1trigirl.org.nz/
She's a member and, while I don't see her around all that much I'm friends w/ her on FB so I follow along w/ her considerable exploits and occasionally check out her blog. Maybe some of her posts would offer some solutions, although one mentions "a handful of sugar from the yacht club" which won't help if you don't have a yacht club handy!
It sounds like you are doing all the "testing" and "science" stuff that you need to do and that it's just hard.I think the only solutions are to log and test a lot. Swimming is a big barrier for me as to me, it's not worth the bother. One of my buddies has suggested I join him for a local tri (sprint I think? 400 yard swim at the giant municipal pool made out of a quarry by a WPA project+ 10K run+ 14ish mile bike ride?) The run and bike ride don't intimidate me at all, except for managing the BG in the toilet while I'm transitioning and I'm sort of ambivalent. Sure it would be fun but running 16 miles or whatever's on the marathon training schedule for that weekend will be fun too. I know there's lots of people, with and without diabetes, who manage to do multiple tris and marathons all the time however I am sort of ambivalent about dealing with swimming.
Another good thing about diabetes is that races are ***ALWAYS*** easier because there's carbs all over the place. I have a stack of Gu I get since they are always passing it out. I don't usually use the stuff but figure "well, as long as it's there...". Lugging stuff along on training runs can be tedious and, for the longer runs I've had a few where I'd eaten most of what I lugged along! A pump makes thing a lot easier, both from the data collection standpoint and in terms of being able to turn your basal rates where you need them.
It's a LOT easier to lug carbs along on your bike though! I could easily fit 2 sleeves of Girl Scout cookies in the pouch under my seat!
You have no idea. *_*
My riding bubs are always amazed at what I haul along on rides in my backpack, not the least of which is my DSLR with 12-24 lens and my strobe flash. Along with nearly an entire bike shop of tools, tubes, twisty ties, leatherman, poncho, space blanket, med supply kit and all my diabetic b*******. Those guys are forever trying to weight weenie their bikes down to the mid-20 pounds region. I'm not so concerned with that as any weight loss in my bike will definitely be offset by my 20 pound pack of shtuff (yes, including food!).
P.S. Here's a shot from a recent ride with my son...
One thing about the gels is that I've noted a lot of them use maltodextrose which I think is absorbed more like "food" (like a couple of hours later, I'll see a spike...) rather than "sugar"/ candy/ glucose/ gatorade, that will show up 15-20 minutes, while you are working out. During the Chicago Marathon, I hit almost every Gatorade stop, I think I ran by one of the first ones, but didn't see much on the CGM running > 130. I had one spot where I decided I wanted Gu w/ caffeine as I was having excruciating cramps and wanted to do something, so I bolused for the 30G of carbs (gatorade+Gu...) but cut the bolus to 33% of what the pump recommended. That worked fine BG wise (although it didn't do anything for the cramps...) and I was down to the 60s or 70s w/ a couple of miles to go, which is sort of where I'd want to be, anticipating a spike when the tort...I mean race ended?
It's actually maltodextrin. Good stuff -- long chain carbs. Not so spiky.
Hammer Nutrition uses maltodextrin in all their sports-related gels and such. I've been using it for years (especially their Perpetuem for 12 hour races...). Here's a very concise description from their Hammer Gel page:
"The staple of any energy drink, bar, or gel is carbohydrate, and Hammer Gel stands alone in today's glutted market of energy products. A look at the ingredient list on the label will tell you why: we use long-chain complex carbohydrates for smooth, consistent energy release. There's only a trace of sugar, so Hammer Gel doesn't set off wild insulin spikes causing "sugar high" and "sugar crash." You won't find our products saturated with cheap, ineffective, commercial-grade sugars, which can ruin health and performance. Hammer Gel is an easily digested, concentrated source of complex carbohydrates with four amino acids added to enhance performance and prolong energy levels during intense training and competition. Hammer Gel has a syrup-like consistency that mixes easily with water if so desired. You can drink it straight, dilute it, or use it to flavor other components. Use it before, during, and after exercise."
See Hammer Nutrition
I've read all that stuff but, just based on my observations with my CGM/ BG meter, the maltodextrose-based fuel seems to take about 2 hours for me to "process", which sort of makes it useless for "fixing" errant hypos? I am sort of with Timmy on this, in that my main use for the stuff is to eat before the race, if circumstances transpire that make me run lower than I want to be, as sort of a "meal enhancer" but, even then, it doesn't seem to work fast. I prefer to have a piece of toast or two though, as I've never run into any GI issues running. If my BG is low or heading that way, I want something that's going to work *now* to fix things before it slows me down?
Whats up Timmy! Quick question...what are you using for basal insulin (lantus, levemir) and how much are you using? What are the "minor changes" that you make prior to a training day?
I ask because I find that it can play a huge role in what's going on, especially for endurance training.
First let me say that you are doing everything right in the sense of experimentation, logging, and especially coming here for help. I've had this condition for a long time, and it never lets you rest. I don't care if you're a pumper, shooter, honeymooner...what works for you today might not work for you tomorrow, so the key to success is to be patient with your numbers and not allow diabetes to frustrate you.
My take is that you may be taking too much basal insulin for your level of activity, especially as a honeymooner. Since your body may still be producing insulin, the combination of natural insulin and synthetic insulin could be a little much, especially in the water...where every muscle in your body from your diaphragm to your quads is demanding sugar just to keep you afloat. I find that surfing or just swimming in the ocean is the most taxing activity when it comes to my blood sugar...which makes sense when you consider the amount of muscle activity it takes just to battle the current and stay afloat.
...ironically, I have to cut this long reply short to treat a low blood sugar right now (60mg/dl) but I look forward to your response brother!!
im using lantus, if i exercise hard at night or will be in the morning then its 7 units. Usually wake between 5.5-6mmols. Otherwise its 8units and i wake 3.7-4.5.
I train every day except for tuesday in which i just do weights. That doesnt move my sugars too much, only up slightly then slight dip again.
I will try more pure malto gels. I usually have one about half an hour before training. I dont know, unless i really try with a tonne of carbs, i find it hard to get above 8mmols.
Go treat that low man hahaha