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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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vinnie wrote:
Higher Basal + Bolus Pre/During race = Better levels during the event

That said don't expect to hit it perfectly, just by having some more insulin on board you are way ahead of the game than before.

So, as a coach, do you think the extra 4 basal units (1/3 of my normal basal dose) a few hours before the race will help (with injections) rather than running a normal basal + bolus? Im really hoping that after a T1 bolus of a unit or two (depending on bs level) the exercise + basal may take over a bit more, things will settle and i will be able to just feed the basal. I doubt that will happen, but thats a dream tri for me.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Sounds like a reasonable plan. I would only take an emergency flask with extra calories on the run (and another on Special Needs) just in case that extra 4u of Lantus "bites you back" once you become too insulin sensitive.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business.ô * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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excellent, thanks for your help with all this. I run with a spibelt with a glucometer and gels/etc so hopefully should be good
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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My concern taking extra 4 units of Lantus is the peak. For me Lantus peaks about 6 hours after injection. I inject at 11 am 10u everyday and hit my low (usually) at 5pm on the nose. Could be coincidence but I figure its the Lantus peaking.

I think I would rather take the humalog as needed to cover vs more Lantus

Only one way to find out what works though....experiment



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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coates_hbk wrote:
vinnie wrote:
Higher Basal + Bolus Pre/During race = Better levels during the event

That said don't expect to hit it perfectly, just by having some more insulin on board you are way ahead of the game than before.


So, as a coach, do you think the extra 4 basal units (1/3 of my normal basal dose) a few hours before the race will help (with injections) rather than running a normal basal + bolus? Im really hoping that after a T1 bolus of a unit or two (depending on bs level) the exercise + basal may take over a bit more, things will settle and i will be able to just feed the basal. I doubt that will happen, but thats a dream tri for me.

After your bike race this weekend, considering changing to LCHF, the below podcast explains some of the benefits for sports performance, but the biggest ones are definitely for Diabetics:

http://www.innerfight.com/podcast107

Less lows, less insulin, normal BG levels, steadier energy flow.

Have a good race presuming you are doing IMOZ!

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business.ô * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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70.3 busso, wont catch me doing ironmans, training for 70.3's is long enough!....a tad nervous dosing an extra hit of lantus in the morning but ill know ill need it
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Good Luck this weekend! Be sure to let us know how the race goes!

BTW- I am seeing a tad bit higher bg #'s in the evening and overnight into the morning....trying to figure it out.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Shot race slower than last year! Anyway... Usual 12 units lantus night before and woke up with good levels... Bolused normal amount to cover food aswell as extra 4 units of lantus...start line was 8mmols.

Swim of 35mins which is 6 minutes quicker than last year... Had a gel midway through swim, checked blood in t1, bang, 3.4mmols... Crap! Sucked another gel and 2 jellybeans for something tasty:)... Now I took my needle with me and I needed to bolus on the bike twice to bring higher sugars down more quickly and allow me to eat. The problem was my legs just weren't on as soon as I mounted the bike...not sure if I was tapered enough or not who knows.

Bike was 2:32, 3 mins slower than last year all similar conditions...
I pushed hard on the bike to force the legs to wake up but cooked them and ran a slow 1:49, some cramp issues but now some GI issues starting to come into it.
Didn't need insulin on the run but had to have about 5 gels and a bit of coke every now and again (which wasn't flat!!).. Ran a 1:38 last year.
Total if 5:04 with a long t1 and t2 time, last year was 4:55.... Bs was 7.4mmol at finish

What I learned- I'm a much better sprinter than longer stuff but on the diabetic side-pumps are easier I would say!!

