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Re: The Official Diabetic Triathlete Thread [RFXCrunner] [ In reply to ]
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T1D since 2000, diagnosed at age 17. Managed to go pretty fast at tris, 8h50 IM PB and qualified for Kona in 07, still stands as the fastest diabetic IM time.

Followed the conventional advice but never got my A1C at normal levels, would celebrate a 6.9% but the norm back in the heavy training days were 8%, until I found about Dr Bernstein book and that was a slap in my face. Dropped from 7% to 5.8% in 7 weeks, that was 1 year ago and been testing every 2 months since, lowest was 5.3% and highest 5.8%. My experience is explained in the article below. These days I find it just impossible to have normal levels on a high carb diet. The T1D here that can maintain mid 5's A1C on a medium to high carb diet are nothing short of amazing, I wish I could do that.

http://www.ironguides.net/...w-carb-high-fat-diet

I still have to take small amounts of insulin before high intensity training (ie, 1/2 oe 1u before to keep it 100-120mg presuming a 85mg/dl start) and large amounts before races and during races (2-3 pre race, plus 1-2 during, that for sprints, IM more during.). Mostly to cover adrenalin and in training liver release of glucose.

Vinnie

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business.ô * * *
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Re: The Official Diabetic Triathlete Thread [RFXCrunner] [ In reply to ]
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I think I'm producing less insulin too, honeymoon will be over at some point. I am seeing less lows and higher highs. Tested this morning before breakfast at 143 and yesterday at 132. Guessing I need more Lantus? I have an endo appointment this month so will see what she says. My first A1c was 8.0



"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:
see this is what im failing to understand, as before? Why would you bolus during a race? If muscle contraction in itself is enough to absorb blood glucose, why would you bolus? Arent you just increasing the risk of a hypo?


There are two ways the Glut 4 receptors in your cells are activated to take the sugar off your blood, one is with insulin and the other is with physical activity. Insulin (for me) is more efficient than physical activity.

Because the physical activity during a race is not enough to absorb all the sugar I take in through the race I also need to bolus. I would normally take 1 unit of insulin per 15 grams of carbs on a regular work day, but during a race I take 1 unit per 40 grams of carbs due to the physical activity helping with the Glut 4 activation in my cells.

If I didnít bolus during the race I would not get the full benefit of my nutrition and I would be finishing my races with high blood sugars.

Obviously this is an overly simplified explanation and it takes time and practice to find what works for you!

I wanted to add the following

Iím sure it is possible for some diabetics to not need a bolus and completely rely on the physical activity alone to keep the blood glucose in check, for me though that is not the case as I take in a lot of calories/carbs during a 70.3.
Last edited by: noxious: Nov 6, 13 7:29
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Type 1 - Diagnosed in 1993 at 24 years of age. 30 plus marathons, ultras & 13 IM's...racing triathlons since 1991.

Insulin: Lantus & Humalog
CGM: Dexcom G4 Platinum

2014 Races: Boston Marathon, Challenge AC, IM Chattanooga
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Re: The Official Diabetic Triathlete Thread [noxious] [ In reply to ]
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What is your BG range during races?



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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On average I start at 150-180 and finish right around 100, I have finished above 200 on rare occasions.
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Re: The Official Diabetic Triathlete Thread [noxious] [ In reply to ]
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Mine is similar, at least for now.

Around 120-140 in the morning, food and a gel push it up around 180 at the start. When I finished B2B full a couple weeks ago I was at 125 when I tested at the finish. I had no idea on my BG was going to respond during the run but it held steady just like training. Did go low afterwards either.



"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:
Mine is similar, at least for now.

Around 120-140 in the morning, food and a gel push it up around 180 at the start. When I finished B2B full a couple weeks ago I was at 125 when I tested at the finish. I had no idea on my BG was going to respond during the run but it held steady just like training. Did go low afterwards either.

Are you testing during races? For this 2013 season I would test before and after only, I am trying now to get insurance to pay for a dexcom but that is proving to be a pain!
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Type 1 Diabetic diagnosed at 14 in 1999. It was a very slow road to feeling comfortable with doing anything in the realm of tri's (and I wasn't a runner and even less of a swimmer), but I did my first sprint in 2006 and have been hooked ever since.

I slowly built my way in distance, doing sprints for a couple of years, olympics for a couple of years, 70.3's for a few years, and finally completed IMLP this past summer (that was more of a life-timing thing than knowing I could do it at this point though).

I've used Lantus and Humalog since they were developed (shout out to everyone who used to struggle through NPH and Regular, ha!) mainly because I've had A1C's in the low-6 to high-5 range and don't really want to have the pump on me 24/7 (though I have heard it's a wonderful thing). My doses during IM training this year were 20-21 units Lantus before bed and about 31-35 of Humalog each day. Now, in the off-season I'm up to 26 Lantus and about the same Humalog (but I eat less now).

