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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Hardcore... Why lantus anyway? Why not a bolus? Just curious how others do things...I would have given up after 3 flats haha, u really wanted to gut that one out!
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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It was pretty much NOT GOING below 200 all day despite 3500kj out on the bike and not eating a lot.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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i use levemir not lantus, i rum a lower basal to race, even lower at altitude (because, y'know it's what Science and non diabetic bodies do) and eat plenty of carbs in the race. If i stop i'm just going to creep up so i took basal to set myself straight for what i thought would be a long wait as every single person in the race passed me and i waited for th broom wagon
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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I started keto about a week ago. What it has done to my blood sugar is remarkable. I have been able to lower my basal and bolus...my question is when training what about going hypo? Obviously you don't want to take carbs...I am wondering if I maybe ran too soon after a bolus, thinking this is most likely since I ran and biked numerous other times in the last week with no issues. I don't need to hear any negative comments from people who have never tried this diet but know a guy that knows a guy. I have spent hours reading on the net but a lot of the keto and training is not people with type 1 for obvious reasons.

And no I haven't consulted my dr who pretty said eat what you want and cover with insulin
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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Congrats, I wish I would have found out about VLC diet straight after my diagnosis like happened with you. You are blessed and this has literally saved your life and made diabetes very easy to deal with.

As you antecipated, be ready for some attacks of people that never tried Keto and don't know how it feels for a T1D. Ignore it. Can't blame your doctor as thats what its taught on Med School still, but yes, criminal information. I believe you also read Dr Bernstain 'Diabetes Solution'?

On your questions:

a) my question is when training what about going hypo? Obviously you don't want to take carbs.

As you are likely still on honeymoon, you may be still producing insulin (keto will prolong this for a long, long time, more than 6 months likely, you can test it). For now, aim to train when you have zero bolus insulin on board, best time would be before main meals. o h

Dont be afraid of taking small amounts of carbs if that gives you a little cushion. Another option is protein, as gluconeogenesis will act like a very slow carb. My favorite snack if I'm at normal levels (70-90) and want to stay there during an aerobic training is a pack of nuts or a couple boiled eggs. Just enough to hold it in place.

b) I am wondering if I maybe ran too soon after a bolus, thinking this is most likely since I ran and biked numerous other times in the last week with no issues.

Yes, training and bolus combined can be a very powerful tool to drop your BG levels. Best to change the time you train or the time you eat.

Personally I do my training first thing in the morning on a cup of 'bullet proof' coffee and couple eggs or before lunch/dinner when there is minimal insulin on board.

Formore info, I've put on a basic article on tri-training and LCHF with diabetes T1: http://www.ironguides.net/...-carb-high-fat-diet/

Vinnie

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business.™ * * *
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Race report from 70.3 last month

Deer Creek Fall Challenge 9/28/2014

This race had a 9:16am start time so I got to sleep in until 6am, yay! Woke and check blood sugar, it was 157mg. Not awful, not great but about what I expected. My bg tends to rise pretty high out of bed due to the dawn phenomon. Made some coffee and tried to eat two English muffins with peanut butter and 3 units of bolus (Humalog). The insulin was pretty much ineffective at keeping my bg from trending upwards. Adrenaline can cause bg to rise and this happens to me at every race.
I tested my bg 8 times before the start, it was as high as 243 and last test before the start was 203. I typically burn off the high when swimming in the morning so I was pretty confident I could swim for around 45 minutes with no carbs and come out of the water within a normal range.