Increasing basal works but hits me viciously in the swim so I would need to spike before swimming as well as mid swim if I want to dose up basal. The bike needs insulin because my bs takes too long to come back down- it needs a bit of help as well as the nutrition need. The run, by that time, I can feed the basal... Also I need to look at my taper better i think, I did a bit too much running leading up.. Looking at my logs I ran sat, sun,mon,tue and wed for a sat race, every though they were easy paces (bar one) and range from 8-12kms in length... I was trying to avoid messing up bs from a lack of exercise but it seemed I went in a bit too cooked
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Thanks for sharing your race report! The low after the swim would have slowed me a bit. It's possible it took a bit out of your legs on the bike and run.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Congrats man, thats a solid time!!

Looks like a little slower than previous year but hey, they can't all be PR's!

Would you do Lantus before race again?

I think I would rather run a little on the high side vs the low side. All in all looks like bg did pretty good, especially from last race!?



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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i think the lantus came into its own during the run. I didnt need any jabbing at all then. The problems i encountered was that swimming smashes my blood sugar the most, so the lantus aided this more so, hence the low. To counteract i can gel pre-race AND during the latter half of the swim. I didnt have anything pre-race for the 70.3, if i did im sure i wouldnt have gotten low.
Anyway, I would get onto the bike and see if these gels start to gang up on me, in which case i would shoot a unit. If they dont then i have another 45 mins roughly before i need any more nutrition so hopefully the lantus plus exercise would start bringing them down naturally.
Its funny, biking in races requires a bolus or several even.
The thing is, if i didnt have the lantus extra on board, i may have had to jab a lot more frequently for bolusing for food, even maybe on the run. I simply dont know how much i would have to bolus if i just had my normal basal in.
If i had a pump this wouldnt be an issue. But since i have to coast and inject while riding, its a pain in the ass and i didnt want to inject while running as well. The only negative is by the run your feeding yourself quite a bit to feed the extra basal. I had about 5 gels, coke etc on the run. In fact i dont know how my guts didnt explode. Again, an advantage in having a pump. Doing this on needles blows.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Finally got my B2B race report from October posted