For any race up to 70.3, I'll dial back my Lantus (down to around 14-15 for 70.3 and less for shorter) and do not require any bolus. For IMLP, I had my Humalog in my bike bag on the bike and attached my meter to my aero bars. I tested every hour, and had to take 3 units of Humalog at about mile 70 on the bike. My plan for the run was to have my wife have another meter and Humalog and we had set up places for her to be on the course that I would test and bolus if needed. Turned out that my parents and her parents were with her and were worried about missing the finish of the race, so I only saw them at miles 3 and 11. At 3, I had just tested in transition so didn't need to test. At 11 I was at 160, and figured I'd test again when I saw her at mile 15 and probably take a bolus at that point. Well, I never saw her at 15, or anywhere else along the course. I felt like my blood sugar was high but couldn't confirm, so I barely took in any carbs after special needs and tried to only drink water. My mouth would get dry about 30 seconds after I passed through an aid station and I felt quite dehydrated. After crossing the finish line I think I was down to 90, so I think I may have been high for a while, but did eventually bring it down towards the end of the run. Lesson learned: if I ever do IM again, I have to have a meter and insulin with ME for the flexibility to test when I need to test.
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Re: The Official Diabetic Triathlete Thread [noxious] [ In reply to ]
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Yes I test during but I have only raced once since I was diagnosed (aug 14th). I tested every bike aid station so 6-7 times . Tested several times before the swim and a handful on the run.

No pump for me...yet. I do like the idea of a CGM, thinking dexcom G4. I see no downside to a CGM



"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:
Yes I test during but I have only raced once since I was diagnosed (aug 14th). I tested every bike aid station so 6-7 times . Tested several times before the swim and a handful on the run.

No pump for me...yet. I do like the idea of a CGM, thinking dexcom G4. I see no downside to a CGM

Every diabetic on a pump that I talk to says it is the best decision they have ever made, and Im sure you have heard the same. Ill be honest with you though! I had great control with injections and sometimes I think about going back but I do get more flexibility with the pump. For example if I test 80 an hour before a long or hard run I can simply reduce my basil and let my sugars come up without eating, you canít do this on a long lasting injection you took hours ago.

With that said I hate, hate, hate having the pump attached to me, I never really felt like a diabetic until I started wearing a pump. That might sound a little weird but as soon as I was done with an injection I had nothing that made me think about being a diabetic, with the pump I have to manage the tubing and where I store the device and sleeping with the thing is a total nightmare!

Ill be on the pump for the foreseeable future but I do have my gripes!
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Honeymoon may not be over yet, but you may be seeing "dawn phenomenon" with your morning BGs. It happens naturally for everybody, but we diabetics "see" it because it's when hormones tell the body/liver "Hey, you're going to wake up soon. You're going to need some energy. Put some sugar out." Your endo will probably tell you to take a bit more Lantus at night to cover for it.

While we're talking about diabetes, I highly recommend seeing if you can be involved in any clinical trials going on. I know that for the newly diagnosed, there are a lot of trials going on that are studying ways to slow down beta cell death and prolong the "honeymoon phase". Follow this link here: http://www.diabetestrialnet.org/
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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And for the self intro-
Diagnosed in April 2006, just before high school graduation. I was a cross country runner in HS, but it took me a few years to get back into it after diagnosis.

I had a lot of issues with lows during exercise while on MDI. I just couldn't get the routine right on top of a college schedule. I went on the pump in 2008, and it has made all the difference - namely, I don't have to figure out what physical activity I'm going to do 24 hours ahead of time and adjust Lantus dose.

I'm more of a runner than a triathlete, but I'm working on it. Done 5ks up to a 50k with Type 1. I do a fair amount of biking (by fair, I mean I live in Seattle and am a fair weather cyclist - you can decide what that means for yourself). I've ridden a century, albeit slowly and with many stops for food. I chronicle most of my adventures at lindsayonthego.com .
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Vinnie I'm coming for that record.

Diagnosed at 17 im 28 now. A1c of 6.3. I do use a Pump of straight humalog and CGM. During a race I find the CGM doesnt work for the exact number you are at, but you can see if you are trending up or down. Raced only sprints and olympics moving up distance next year. I will be the fastest diabetic by 2015 no doubt if I can get sponsors.

I do fairly well on a lower carb diet for a better A1c, but I found I lacked that extra gear I needed for high instensity stuff. So I stick with medium carbs and try to get my body to mostly burn fat during normal training sessions.

