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IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong
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Writing this to get it down before I forget, and also in the hopes that someone else who is training with diabetes can gain some insight on how to handle long races. I'll try to keep it as interesting as possible to non-diabetics here.

Lead up:
The week leading into the race was pretty stressful. My training partner ended up getting pretty sick and ended up going in for surgery. Poor guy, couldnt get a break and had to miss the race. Suddenly with no ride I had to scramble. Luckily a teammate came to the rescue just as I was looking at buying Greyhound tickets(can't drive due to epilepsy condition). On top of that, I found a crack in my 2010 Cervelo P2 as I was cleaning it about two weeks prior to IMLP. Contacted Cervelo, sent some pics and rushed a warranty replacement frame. I was nervous having an entirely rebuilt bike so close to the event, but I figured with the geometry basically the same it would be ok. I took it for a few test rides, swapped the tires just before heading to LP on Thursday morning.

Bike setup:
2011 Cervelo P2, 56cm
167.5mm Dura-ace cranks
Front Shimano Training wheel
Rear Mavic Open Pro with Powertap and Wheelbuilder Disc cover
Two tubes velcroed under my ISM TT saddle.

Insulin Pump:
Minimed Paradigm
I inserted three infusion sets, one in the butt, one in the abdomen, and one in the thigh. I always prefer the abdomen because it seems to accept and process insulin better than legs and but while racing, but I wanted backups just in case.

Fluid setup:
I bought a set of Arundel Crono Aerobottles for the downtube but decided to ditch them at the last second and stick with the round cages. I was worried about dropping bottles on the crummy LP roads and figured it would be better to be able to swap in Perform if I lost my nutrition. Between the aerobars I had a Xlab torpedo mount cage for swapping in fluid from aid stations.

Pre-race:
Woke up around 3:45, tested my sugar and it was right on target, 93mg. I took one Ensure, a small bagel with some smooth peanut butter and drank a cup of coffee. I bolused 50% of what I would normally so as to not have too much insulin on board. I would later regret this...

When I arrived at the transition area at around 6:00, I setup my gear and tested my sugar before prepping for the water. Sugar was 445mg, way too high. It must have been the adrenalin rushing through my body, because that is a crazy spike in two hours. I sat down and quickly gave myself 6 units of humalog via syringe into the thigh. I was worried about swimming and having my pump off as my sugar started climbing. I do notice that I get crazy spikes in my sugar during adrenalin rushes and hard intervals. My team's coach lent me two gels to stuff in my sleeves(yup, I wore a wetsuit...) just in case my sugar dived from the bolus.

Swim - 1:12:19
Lined up in the middle ranks off to the right. Some lady was yelling to "stay the hell away!!", and seemed to be getting really nervous. I was also pretty freaked. I have really struggled with my swimming. There had been many races where I was basically dead last out of the water. Last year at Syracuse 70.3 I lost it and breast stroked the whole thing. This was my focus for 2011, figure out how to keep my cool in mass start OWS. Practice paid off and I had an expected rough start(left goggle lens was kicked in and was full of water the whole second loop). I swam calmly and was crawled over by some terribly rude swimmers. I am sure it was unintentional... I merged in half way up to the red turn buoy and stayed on the line the rest of the way, nice and chill in my own space. As I entered the water for my second loop I took one gel just in case my sugar was dropping, somehow I just had a feeling it was going down...

T1 - 9:46
This was pretty brutal. The medical bags near the start had been moved to a different table. Inside a ziplock was my insulin pump and my glasses. I scrambled around trying to find the bags, located mine buried(and open!) and proceeded to wetsuit stripping area. I planned on doing it myself, but relented and fell on my back to have a nice lady strip it off for me. In the mess, I think my glasses fell out of the bag, because when I arrived at the tent they were gone. I looked all over the place, pacing back around, on the ground amongst a bunch of half naked dudes all yelling and excited to get on the road. After wasting a bunch of time looking, I gave up, inserted my pump, tested(143mg), and ran to the bikes. I turned my pump on and left it at a normal basal rate to compensate for the rush of climbing up that first hill to the descent into Keene.

Bike - 5:41:15
I planned on riding pretty conservatively. Looking at the power data, I think maybe I was a little too conservative. That being said, from my very inexperienced eye, it seems maybe I did not ride very consistently/smart. I welcome any and all feedback here.

Work: 3880Kj
Avg. Power: 188watts
Normalized Power: 207watts
Avg. Speed: 19.52mph

I was aiming at keeping my power at around 210. Seems I was a little below that. The bike felt great. I was amazed at all the drafting though. I was swallowed up by a peloton of at least 20 riders at one point on the first OAB. I swapped water bottles at each station and took 2 salt sticks every hour. At the special needs section I tested my sugar and came in at 152mg. Not bad! I was pretty happy about that and decided to pick up the pace a little. I gave myself a bolus of 1.5 units of Humalog and dialed my basal down to 60%. The rest of the ride was awesome. I passed a lot of people and saw a wide spectrum of riders out there. One guy with a custom Shiv and 1080's on the front and back, sick aero gear, and his hands on top of the aeropads wobbling back and forth... and other dudes/ladies crushing it. Very illuminating. Papa bear was fun, saw some people I knew who cheered me on and had that "I'm in the TDF!!" moment.