The race start late, my age group started at 9:37, over 20 minutes late. I had a horrible swim and I’m not sure why. I swam for 10 minutes the day before with no issues so I was feeling pretty excited. However, once I was in the water I was freezing! I had opted to wear my sleeveless wetsuit, maybe it was a bad idea. I did a lot of backstroking on the swim. One funny comment a lifeguard made to me “most people can’t swim straight backstroking”, well at least I have that going for me. So finally I was out of the water, nearly dead last. Oh well, get to T1, test bg and start biking! Swim time was 43 minutes
Got to T1 and tested my bg, 116mg, nice! I decided to take 4 units Lantus to keep from going high. I felt kind of hungry so I ate one Hammer Gel. Got all my crap together and off I went. T1 Time-6:13

I carry my own nutrition. For this race I had one bottle on the front with 1 scoop of Heed and another bottle with Hammer Perpetum. I also had 4 Gu gels on my bike and 2 sandwich bags with 1.5 scoops of Perpetum in them. The bike course was three loops, mostly flat with a few rollers and 2 small climbs. So as I got started on the bike I noticed my Garmin 510 wasn’t picking up my heart race, cadence or power. Not sure what happened but I powered it off and back on then it picked up the data, weird. On my bike I was running a 44mm carbon front and wheelcover on the back with my LG Vorritice helmet.

The bike course was pancake flat for the first 10-12 miles with rollers and one small climb at the end of each loop. I was feeling pretty good on the bike. Power was hovering around 180-200 avg which put me right around 20mph, much faster than I had anticipated. I was watching power but decided to go off heart rate data instead of power. Finished the first lap in 55 minutes and change, avg power was 179 np 193 avg hr 147. Stopped at the aid station, check bg and was 200mg, yikes! Refilled one bottle and dumped my bag of perpetum in it and also grabbed a bottle of just water. Now the plan was to drink water only for about 30 minutes to bring down the high.
Felt pretty good on the second loop. The sun was out and the wind was light. I wanted to ride a bit faster but decided to maintain current effort. I finished the second lap in about 55 minutes, the same as the first. This time I didn’t stop to test bg, grabbed another bottle of water and kept on going. Second lap data, avg power 188, np 197, avg hr 146.

Just a few minutes into the 3rd and final lap I managed to knock my Garmin 510 off and it went rolling down the road behind. I looked back and see a car run right over the top of it but didn’t hit. I about had a stroke. Turned around and quickly picked it up. I was starting to get a little fatigued and was ready to get off the bike. 3rd lap data, was 54 minutes and change, avg power 184, np 194 avg hr 152. Overall bike data 2:50 19.73 mph avg, avg power 183, np 194, avg hr 148. Very pleased with the bike split.
Tested bg in T2 and was around 120. Grabbed my running stuff and was off. T2 4:02

I carry my own nutrition for running as well. For this race I had 3 or 4 gu gels on me along with perpetum in my camelback quikdraw. Run legs felt really good, like I could go faster. It was really warm and all sun at this point in the day so I decided to stay conservative and keep heart rate under control which was around 8:30-9:00 minute pace. I was just hoping for 2 hours. The run was a double out and back on mostly pavement and nowhere to hide from the sun. Every aid station I grabbed water and ice and dumped in over my head and chest to try and keep my core cool. I did stop once to check my bg it was 90 which is a little lower than I like but nothing to be too concerned about. One thing that frustrated me, I forgot to turn off auto pause. So when I stopped to check my bg my run time stopped on my Garmin 910, no biggie though.

The run was pretty boring in the middle of nowhere surrounded by cornfields. One thing I do well at long course triathlon is keep moving when my brain is telling me to stop. Sometimes it’s difficult to stay motivated out there. Also want to set a good example for other T1D out there. So I was finally in the home stretch and new it wasn’t going to be my fastest 70.3 and I had no idea what my overall time was at this point. Suspected I was around 5:50 thanks to all of stoppages. I crossed the finish line and new my run was under 2 hours so I was pleased with that. 1:57 offically

One of my tri buddies went to get my final finish time ticket from the timers and brought it to me. To my surprise it was 5:41! I was very pleased with the finish time. However I was very disappointed with my swim time/effort. Stoppages cost me at least 5-6 minutes overall and had a few silly mistakes but hey, that’s how long course goes. I have lots to learn about long course and being T1D but I know I can be much more efficient. Just need to do more racing. My bg was steady the rest of the evening. No issues with highs or lows.



