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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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The ratio of Lantus:Humalog is a bit off in my opinion. It looks like Lantus is being used to lower glucose when it should be used only to cover the liver dumping glucose. a 50:50% or thereabouts is more appropriate. Personally Im on 1:1.5-2 if you count regular as a meal based insulin. Keep on lowering the lantus and add more basal to cover the spikes.

I also presume you are on MDI so consider adding R for protein, just be careful as its a potent dose and can last ~8h so avoid taking 1 meal before training (ie, if you use for lunch and train in the evening you will crash).

Good luck, its a bit of a trial and error and Im still learning after 20y of T1D but its sort of becomes a fun after a while once you can figure out the outcome most of the time ;-)

--
Vinnie Santana, Multisport Coach
http://www.ironguides.net
* * * Your best is our business.� * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Really good stuff and really appreciated. Thank you again.

Yes, the ratios are all off right now. I've decreased my Lantus from 64 to 30 over the course of a few months due to recent positive health and activity changes and simultaneous addition of Jardiance. So everything's kind of upturned at the same time that I adding in distance/intensity, etc.

Not sure what MDI or R is.

Thanks for your input though. Your notes and this thread is providing useful talking points for an appointment with my sports physician next week to see if he knows an endo to refer me to.

Enjoy your weekend!
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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Just diagnosed as a type 1 diabetic. Setting up an apt with endo this week.
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Re: The Official Diabetic Triathlete Thread [TNTRI] [ In reply to ]
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Without sounding flippant about your life change, welcome to the family. Was it a surprise thing, or migration from T2 to T1? Best wishes on your journey.
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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Thanks for reviving this thread!

Do you have a CGM?

I would be very cautious of taking bolus for any race but especially longer distances. If you do take a bolus I would greatly reduce what you normally would take. If I have a bolus in my system, I will crash, fast.

Everyone is different with how their bodies react because of different dosages ect. While I don't race 140.6 anymore, I still do marathons and long rides/runs. I don't really adjust my basal for it. I take 27 units of Tresiba.

Gadgets I'm using to make my life easier, DexG6, iPhone XR, Apple Watch which I always wear to more easily display my BG and AirPods! AirPods for workouts are amazing because I can just say " hey Seri what's my glucose" and I get the number without taking out my phone or tapping my watch.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Just passing this along, Kris Freeman who was a 3x Olympic nordic skier and also T1 is transitioning to Triathlon for his retirement. He posts a lot about training and racing with T1 on his facebook page Kris Freeman Fortitude.
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Re: The Official Diabetic Triathlete Thread [endosch2] [ In reply to ]
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Quote:
endosch2 wrote:
Just passing this along, Kris Freeman who was a 3x Olympic nordic skier and also T1 is transitioning to Triathlon for his retirement. He posts a lot about training and racing with T1 on his facebook page Kris Freeman Fortitude.


That’s an awesome resource. Thank you. I’m trying to compile a list of T1’s to follow for inspiration and whatever insights they might have. Will check him out.
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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runnerwv wrote:
Thanks for reviving this thread!

Do you have a CGM?

I would be very cautious of taking bolus for any race but especially longer distances. If you do take a bolus I would greatly reduce what you normally would take. If I have a bolus in my system, I will crash, fast.

Everyone is different with how their bodies react because of different dosages ect. While I don't race 140.6 anymore, I still do marathons and long rides/runs. I don't really adjust my basal for it. I take 27 units of Tresiba.

Gadgets I'm using to make my life easier, DexG6, iPhone XR, Apple Watch which I always wear to more easily display my BG and AirPods! AirPods for workouts are amazing because I can just say " hey Seri what's my glucose" and I get the number without taking out my phone or tapping my watch.

No GSM, just injections. With public health here it’s a process and I’ve had too much endo turnover to have the consistent 3-year run required to get one...

Yes the inconsistencies are maddening. For now I’m starting intentionally quite high, without bolus, to give myself some buffer and test reactions. But results are way off.

Eg. Friday I did a 16k racewalk and dropped 8+ points. Yesterday I did a 3-hour bike ride and dropped 2+ points. Same time of day. Same heat.

Madness.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Quick question - any insulin-dependent diabetics out there also doing 70.3+ tri's, or marathons/ultras on a plant-based diet? If so, how's it going? Learnings?