I caught cold at the end of July that sidelined me for about week. Nothing serious, just felt extremely tired. This derailed my training plan as I was supposed to start training for B2B August 1st, that didnít happen. The cold went away after a week or so but it left me with extreme dry/cotton mouth, bad enough I had decided to go to the doctor. I was also having some vision issues and had lost 15lbs over a 10 days, I knew it was something serious. I thought I was dying!
August 13th I was registering for B2B full but something was telling not to do it, something just didnít feel right. I went ahead and submitted and signed up because there were only a few spots left. The next day (Aug 14th) I went to the doctor with my symptoms, he pricks my finger and takes a small blood sample that says 360, proceeds to tell me I am diabetic. My eyes are swelling with tears as I am in complete shock, he is telling me stuff but all I hear is BLAH BLAH BLAH. So he sends me out with a bag of needles and insulin I have no idea how to use. I am 37, fit and do endurance races, how is this possible?
I pretty much figured my fall 140.6 was history since I couldnít run 30 minutes without my blood sugar going low and nearly passing out. I actually withdrew from B2B. My blood work confirmed as suspected that I am Type 1 diabetic, an autoimmune disease where your body kills your pancreas requiring insulin injections. Over the next few weeks I slowly began to gain weight as my body recovered and I was getting the hang of the insulin/carb ratios. It was a lot of trial and error. I am proud to say I swam, biked or ran every day since being diagnosed August 14th. Most of it was really really slow but at least I was moving. My run pace was reduced to 10-11 minute miles and my bike FTP totally plunged as I just couldnít produce any power. The more I experimented the more confident I got and the further/faster I could go.
I saw my endocrinologist on August 28th , she isnít an endurance athlete but understands what I like to do and she gave me the okay to do the full 140.6! She reduced my Lantus to 10 units a day, Humalog to 1 unit per 20g carb. Now I had two problems, 1) I had withdrawn from the race 2) I was very concerned about the swim in open water. I contacted Jeremy the race director, told him my story and he let me back in the race and gave ok for me to bring my own kayak support in case I got into serious trouble. So I started training.
When diagnosed on August 14th I was put on 20 units of Lantus and Humalog as needed via sliding scale. I quickly learned I was very insulin sensitive. Taking insulin along with me still producing was causing me to go low real fast. I was testing every 15 minutes running and having to consume carb every 15-20 minutes to keep from going low. It was crazy! I used to go for a 1 hour run and not take any calories with me. So carrying gels an HEED (sports drink) for a 30min run was an adjustment.
Exercising was scary! While running I started with half mile out and backs. I was going low so fast I didnít want to be far from my car. As I steadily gained my weight back and figuring out how my blood sugar was reacting I started running further and further. I got back on the bike but started on the trainer and my power had dropped significantly. It was about a month before I rode outside. The bike was a little scarier than running. I thought it was harder get a feel for where my sugar was and where it was trending. But eventually I figured it out. The bike was really no different than running, I needed at least 25g carbs every 30 minutes to keep my BG in the 100-140 range. For bike nutrition I was taking Hammer Perpetum for my long rides of 3 hours or more and would pop a Hammer gel periodically. Swim training was the scariest! I expected my BG to stay steady while swimming, but it didnít. I tested frequently in the pool and learned that I needed the same amount of carb swimming as I did running and biking. How in heck was I going to swim 2.4 miles in open water without testing and carrying gels?
For running and biking I carry an Amphipod belt that I can stash my BG meter, test strips and lancer. It works perfectly! I also use a small backpack that allows me to stash additional items, gels, insulin and needles ect. I feel its very important to carry testing supplies and test frequently. As I got better feel for my BG I would test less and less while running and biking.
Race Week
I was feeling pretty good coming into race week having completed several 4-5 hour bike rides and maxing out my long run at 21 miles. The swim was still my biggest concern because I didnít have good swim fitness. My longest swim was 3,000m, two times and average 6,000-7,000k meters per week in the two months prior to race day. I knew I couldnít improve my swim much in two months anyways so I just tried to do what I could. The swim is my biggest weakness, especially open water swimming. Add diabetic concerns to an already anxious swimmer and you have one paranoid triathlete.
My main goal was to simply finish the race but I did have an expected range of 12-14 hours I felt I was capable of from training. I expected the swim to take an estimated 1:30-40, bike 6:00-6:30 and run was kind of up in the air but I was targeting 4:22 (10 min pace). Transitions I knew would be extra slow due to having to test my BG.
As luck (bad luck) would have it an arctic low was moving through the night before the race that would push temperatures into mid to low 30ís. Not really what you want to see when swimming 2.4 miles in open water. The expected water temperature was hovering around 70 degrees (supposedly).
Friday October 25th was mandatory bike check in along with our T2 (transition) bag. While putting my bike together before checkin I bent the valve while inflating my rear wheel ( used a wheel cover). I opted to not change it hoping it wouldnít leak. In hindsight this was a bad decision. Got the bike set up and dropped at T1 and dropped my T2 bag at the convention center during the mandatory prerace meeting. The convention was the T2 site. Bags are all packed up and ready to race.