"Keep those feet moving!" Me
Last edited by: runnerwv: Oct 22, 14 8:46
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Lanuts patent is expiring in early 2015 woot woot, going to save some $$$



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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I have yet another question for you guys this one regarding dawn phenomenon....I usually work out before work and after the kids are in bed. So usually at 4AM and after 8PM....For the last 3 weeks I have been getting up at 4AM to work out because I have to be to work at 6. Since I have been doing this I have had no high readings. I get up and it is between 80-100. It would shoot up a little after breakfast but since I have started keto it doesn't. It seems I am beating the dawn phenomenon to the punch. Any one have this experience?
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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Perhaps

In my experience, the more I hit snooze and try and get out of bed the higher my bg goes. I never wake up in the 80-100 range, its usually 115-170.

Have you had ceptide tested to see if you're still producing insulin? I have mine tested with a1c

Maybe your liver stores less sugar in keto?



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [nicholasJ] [ In reply to ]
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Also, I tend to be more insulin resistant and carb sensitive in the mornings



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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i have asked Del this question but i may as well ask you guys as well

Theoretically, should we be ale to race spprint tri's with just basal in the background? Im assuming the body has enough energy in muscle glycogen for this distance is this correct?
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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You're not accounting for the glucogen dump and this glucose surge caused by the adrenalin of shorter aerobic events such as a sprint tri. That is why I tend to bolus for events like that (crits in my case) and then if I need to eat, I do. Not so much for fuel but to prevent hyper or hypo glycaemia
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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This is true, but I thought the dump didn't matter if the glucose stored in the muscle itself is enough to get us through ? Don't we have enough 'power' for about 80 mins before nutrition needed and thus a bolus?

Edit- with that glucose dump I think we all get it, but my understanding was it isn't something needed to bolus for because we had enough energy stored to go on with anyway?
Last edited by: coates_hbk: Nov 9, 14 19:58
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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you have enough stored energy yes, but the issue is that hyperglycaemia (high blood glucose) has negative health and performance consequences. As i said above I don't see this as a "fuel" issue but rather an optional performance issue
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Ahhh I see... So it's more of a problem if ur seeing numbers like 250 or something instead of, say, 180? ... Where the high starts to interfere with performance (sluggish etc)?
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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coates_hbk wrote:
Ahhh I see... So it's more of a problem if ur seeing numbers like 250 or something instead of, say, 180? ... Where the high starts to interfere with performance (sluggish etc)?
exactly yes. Much above 200 and you'll see a drop in high level output . Try it in training (you'll do so eventually wether you want To or not !)
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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I've done quite a few races where I've been over 20 (360 mg/dL), whilst my performances might have been affected, I haven't done horrendously being that high.

Sprint races, I can get by on just a sports drink or perhaps even water (yet to try). I just sip to thirst.

I think 200 is a pretty ok level to have whilst racing as it lessens the risk of going low, which is going to be a real performance killer. I've been above 20 and gone low in the same race, after injecting myself after the high.

Racing is a whole different kettle of fish to training when it comes to managing blood glucose levels.
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Re: The Official Diabetic Triathlete Thread [fulla] [ In reply to ]
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definitely...i have been getting by with sprint races with basal in the background, but since the bike sends me so high, i wondered if there is any advantage in me bolusing a unit or two in T1. I dont go any higher than, say, 13mmols (234)...but if 2 units kept me to 9mmols (162), would i be faster, all things equal?

I guess the question becomes ' how high is too high before sporting performance is impaired?'