The excercise and other diet changes have already dropped my basal Lantus 36 units/day in the last 4-6 months. Wondering if changing to plant-based would show additional benefits...

Cheers.
Last edited by: insulinpower: Jul 19, 20 10:18
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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Never received a notification about this response. Was told I was T2 in high school and now 15 years later its been decided its T1 instead. Now on Novolog, Tresiba, and Metformin. Switching to an insulin pump soon. Having bad drops in sugar levels so havent had much success lately in working out. Hoping to get it stabilized and get back into shape.
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Re: The Official Diabetic Triathlete Thread [TNTRI] [ In reply to ]
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Sorry to hear about your tribulations. The lows on insulin can get scary quickly, so I empathize with you. Have a similar situation now as body and dosages change, creating wild unpredictbility. Having to take so many sugar sources, etc. on every bike and run now it's ridiculous. I look like that one guy you always see at marathons who's carrying a backpack full of food and drinks as if they're on an expedition, lol...

Do you find the lows are the same intensity or different compared to your previous meds? Are you new to the Metformin? I was doing the Metformain/insulin speedball as well. How's your stomach handling it? I couldn't take it and got switched to Jardiance with great results.

Good luck out there!
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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I am having some stomach issues. Nothing major but def 1-2 times a week I have some vowel issues. Yeah I feel the same way when I do go for a ride. Packed out with sugar to make sure I make it fine.
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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I got on Afrezza, the inhaled insulin, 2 years ago and it has changed everything as far as training and racing. It starts working very quickly in your system (peaks in 15 min) and leaves rapidly too. It is almost out of the system in 1.5 hours. I can start a training session 1.5 hours after eating and taking Afrezza and I will not come crashing down like with novolog/humalog, which takes longer to start working and it’s in your body much longer, 4 hours or more. I still use the pump for the basal rate and I still bolus. But if I have a 250-300 BG I can take some Afrezza and have less than a 120 BG in 30-40 min. Then I can start a session with the insulin peak long gone within the hour. I had to cancel so many training sessions because of a 250 BG. I would inject, then an hour later, nothing. Then I would inject again ( stacking insulin) and come crashing down 2 hours later and I would get 50s during a training session. I am sure everyone can relate.

I was worried about "inhaled" insulin because I am an athlete. However, no residual respiratory side effects after two years of use.
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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At first I never imagined steady BG on a plant diet was possible, but I can see it happening unless you are putting out more than 20h of training per week, sure not as easy as when adding some animal protein as that just kills hunger and you need less volume of food, but if you are OK with adding some eggs (very little gluconeogenesis) then I imagine is possible to be plant based and maintain an A1C of sub 6%.

-Daily avocados
-Coconut & Olive Oil (potentially butter)
-All the slow carbs veggies
-Coconut milk
-Nuts in moderation
-Eggs x3 a day

For the previous posts, Im also on metformin, 2x500mg (10am, 5pm), my insulin requirements is very low, I do R insulin before high protein meals (0.5-1u), Lantus 2x a day (2-2u) and Novorapid ~3x a day 1-2u. Total insulin intake is around 10u.

--
Vinnie Santana, Multisport Coach
http://www.ironguides.net
* * * Your best is our business.� * * *
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Re: The Official Diabetic Triathlete Thread [Jimbotri] [ In reply to ]
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Thanks for the post. This is very interesting to me. Never heard of it before. I got a referral to an endo in my city who is apparently "performance-focused" so will ask them about it. I find Humalog surges late and with varying intensity for me (around 3-hours), depending on other factors, so finding it hard to guage. Would rather have something like you're describing.

The drug companies are missing an opportunity to jump into the conversation on this forum. If their marketers were aware of the conversations about their brands through social media listening and really are interested in leveraging the "active lifestyle" angle, then it would be great to get them weighing-in. The bike and equipment manufacturers have already figured that out and they have a lot less money than Lilly, et al...
Last edited by: insulinpower: Jul 22, 20 6:26
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Thanks for that. Agree about the need to "feel full." Nothing does that for me quite like meat. On my 2nd bowl of chick pea, cauliflower and tofu curry right now actually and still not feeling like I've had a meal yet, no matter how "rich and thick" I made the sauce, lol.

Reminds me of one the lines in a Michael Arnstein (the Fruitarin ultra guy) video about, "If you have to eat 9 or 10 bananas to feel full before going to bed at night..." Yikes.