Race Day
Didnít sleep well which is typical. Woke up around 3:30 and got up at 3:45. First thing I did was check my BG, I was very interested to see what it would be given race day nerves. Pricked my finger and see 125mg, sweet! Thatís very normal for me to see in the morning. I was expecting to see a much higher number. I made some coffee and ate two multigrain English muffins with peanut butter just as I did for all my long training. I triple checked all my bags to make sure I had everything and my dad picked up at 5:30am to drop me at T1. This race is point to point so it makes for some logistic problems. My dad was serving as my personal Kayak support to make sure I didnít get into any trouble on the swim course. I was so happy to have him (and my stepmom Paula) there, a huge confidence boost.
They drop me off at T1 and it is COLD and dark. I was wearing my full sleeve wetsuit and already had it on along with wearing a garbage bag to stay warm. I rush over to my bike to check the rear wheel and sure enough its LOW!! I shouldíve changed that tube. Anyways I inflate it, drop my T1 bag and get on the shuttle to the swim start.
The plan was for Paula to drop my dad and the Canoe at the swim start and then drive to the swim finish. But she stayed at the start which meant me and my dad could sit in the nice warm car instead of standing around outside for an hour + waiting on the start of the race 7:30am. That was some VIP stuff right there! Thanks Paula!
I check my BG about 10 minutes before the start and Iím sitting at 180 after hitting a GU gel about 10 minutes prior. Thatís exactly where I wanted to be starting the swim. 160-180 is where I started most of my early morning swims in the pool and I knew training I needed to consume approx 1 GU gel at LEAST every 30 minutes, for open water probably more frequently. I set my Garmin 910 alarm to beep every 25 minutes in the water. I was wearing a full sleeve wetsuit with GU gel stashed in my right sleeve, both ankles and neck. A total of 4 gels for the swim.
Beach2Battleship is known for one thing, the current aided swim. It starts in a channel Masonboro Inlet at Wrightsville Beach. This was a year with little or no tide assistance. Typically the swim has a wicked fast current pushing athletes to the end of the point to point swim. You can usually count on a FAST swim split, 2013 is a rare year with little to no tide assistance. The race started during a slack period of no incoming tide. So I knew my swim time would suffer more than I had hoped.
7:30am the cannon goes off and the race is under way. My dad and I were actually loading the canoe in the water when the cannon went off. I wasnít in a huge hurry though, just took my time. I was probably next to last to enter the water. As I entered the water reality set in and it was scary. The water was chilly as it tricked up my back in the wetsuit. I put my face down and tried to take off but panicked within 30 seconds. This is very common for me to do historically speaking. I flipped over on my back and proceeded to backstroke. My dad was following me closely from behind. It was comforting having him there. My initial reaction to the water was ďThis sucks, get the heck outĒ. Iím glad I didnít
As I was backstroking I could see the starting area getting further and further away. I thought I could feel a little bit of a push from the tide. Time seems to go by very slow during the open water swim for me, especially when Iím staring up at the sky! I was very nervous/anxious in the water. After 15 minutes I was still having anxiety and knew it was going to be a mental struggle the rest of the way. I took my gels every 25ish minutes just as I did in training but the longer I was in the water the more tired I got. Backstroking was wearing me down big time! I would occasionally flip over and freestyle for a few minutes then back to the backstroke. The water was also very choppy once I had the turn buoy in sight. The choppy water was rolling right over my face and I was taking in LOTS of water. It was a struggle at that point to keep going and I had to stop several times. I was tired and wasnít sure if it was from my BG going low or just physical exertion. My dad kept telling me I was doing great, and to keep going. In reality I knew I was sucking ass but it was also somewhat expected. I finally made it through the turn buoy and across the windy, choppy channel. Now I knew I was going to finish the swim. Finally I reached the ladders to get out of that damn water. I gave my dad a shout out as I slowed moved up the ladder. Iím finally on the dock and walking, look at my watch and it says 1:35. I was very eager to test my BG to see where it was.
Swim time 1:38 479/499
T1 (Swim to Bike Transition)
To get to T1 it required us to run about 400 yards which usually isnít an issue. However most of this was on a pavement surface. I may as well have been running on hot coals! The pavement was COLD and combined with wet feet made for misery! I went to pick up my bike bag and it was one of a handful left. Not surprising, I was one of the last ones out of the water. First thing I did was find my BG monitor and test at 125, great! Thatís about where I was hoping to be. I took my time and dried off thoroughly. With the temps being rather chilly I decided to wear my Gore Windstopper Jacket (sleeves zip off), gloves, craft windstopper baselayer, calf sleeves, socks, toe warmers and aero helmet. I made sure I had all of my nutrition in my little backpack because I planned to use my own on course.
T1 Time 21:09 455/499
Bike
The sun was shining bright as I set off on the bike. I didnít really know what to expect on the bike since I didnít have the base I had in the two previous years. My plan was simple, take it easyish and test my BG at every aid station. I made it out of Wrightsville Beach Area with no issues. The first 3-5 miles was pretty slow and my heart rate was high given my output. One interesting thing about this bike course, thereís a 12 mile stretch of the bike on the interstate. Riding on the interstate is sketchy for a couple of reasons. 1) The half and full are all riding together 2) We ride in the left lane with cones between the lanes. The issue with the cones is they are easy to hit. I saw one lady hit a cone and go down. I made it off that stretch without incident.