Oly's and above, definitely needing insulin of that bit i know....i did a 70.3 on the weekend and should have front loaded a stack of insulin in T1...instead i spent my bike leg not really racing but trying to get nutrition in while injecting to bring down the highs. I injected myself 7 fuckin times on the bike. Sit up, coast, inject repeat. I was mostly 11-14mmols except the last 1/4 of the bike in which time i could finally feed the blood sugar drops. It was a very very hot day, i didnt push the bike, but was gone when i got off of it. Hell, in training i was doing 210NP for 2 x 1 hr blocks...i did 184np for the race i was just chasing blood sugar...it was a 2 lap bike, my first lap power was ok, i didnt feel fatigued nor was i burning matches.....but the second lap, wether it was just me or chasing the highs and getting no nutrition in through to the muscles, it musnt have been working. I think i ran out of muscle glycogen, and by the time i finally got my blood sugar down in the second lap, it was too late.
Cramped to shit. I shuffled the run but ofcourse needed to snort every gel known to man at every aid station, coz hooray, now insulin decides to work.
A big F you to hormones that cause hyperglycemia
Last edited by: coates_hbk: Nov 10, 14 5:22
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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i managed to have a look at my glucometer post 70.3
Full basal on board during the race, fully tapered.


1/2cup oats with protein shake for breakfast. Normal bolus to cover all about 2.5hrs before event.
No nutrition pre-swim, was 9mmols (162). Had a Gel halfway through swim as swimming drops me low in racing and training.

T1 = 5.5mmols, ate 2 gluogel jelly beans (15cals per bean, 4gms carbs mix of glucose/malto) - i wasnt expecting the reaction below!
7mins into ride = 10.1mmols (180) – injected a unit
+17mins = 14.4mmols (260) – from memory may have injected 2 units here
+25mins = 14mmols (252)
+32mins = 13.9mmol (250) – had a gel here with maybe 3 units? I know I injected again
+38mins = 16.4mmols (295)
+48mins = 12.3mmols (221)
+58mins = 12.7mmols (228) – may have had more nutrition here with more insulin
+1hr05 = 13.4mmols (241)
+1hr15 = 14.4mmols (260) – injected more

+1hr25 = 7.9mmols (142) and the rest of the ride AND run between 4-8mmols.
At a guess I took about 7 units of insulin during my ride, unfortunatley i cant remember how much but it was a shit tonne.

It took me 1hr25mins to bring blood sugar down on the bike. No wonder I had a good first lap, I was perhaps cycling on stored glycogen in muscle? but ran out of gas and cramped badly just when my sugars were good again in the latter part of the ride and run.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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I also used to get high on the first hour in the bike, between 200-300, but I realized that after that my sugar went down pretty fast, to the point that eating tons of gels did not keep it high enough. Now I take 4units less of lantus (12 instead of 16) before races, at t1 I measure my bg and if im high I get a "regular" corrective dose. After I just ride "by feeling" and measure again at t2, which usually has me at 100-120. I get around 1200kcal on the bike (2.30h bike leg usually). I have a glucometer on my bike with an apidra pen, but i only use it if i feel something's wrong. Next HIM will be my first time using power on a race and I will try to pace it evenly at 240-270NP (0.8-0.9IF). Last simulation I did was a 1.5h bike @270AP, started at 250, got 2units, took 400kcal during bike and at the end i was at 56 (did not reduce my basal that day), took 10min to feel normal again and ran a 40min 10km, but at the end I was feeling empty, so now I might try upping my calories a little bit and maybe just reducing one lantus unit on competition. You know, as diabetic, I am (we should be) used to make many trial and error tests, with food, exercise, alcohol, emotions.

Hope you have better luck next time! It takes time but you will dial it for sure!


Stefano
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Hey all, I'm a newly diagnosed type 2 diabetic. Raced my first 70.3 In September. Didn't know I was diabetic at the time. Had a bad race, despite being well hydrated and really taking it easy early in the race my lower body started to cramp severely. I was only about 90 mins into the race when this happened. Don't even know if cramping can come from diabetes side effects but I never once cramped in practice ever.