Yes, I'm open to "meat/protein cheats" and love eggs. Eat a lot of egg whites already. Not looking at plant-based as a hardcore, long term lifestyle change, or as a philosophical decision, so won't be semantic about boundaries and adherences. This is more of a test & learn thing to see if it will help me cut weight and insulin requirements faster in the short term. I've posted elsewhere that I've cut my basal from 64 units/day to 28 units/day in a few months from just excercise and weight loss. In the week that I've been experimenting with non-meat meals I find I'm already "running hot" on my insulin and so probably going to drop it even more.

Would like to see what happens over a 90-day test period...
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Anybody here on the Freestyle Libre system and if so, how are you finding longevity for the sensors and any hacks to share?

I've been using them since they became available here in Canada and have to admit the product and customer experience more like supporting a "necessary evil" than something I'm thrilled about. The ease of use is great, but finding issues with accuracy in general and sensor life and just keeping the darn thing in with training activities.

Find that the sensor will overheat (giving me a "sensor too hot" error message, or just crap out entirely (too much sweat maybe...?), or dislodge. I have it applied by a nurse (my partner), under 2 Tegaderm dressings and have it re-dressed when it starts to peel, so it's securely held in place and protected from elements. Doesn't seem to help. Have had them rendered useless in as little as 2-days. Given the cost, it's a little frustrating (yes, I know that you can call their help line for replacement, but here in Canada, the customer service is shambolic. Truly :( Gave up on bothering with that a long time ago...

I'm particularly wary about how it's going to fare under a wetsuit. Any thoughts?

Likewise, where have you found effective placements on your body and what are you doing for taking readings on race day? Carrying your phone with you to tap? Not sure if I want to be schlepping my phone with me through a 70.3+...

Cheers.
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Re: The Official Diabetic Triathlete Thread [insulinpower] [ In reply to ]
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I've been using FreeStyle Libre for a few months and haven't really had any issues yet. The biggest problem is just being aware that it is there and making sure not to brush up against a door frame, etc, to dislodge it, which I did with the first one. Luckily I only had another day to go with that sensor. I've been out training quite a bit (I live in the Canary Islands), running/biking in the heat, swimming in the ocean both with and without a wetsuit, and I haven't yet had a problem with it coming lose, or with getting a reading. My doctor put on the first one, but I've been doing it since then and no issues, just watching myself in the mirror for the application, switching arms each time. The biggest issue is actually getting the sensors delivered, but it is the same with all deliveries here in Gran Canaria so you get used to the wait.

I was diagnosed with T2 back in 2012 while living in Montreal, so a longtime metformin then janumet user, but confinement here in Spain led to an intense episode that put me in the hospital, where I was rediagnosed with LADA and have since started using insulin. Now doing janumet & 2u apidra before breakfast, jardiance before lunch, another janumet before dinner, then 8u teojou after 10pm. Along with daily training things are going well with this setup.

Drew

---------------------------------------
I am a living animal, tied to a dying soul. -PKD

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Re: The Official Diabetic Triathlete Thread [TNTRI] [ In reply to ]
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So I was diagnosed a few months ago as type 1. I have been having a really hard time finding a balance with insulin and keeping my sugar levels where they need to be to safely exercise. I use a CGM and went for a one hour ride today. At the start of my ride my BG was reading close to 150. By about 30 minutes in it was showing that my BG was 70 which is when it alerts me that its getting low. I consumed a Clif gel and continued to ride. I get a reading every 5 minutes and for the continuation of my ride my reading kept reading lower and lower actually staying in the 40s. I ate 2 more times consuming small packs of welchs fruit snacks. I made it home and drank about 3oz of hot coca cola and finally after being home for about 10 minutes my numbers started slowly rising back up. I havent eaten or drank anything else except water since then and its been about an hour and a half since i rode. My BG has now shot up and is reading 248. Anyone else experiencing these kind of issues? Am I just not processing the carbs at a normal pace and my body is taking longer to get them into my system?
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Hi vinnie and others -