I kept looking down at my rear wheel thinking the tire looked low but just shrugged it off as paranoia. Once the half and full bike course split it was much safer. But one disadvantages with the races splitting apart is you get left in no mans land. I could go miles and miles without seeing a bike and we are in the middle of nowhere! My legs started start to tire, butt was hurting and then the negative voices start talking in my head. I also seemed to have an annoying headwind all damn day, we never seemed to pick up a tailwind. I think around 70-80 mile mark I really lost it mentally and was questioning if I could finish the bike. I was hurting, bad! At mile 90 I stopped to check my tire, it was damn near flat!! The valve had leaked, slowly. I had stopped enough already and didnít want to waste more time changing a tube I shouldíve already changed. So I just reinflated it with a CO2 and hoped it would hold for the next 22 miles.
At this point my avg speed is much slower than I expected so that was a little disappointing. I do ride with power but had opted to try and not ride a power # and simply go off heart rate. Tried to keep my heart rate in the 140ís and I did just that. Those last 22 miles were brutal. By this point my shoulders were so sore I couldnít even ride in the aerobars. I kept telling trying to tell myself to get to the run. I was pretty confident I biked easy enough that I could run. Man was I happy to cross over the bridge and see the convention center. I finally made it to T2. Bike data. Avg Power 133 NP 145 Avg Heart Rate 138. My power in training was 180ish avg For nutrition I drank approx 6 bottles of Hammer Perpetum, one every hour and also GU Gel here and there as needed and also ate one English muffin.
Bike Time 6:32 280/499
T2 15:57 462/499
I arrived at the convention center and dismounted. Volunteers grabbed my bike and took it, I just walked and took my time as another volunteer brought me my T2 bag. Tested my BG and it was 120ish, perfect! I didnít have to change much other than shedding my jacket. In my T2 bag I had my shoes, arm warmers for the run, my camelbak bottle and my Go Lite backpack I used on the bike. Hit the bathroom, took a gel and I was off. My nutrition plan for the run was 1 bottle of perpetum per hour. So I had 4 bags portioned and stashed 3 of them in my backpack. However the thought of drinking more perpetum made me gag. So I decided to try on course Heed and hammer gels. Instead of Perpetum I would drink 4 bottles of Heed(refilling at aid stations) and one gel approx every 30 minutes.
Run
My two previous Ironman races resulted in complete blowups on the run leg. I really wanted together a good run, while I was content with my swim and bike splits they were slower than I wouldíve liked. My goal for the run was just try and be consistent and run the entire time. So I set off and tried to settle into an easy 10ish minute per mile pace. The run course was a double out and back. I really enjoy this run course. It takes you through the waterfront of downtown Wilmington, past many old historic homes and really nice park. The spectators, volunteers and aid stations are all amazing!
The miles were flying by and I was feeling great! My heart rate was staying low and my legs left good as I was finished my first 13.1 loop. I stopped at run special needs and picked up some Gu gel and my light that clips to my hat because I knew I would be running at dark. My mile splits were fairly consistent only stopping to refill my bottle and hit the porta johns.
The bad part of a double out and back run course is passing the finish line and seeing people cross the line knowing you have another lap left. I stopped at run special needs and picked my light that clips to my hat and arm warmers because I knew darkness coming. It gets very dark( and chilly) on the run course in parts so itís very helpful to have some visibility. I was taking a Hammer gel every 30 minutes and 1 bottle of Heed per hour. This seemed to be working as my blood sugar seemed stable and I was still moving a long at 10ish pace.
As I approached the last turn-around I knew I was going to finish and I was pumped! However, my quads were now feeling the full effect of the day. My pace began to slow a bit but I didnít care, I kept plugging along. My brain was telling me to stop at this point but I had two things keeping my feet moving. 1) If I walked the rest of the way that would put me at the finish line after my sonís bedtime and I didnít want that to happen. 2) The longer I was out on the course the higher the chance of having bg issues. So I kept going!
Now Iím in the home stretch, less than a mile to go. All smiles and high fives from here on in!! The spectators are amazing in the final stretch of this race. The folks of Wilmington really embrace this race! I can now see the finish chute and the music is pumping, I slow my pace and soak it up, giving high fives all the way across the finish line. I actually set a PR on the run (for 140.6 run) with a 4:32 run split. I was Sooooo stoaked about my run! Finish 13:21, not to shabby!
Run Time 4:32 176/499
Overall 13:21 281/499
Now the scary part, the unknown of how my bg will react now that the race is over. Once I crossed the line Iím asked how I feel, I say pretty good but Iím a diabetic and Iím not sure whatís going to happen to me now. The volunteer kind of panics and immediately sends me to the finish tent to be evaluated. They didnít have anything to test blood (which was odd), luckily I had my supplies. I was so nervous! First test was 130ís, I will take it! I was expecting my bg to take a big drop but it never did. It pretty much stayed around 130-150 through the night and following day.
This was my most emotional finish and the most prized accomplishment in my endurance career. I just proved Diabetes CANĒT & WONĒT stop me from doing anything I want to do.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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So I did twoindividual time trials this past weekend. Each was 7.1 miles, one aero and one merx. Got some interesting bg data.