T2 - 4:27
Tested glucose, came in at 112mg. Reduced my basal to 25%, someone slathered sunscreen all over me and I was off with pockets full of Gu Roctane's and salt sticks in a pill packet.

Run - 4:39:17
I was feeling great coming out of the tent. I knew I had to keep it easy and within my pace. I had planned on keeping the first three miles quite slow at 10:00. Stuck to that and decided to really run by the time I got down to ski jump hill. Picked up the pace to 9:00miles and popped salt sticks every 3 miles. I knew I was going to walk aid stations and took on two cups of water at each aid station. Damn it was hot out there! Stuffed ice down my jersey and poured water on my head but still, I was burning up out there. I stuck to my nutrition plan and felt consistant and on pace up until my first attempt at IGA hill. I noticed I was starting to feel tiiiiired. And emotional. Sortive felt like crying... This was when I knew I was getting pretty low on sugar. Unexplained overwhelming emotions and dead legs... bad sign. I walked/shuffled to run special needs and tried to test my sugar. But alas, the glucometer had been baking in the sun all day and gave me the high temp warning so I couldn't test. I felt terrible and walked with it in my jersey amongst a bunch of ice. After a few mins in the ice I stopped in the shade and tested and it read out at 37mg. I had screwed up and had set my temp. basal of 25% to only last 1 hour. I had probably stacked those boluses too, so I was dropping pretty hard. I stuffed the tester back in my jersey and started surging to get some stored glycogen to dump from my liver. 10seconds sprint, 20seconds walk... did that a few times as hard as I could till I came up to another aid station and started taking on spare gels with water and Perform. The second loop was difficult. And slow. Noticed my pace drop to a depressing 10, then 11 minute mile. I was keeping form and running, just super duper slow. I had estimated a 4:30 run, but really was hoping for more like a 4:00 marathon. Oh well.

Summary
I came in the Oval at 11:47:02. I was happy with my time and overall how I managed my sugar while racing. I probably looked like crap because they took me straight to the med tent. I lost 9 pounds that day(yikes!). Thankfully, when I tested, I was back to a solid 150mg. Awesome day, thrilled. signed up for 2012 and can't wait to kill it next year. More run training in my future.

Last edited by: amclean: Jul 26, 11 16:40
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Dang! Awesome race! Can't imagine how well you'll do when you get your insulin situation dialed in.
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Dude, I have enough trouble figuring out nutrition stuff without worrying about diabetic concerns. I can't imagine having to work that into the equation, but bravo to you for making it happen.
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [bltri] [ In reply to ]
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Thanks! I was thinking of excluding the diabetic stuff from the race report, because I don't like sounding like I have excuses out there. I might have walked IGA hill the first time because damn, I'm not nearly strong enough yet! But there are a few diabetics on here who I figure might benefit from it.
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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great RR, thanks for leaving in the BG stuff. I'm a pharmacist and deal with some diabetic athletes and it's very interesting to see what they have to deal with
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [npage148] [ In reply to ]
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The main thing I've learned over time in training is that it's(at least for me) almost more important to ensure your sugar doesn't go high, rather than dropping too low. Obviously, if it goes too low the wheels can fly off. But if you are out there for 9+ hours, and you're taking correction doses it quickly becomes very difficult to manage and keep together. There are just too many variables to handle. If it runs low, you surge and dump some remaining glycogen, take some extra gel/nutrition and deal. Go high and you start peeing too much, losing electrolytes, and cramp like its going out of style.
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Great race........congrats am.......see you next year. YEAH!
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Awesome race & thanks for a great report! I'm also a Type 1 Diabetic...rock on!!!
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Nicely executed race. I'm sure you're use to it now, but i couldn't imagine having 1 more thing to think about getting "dialed in". Kudo's to your determination and mental focus
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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You are one sick mofo - great job.

It been a pleasure getting my ass kicked on the bike a few times a week for the last 9 months.

Good on you for posting all the details since I have a few friends that I will point to this for help if needed.

Peace brother.
-murph

2013 Battenkill - Rock the Ridge 50 - AmZof Chris Gleason Memorial - Rev3 Half - IM Tremblant - SOS - Stone Mill 50
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [campmurphy] [ In reply to ]
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Both of you looked so strong out there. Alan, I can't wait to read your race report in full, but this IronMama needs to go to bed. I've spent the last hour trying to find the last Garmin file which contains my marathon splits. ARGH. They're somewhere here but not uploading.