Has anyone found tapers don’t work so well with long course with type 1? Had my usually 10 day taper for a half. Reduced volume a touch and from 7 days brought it down to half volume but maintained intensity but even the day before the race I was concerned. I was sweating bullets on a 30 min ride, like my body has gone into full recovery mode and had no sharpness and power.
Race day I was plagued with cramps. Coming out of the swim my legs were locked. It’s as if they had no power and was asking too much of them and they were seizing from very early on? Again I had enough intensity in my taper to try keep sharp. I was well hydrated in the lead up even had pickle juice and crampfix and couldn’t get rid of them. I had zero power and just had to finish with a shit time. My vmo in particular was going mental with cramp.
Looking back I always seem to race better with less rest but A touch more fatigue and buzz in the legs. Too much taper (for me) and my legs are flat and blood is all over the place.
Is anyone else similar ? Could there be any reason behind this from a diabetic point of view ? Or is this just individual ?
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Re: The Official Diabetic Triathlete Thread [IamSpartacus] [ In reply to ]
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How were your blood sugars on race day? I used to have massive cramp problems in longer races, especially when I was high. I changed my drink and hardly ever get them these days.
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Re: The Official Diabetic Triathlete Thread [fulla] [ In reply to ]
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i actually had to have a gel pre swim. I overbolused breakfast so had to bring them back up. On the bike i was trending low when i normally need insulin from adrenaline highs. I needed a 360 cal bottle of Torq as well as 6 or 7 GU gels to stay afloat on the bike alone. rode 15mins slower than normal for 2:40 ride. Had a gel mid swim too. It was ridiculous. I was a sugar pig. Had no power at all. Got to the run and didnt bring needle with me, and low and behold blood went up to 13 over the distance with just elecrolytes, 1 swig of coke and about 5 lollies for the entire 21kms. Was shuffling 5:25km pace doing my best to fight cramps.
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Re: The Official Diabetic Triathlete Thread [IamSpartacus] [ In reply to ]
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Yes, I recommend Tapering a little different, if you spend several months training XX hours a week, then race week sub 50% of that, is not going end up well in terms of BG levels, insulin requirements. I recommend something along the lines of

Do a freshen (~3 days long) ~2 weeks out just to get rid of that deep fatigue. A day off and a couple very easy days
Then back into a semi-normal week (say 75% of the volume, tad less intensity, dont redline, aim to maintain fitness)
Pull back on the intensity days leading into the race, some volume ok

Dont try to carb load much, liver will be topped off with glycogen anyways from reduced training load. You may need to increase basal insulin amount to cover that. And by no means try to 'water load'

--
Vinnie Santana, Multisport Coach
http://www.ironguides.net
* * * Your best is our business.� * * *
Last edited by: vinnie: Oct 18, 20 0:46
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Re: The Official Diabetic Triathlete Thread [TNTRI] [ In reply to ]
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TNTRI wrote:
So I was diagnosed a few months ago as type 1. I have been having a really hard time finding a balance with insulin and keeping my sugar levels where they need to be to safely exercise. I use a CGM and went for a one hour ride today. At the start of my ride my BG was reading close to 150. By about 30 minutes in it was showing that my BG was 70 which is when it alerts me that its getting low. I consumed a Clif gel and continued to ride. I get a reading every 5 minutes and for the continuation of my ride my reading kept reading lower and lower actually staying in the 40s. I ate 2 more times consuming small packs of welchs fruit snacks. I made it home and drank about 3oz of hot coca cola and finally after being home for about 10 minutes my numbers started slowly rising back up. I havent eaten or drank anything else except water since then and its been about an hour and a half since i rode. My BG has now shot up and is reading 248. Anyone else experiencing these kind of issues? Am I just not processing the carbs at a normal pace and my body is taking longer to get them into my system?

Where is your CGM placed? I had some issues with compression lows with my Dexcom when riding in aero. It's obviously easier to check this when you're on the trainer against your regular meter to see if your numbers are accurate on the CGM. After moving the CGM a little higher on my abdomen up the numbers stabilized out more. Just something to consider.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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vinnie wrote:
Yes, I recommend Tapering a little different, if you spend several months training XX hours a week, then race week sub 50% of that, is not going end up well in terms of BG levels, insulin requirements. I recommend something along the lines of

Do a freshen (~3 days long) ~2 weeks out just to get rid of that deep fatigue. A day off and a couple very easy days
Then back into a semi-normal week (say 75% of the volume, tad less intensity, dont redline, aim to maintain fitness)
Pull back on the intensity days leading into the race, some volume ok

Dont try to carb load much, liver will be topped off with glycogen anyways from reduced training load. You may need to increase basal insulin amount to cover that. And by no means try to 'water load'

Gonna save this Info, much appreciated !
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