First the aero race went great! Did 17:25 24.5 MPH @ 323 avg watts. I have gained all of the power I lost at dx back. Finished 4th overall

Merx was 19:04 @ 306 avg watts good for 1st in age group

What I found interesting is my bg went up during these events. Started aero @ 131mg tested 190 after. I don't believe it affected my performance though



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Did my first tri of the year this past Saturday. Went well all things considered. 1000m swim, 26 mile bike, 4 mile run. Finish time was 2:21. Swim was not great, 24ish minutes. It was very foggy and hard to sight. Bike was good, very hilly course with 2000ft of climbing, 1:21. Not a suitable course for me on a tri bike with all the decending, avg power was 240, not bad. Run was great, 27 minutes.

Bg did well, no real issues other than seeing some highs at the start.

Was 200 right before swim start.

167 into T1
140 into T2
162 at finish

That's higher than I expected but learned a lot about my bg on race morning. I don't need nearly as much carb



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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haha yep! Hormones etc are a bitch at times. Much different to training. You may find on longer stuff (70.3) you may need to inject insulin?

Anyway how much/what did you supplement during the race?

I did a bike race yesterday - 52kms total. I managed to win, but for the 1hr20mins it took i only at 3 jelly beans. I started at 8.5mmols (153) and finished on 11.2 (201). For oly's and above im now having to inject to get that glucose working better and intot he muscles more efficiently than muscle contraction alone.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Great question

Your right, my bg is much different while training vs race. I am finding I need way less carb on race day but I have done only one triathlon this year and a handful of running races.

Also, most of my workouts are in the PM not AM and my bg is a totally different in morning vs evening. This is because of my Lantus which I take around 11am. Maybe I need revisit that plan. I am higher in the AM than the PM and need more carb in the PM.

I have a 15 mile running race this weekend and should get some good data from it.

Also doing a HIM sept 28th. Will be interesting to see how bg does. I "think" I can control it without injecting during the race.