Murph ~ you got your race report yet?

Congrats Murph + Alan. Look forward to more celebrating soon.

~Heather
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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I was swallowed up by a peloton of at least 20 riders at one point on the first OAB.

I saw that peloton near the end of the out and back as I started into the OAB. By then it was a good 60 riders strong. The second and only other pack was behind me on the second time through the OAB, and it was even bigger! Strange converging vortex in that section of the course.

Terrific first IM. Nutrition screwups and pacing issues result in many first timers going far slower than they are capable the first time out. Good job!

Lastly, if that "looong" in your trhread title is a reference to the length of your race report, ya still got a few thngs to learn. ;-)


Behold the turtle! He makes progess only when he sticks his neck out. (James Bryant Conant)
GET OFF THE F*%KING WALL!!!!!!! (Doug Stern)
Brevity is the soul of wit. (William Shakespeare)
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [campmurphy] [ In reply to ]
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Thanks man! It's been a pleasure to see you on the bike since I always knew we see each other on the run shortly after ;)
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [parkito] [ In reply to ]
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Maybe 20 riders was a conservative number, because yeah, wow... it was huge! There was a point where someone yelled out "Draft Police!! Break it up!" and the pack spread out till the motorcycles were gone. Shortly after, it converged again and I was behind a giant draft.

No offense to the solid/experienced riders out there, but honestly, most of those guys/gals just didn't have it together enough to do a real paceline. I was more concerned about someone geeking out messing with their Joule or playing with nutrition and taking out a giant swath of riders.
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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No sh*t - nothing like watching 20+ riders in a peloton, maybe 4 across in one lane - ALL in Aerobars.

2013 Battenkill - Rock the Ridge 50 - AmZof Chris Gleason Memorial - Rev3 Half - IM Tremblant - SOS - Stone Mill 50
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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Quote:
Pre-race:
Woke up around 3:45, tested my sugar and it was right on target, 93mg. I took one Ensure, a small bagel with some smooth peanut butter and drank a cup of coffee. I bolused 50% of what I would normally so as to not have too much insulin on board. I would later regret this...

When I arrived at the transition area at around 6:00, I setup my gear and tested my sugar before prepping for the water. Sugar was 445mg, way too high. It must have been the adrenalin rushing through my body, because that is a crazy spike in two hours. I sat down and quickly gave myself 6 units of humalog via syringe into the thigh. I was worried about swimming and having my pump off as my sugar started climbing. I do notice that I get crazy spikes in my sugar during adrenalin rushes and hard intervals. My team's coach lent me two gels to stuff in my sleeves(yup, I wore a wetsuit...) just in case my sugar dived from the bolus.

I've run into this problem with most of my races before... wake up with perfect blood sugar, skimp on the breakfast bolus because I'm gonna be going hard in a few hours, test before leaving transition/swim start and realize I'm way too high. After this happened a few times and I thought about it some more I realized: I'm always eating breakfast more than 2 hours before the race starts, so I shouldn't skimp AT ALL on the humalog (especially given the adrenaline issues that many of us diabetics experience with our BS spiking) during breakfast. Maybe I should even take a couple of extra units to account for that adrenaline spike. Humalog loses most of its effectiveness after about 2-2.5 hours, so I really don't worry about having some residual humalog on board by the time the race starts.

I used this (new) technique for the first time in an olympic tri in June and it worked great for me. Planning on the same thing in a week and a half for the Steelhead 70.3.


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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [amclean] [ In reply to ]
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I'm married to a type 1 and greatly admire your fortitude, attitude and clarity in treating your blood sugar as one more component of the race that simply must be effectively managed. good on ya. keep up the posts with the blood sugar data.

How were your numbers in the days after? smooth recovery?
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [RobLindqu] [ In reply to ]
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Now that I think about it, this has happened a number of times now. I experienced the same at AmZof and the Hook Half Marathon. At the half marathon I ended up taking too large a correction and crashed pretty hard later.
I think I'm past the whole "don't get low!!" fear, so I'll try this out
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Re: IMLP RR - 11:47, First IM, Type 1 Diabetic, Watts, looong [Sasquatch] [ In reply to ]
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Sasquatch wrote:
I'm married to a type 1 and greatly admire your fortitude, attitude and clarity in treating your blood sugar as one more component of the race that simply must be effectively managed. good on ya. keep up the posts with the blood sugar data.


How were your numbers in the days after? smooth recovery?


Thanks! Honestly I don't think its that big a deal, it's just a logistical challenge. After the race my sugars were pretty normal and things settled back into a good routine. I did notice leading up to the race on the taper that my sugars were VERY high. I really struggled to keep things under control. Another diabetic I spoke to at the race suggested this may be because your insulin sensitivity decreases during a heavy training season. Seems to make sense to me.
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