So the very next day after my race I started getting very thirsty, sudden urges to pee. Fast forward 2 weeks and I had felt exhausted the past 2 weeks, so I thought maybe its lack of training. So i tried to go out and run and barely made it a mile before having to walk. Couple days later my eyesight went. Everything was blurry. I had started my training 9 months ago at 175lbs. I got down to 160lbs for my race........ 1 month later with no exercise at all I had dropped to 143lbs.

Doc gave me my A1C results which were 13.6. I was put on metformin and taking classes right now. Weird thing is, I fell into NONE of the categories of people who should get diabetes. No family history, not obese, good diet, exercise 6 times a week, just turned 41yrs old, and there are a few more, but I don't fit any of the mold. This was truly a shock to me.

My eyesight has gotten worse. I have to wear +3.25 reading glasses to see anything at all. I am trying to learn about nutrition thru taking classes and seeing an endo specialist. I just started walking and jogging again a few days ago. Seems like it might be a long road back. Hoping things clear up soon. I've really been down in the dumps and frustrated the past few weeks. Trying to turn my attitude around now. No need to feel sorry for myself. Time to get things right.

Just want to share my story. I will be going back and reading this thread from start to finish.

-------------------------------------------------------
I quit school because of recess........ I don't play
Last edited by: spiderjunior: Nov 11, 14 9:42
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Re: The Official Diabetic Triathlete Thread [Stefano] [ In reply to ]
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Stefano wrote:
I also used to get high on the first hour in the bike, between 200-300, but I realized that after that my sugar went down pretty fast, to the point that eating tons of gels did not keep it high enough. Now I take 4units less of lantus (12 instead of 16) before races, at t1 I measure my bg and if im high I get a "regular" corrective dose. After I just ride "by feeling" and measure again at t2, which usually has me at 100-120. I get around 1200kcal on the bike (2.30h bike leg usually). I have a glucometer on my bike with an apidra pen, but i only use it if i feel something's wrong. Next HIM will be my first time using power on a race and I will try to pace it evenly at 240-270NP (0.8-0.9IF). Last simulation I did was a 1.5h bike @270AP, started at 250, got 2units, took 400kcal during bike and at the end i was at 56 (did not reduce my basal that day), took 10min to feel normal again and ran a 40min 10km, but at the end I was feeling empty, so now I might try upping my calories a little bit and maybe just reducing one lantus unit on competition. You know, as diabetic, I am (we should be) used to make many trial and error tests, with food, exercise, alcohol, emotions.

Hope you have better luck next time! It takes time but you will dial it for sure!


Stefano

do you find an hour or so riding that high cramps you up etc? i cramp so bad if i spend a significant amount of time with high blood sugar
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Re: The Official Diabetic Triathlete Thread [spiderjunior] [ In reply to ]
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Most of us are very aware of those symptoms, I recall it very well.

It sucks right now but keep your head up. It gets better and easier. If you're Type 2 you can likely control it with a pill.

Keep exercising and a good diet and your A1C will drop.

I had a buddy dx as type 2 about 3-4 months ago. He was way overweight and didnt exercise at all. Depressed, drinking ect ect.

Woke up one day with all the symptoms...type 2. Had to end up going on insulin because the pill wasn't working. He is now a machine. Walking, jogging, clean diet.

In his case diabetes probably saved his life. This was the kick in the ass he needed to make the change and he's hell bent on it.

Keep your head up! Nothing to sulk about. You will get better



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [spiderjunior] [ In reply to ]
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Metformin?
I'm going to recommend they test your GAD antibodies as it sounds like latent auto immune diabetes of adults LADA.
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Resurrecting this thread:

70.3 strategies on mdi and tapered

- what works for you? How do u settle those highs? Inject before the swim ? In t1? Reduce ur basal the night before?

Tired of the bike portion sending me high that it ruins the rest of my races. Injecting 7 units on the first 40 kms of a bike leg is racing blood sugar not the race and not my idea of fun
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