My bg has been all over the map since my saturday long run. I got crushed but some nasty humidity. Dehydrtated and think its causing some instability



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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So I did the 15 Mile running race, The Charleston Distance Run this past weekend.

Had some crazy bg issues.

Start out of bed at 187mg, ate one cup of greek yogurt and had one english muffin no insulin

Tested about about 5 minutes before the start and bg was 279! Yikes! That's the highest I have ever seen before, during or after any workout! Didn't really know what to do at that point other than just run and hope to burn some of that off.

My nutrition play was the same as training. One bottle of Hammer Heed per hour, with about 1.5 scoops=40g carb. I carry my own nutrition with me.

It was hot, 72 degrees at the 7:30am start with 100% humidity. I do not function well in humid conditions as I really sweat a lot. I knew when I took my first step out the door that my goal time of 2 hours was probably not going to happen. This is a very hilly course.

I tested my bg about halfway point of race because I was feeling crappy it bg was 226mg, yikes! Way high for me, never seen this before. I didn't really now what to do other than totally scrap my nutrition plan and just drink water so that's what I did.

Finished the race in 2:07, not bad all things considered.

Bg at finish was 187.

I believe I will need to adjust when I take my Lantus especially on race day



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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runnerwv wrote:
So I did the 15 Mile running race, The Charleston Distance Run this past weekend.

Had some crazy bg issues.

Start out of bed at 187mg, ate one cup of greek yogurt and had one english muffin no insulin

Tested about about 5 minutes before the start and bg was 279! Yikes! That's the highest I have ever seen before, during or after any workout! Didn't really know what to do at that point other than just run and hope to burn some of that off.

My nutrition play was the same as training. One bottle of Hammer Heed per hour, with about 1.5 scoops=40g carb. I carry my own nutrition with me.

It was hot, 72 degrees at the 7:30am start with 100% humidity. I do not function well in humid conditions as I really sweat a lot. I knew when I took my first step out the door that my goal time of 2 hours was probably not going to happen. This is a very hilly course.

I tested my bg about halfway point of race because I was feeling crappy it bg was 226mg, yikes! Way high for me, never seen this before. I didn't really now what to do other than totally scrap my nutrition plan and just drink water so that's what I did.

Finished the race in 2:07, not bad all things considered.

Bg at finish was 187.

I believe I will need to adjust when I take my Lantus especially on race day

starting out of bed you were high, i would have had insulin to cover the yoghurt and muffin- that way you would have started the race at a similar BS to when you woke up. 279 is maybe getting into ketone territory. The fact it got to 226 after around 7 or 8 miles of running sounds too me as though you were lean on insulin. Racing is much different to training- i am finiding i (and many others) could once get away with the regimine you outlined. Allow physical activity to bring sugas down on their own. But training aside, this is hard to do for races over an hour or so, simply because the bsugar just wont come down without assistance of insulin. Note i say over an hour, simply because races that last less than that are usually intense (such as sprint tri's), which often sends the bsugar up on their own. Nutrition not needed.
This is why pumps are handy i guess. Press of a button, inject a bit, and your gold.
During my last 70.3 despite coming out of the water at 3.4mmols (64), i took 1 gel in T1 and jumped on my bike. It shot up to 12mmols (216) in a flash and was holding, it wouldnt drop and i needed nutrition. Whipped out my needle, coasted and injected in my tummy. That got me to 6mmol (108) which was great. Fortunately i only had to inject twice on the bike and that was it.

I think it was amclean who wrote a great report on injecting insulin in T1 prior to the bike.

In any event, 2:07 is nothing to sneeze at!
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Yea, hindsight I would've definately covered the food with insulin. This race made clear a trend I had already been seeing over the last 2-3 weeks which is higher morning bg and more carb sensitive(in the mornings).

I take 10u of Lantus at 11am dailey. It appears I need to bump that Lantus up as I am getting a big liver dump in the morning. Seems to be wearing off faster. Either increase Lantus dose or take some before bed?

I have not had high morning bg issues until the last 2-3 weeks. So something has changed, maybe I'm producing less insulin? IDK

I think if I had taken insuling to cover on race day that I would've still trended up instead of down or stable based on what I have been seeing in the morning.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Read all these pages...There is some good stuff... I just found out I have type 1 about 6 weeks ago at the age of 35. My first ever A1c that day was 13.7. I have gotten my BG under control and have read pretty much everything I can find. I have a question that I need help on. I check my BG at least a dozen times a day. The last week I have not gone higher than 130 and usually am between 90 and 110....I ordered some ketone strips and when they arrived I tested myself. There are "small" ketones. Everything I have read online say call my doctor. I eat low carb am not sick or don't think I am stressed. My BG is not out of control...I am just looking for OPINIONS and Slowtwitch has no shortage of those. I am not concerned with small ketones...is this a mistake?
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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i wouldnt stress it too much- i believe you only check ketones when your super high or sick. If your numbers are fine, you cant really do much, adding insulin will only make you go low. Kudos to your control, especially 6 weeks in.
Welcome to the d club!
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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Gnerally, you are going to be concerned about the ketones is your BG has not been well controlled. Ketones are produced when your body burns fat for energy, which typically happens when you don't have enough insulin in your system to cover your metabolic needs. Unless you have gone away from carbs almost completely and are starving yourself of carbohydrates, ketones shouldn't be a big concern.

On the other hand, a T1 diabetic with an average BG between 90-130 means that you probably shouldn't see any ketones. I don't think ketones are going to stick around for 6+ weeks in your system, so they have to be coming from somewhere. It might be worth a call to your doctor just to see if he/she is concerned too. They're here to help us, after all...
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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Welcome to the T1D club

I was dx 8-14-13 so I'm fairly new to this as well. My A1C was 8ish when tested a month after dx. Now 6.2

Couple of things I suspect. You are probably in the "honeymoon" phase, very common. Did Dr do Cpeptide test? If not, request it. That will tell you if your still producing insulin and how much.

If your still showing keytones signs I figure it could be residual from the highs you were experiencing before dx. In general keytones are only present when bg is running high.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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been away for a while but i thought i would stop back in and report on an interesting t1d experience at crusher in the Tushar.

I won't bore you with the details but i neded up off the front early in a group of 4 - Dopey the Dwarf came across a 4:30 gap (fuelled by EPO, Ego and the crushed dreams of more principled athletes) . We said nasty things to him, he dropped us. I descended irresponsibly. I got a flat, co2 and a tube fixed it. I chased hard, i got a flat.... and so on. 4 flats later i thought i was done, took some lantus and waited for the voiture balai . As it turned out this was a LONG way behind me already. Some guy snapped his carbon bars and very kindly gave me thre emore tubes, so i decided to push on. Obviously at this point i had extra IOB , I was at altitude, I was climbing a very steep and sandy climb so i was forced into sever medicinal cokes and gels. I couldn't maintain a decent BG that way so i resorted to my first ever twinkie (thank you twinkie hand up man) . That worked a bit, as did a snickers (thank you random Utah lady who had no idea what was going on and had nothing to do with the event).

that worked for about an hour but i started to feel sick with all the food, came across an ambulance and they kindly mixed me up some glucagon, i took a mini glucagon shot (just under 1 unit IM) and that got me through the race feeling MUCH stronger. However i did vomit several times afterwards, have high blood glucose all day despite a 3500 kj ride and feel godawful for the next 48 hours.

Has anyone else used glucagon in an event? any n=1 anecdotes regarding this?
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Wow! That's a helleva race report!

I have never needed glucagon, well to this point anyway. Although I do keep a pen in case of emergency.

How was bg afterwards.?



"Keep those feet moving!" Me
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