As for taking insulin racing, If youre doing anything above olympic, I just dont see how you can run strictly off basal and consume that amount of calories and not go high. Unless maybe your just kicking it in zone 2 all day
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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type 1 diagnosed 2005

i've cycled all over the world, continental level so UCI races, i'm by no means a TDF winner but i can get out of my own way on a bike
I'm on levemir and novorapid and holes in my finger and on my bike a lot. I have used a CGM, it's too much diabetes and a bit of a waste of time, test lots in training and when you're racing just get on with it!

FWIW i don't think that, below 7.5 hba1c has that much meaning and some of the people i know who suffer most from diabetes do so in order to maintain a stupidly low a1c. the risk of complications comes at much higher a1c (above 8) (see below) and i don't believe a low carb diet is necessary or beneficial

i run a project workign with cycling and type 2 diabetes in a native American community in Tucson http://www.facebook.com/pascuayaquibike and i'm happy to help anyone who has any questions but don't you dare whine about your diabetes! if you're able to access the internet you're (on a global scale) pretty rich, people in sub saharan Africa die within 12 months of diagnosis, for them diabetes is a burden and a problem for us fortunate few it's a t most a hindrance and for me it's the reason i am able to maintain the (admittedly mediocre) career i've had at the top level of the sport.
Last edited by: jamesstout: Nov 6, 13 15:40
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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I agree with jamesstout on his assessment of A1c. The curve for complications is not linear as many think it is (as shown by that chart). Exercise is the key to health, with and without diabetes, as you all obviously know on slowtwitch.

I've had diabetes for fourteen years since the age of twelve. I played college baseball and never let diabetes slow me down. I've completed many triathlons including an Ironman. I'm on levemir and take injections for meals with humalog. I use a Dexcom but still test a lot. I was also on a pump for about eleven years. I disagree that it's the answer to everything. No matter what anyone says do what works best for you! If that's a pump, do that. If that's injections, do that. A pump is only as good as the tube anyway.

To the low carb thing. That may make diabetes easier to control but it can also kill you instantly. Not driving a car will result in zero car accidents but how else are you going to get to work? Have a low blood sugar in your sleep and if your body has zero glycogen....that's it.

If you want anymore inspiration check out the video of Bill Carlson from 1983.

http://www.youtube.com/watch?v=qk_Kvjvje6U

He was a heretic then. Doctors told him it would kill him. I talk to him a lot now and he still has zero complications, eats a normal healthy diet, not low carb. Actually he'd beat anyone here on the bike besides jamesstout. When asked it's the exercise that has kept him so healthy.

Check out Insulindependence for more on diabetes and exercise.
http://www.insulindependence.org
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Re: The Official Diabetic Triathlete Thread [Delmonsta] [ In reply to ]
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I did a 4:55 70.3 which may not be fast ( was my first) but not 'zone 2'.... I test on the bike and run so I don't consume too many carbs. Not everyone experiences super highs from adrenaline or whatever so don't assume people are just winging their races if there blood sugar in check. Maybe if u ate less carbs u wouldn't need a bolus? But I suspect many go higher easier than others thus might need the bolus but I manage to stay sub 10 mmols throughout all my races and go ok
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Re: The Official Diabetic Triathlete Thread [mrbaseball0] [ In reply to ]
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Couldn't agree more! Bill is my hero and should be to any active person with diabetes. Insulindependence and their triabetes program have helped so many people with diabetes to find community and enjoy exercise. In my opinion The cure isn't something I worry about any more, exercise (along with education and supplies) makes my diabetes a non issue.
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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I didnt assume anyone was "winging" their races. I already dont agree with anything you seem to post about diabetes so Im not even going to comment.
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Re: The Official Diabetic Triathlete Thread [Delmonsta] [ In reply to ]
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Well zone 2 isn't exactly racing ... Have a look at dr Sheri colburg... I concede everyone is different with the beetes so what works for one might not work for another
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Re: The Official Diabetic Triathlete Thread [mrbaseball0] [ In reply to ]
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Wow that's awesome! Not sure I had heard of Bill Carlson prior to this thread. What pioneer! I also like the fact that our first IM finish times as diabetics are nearly identical, within seconds.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [lindsayonthego] [ In reply to ]
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lindsayonthego wrote:
Honeymoon may not be over yet, but you may be seeing "dawn phenomenon" with your morning BGs. It happens naturally for everybody, but we diabetics "see" it because it's when hormones tell the body/liver "Hey, you're going to wake up soon. You're going to need some energy. Put some sugar out." Your endo will probably tell you to take a bit more Lantus at night to cover for it.

While we're talking about diabetes, I highly recommend seeing if you can be involved in any clinical trials going on. I know that for the newly diagnosed, there are a lot of trials going on that are studying ways to slow down beta cell death and prolong the "honeymoon phase". Follow this link here: http://www.diabetestrialnet.org/

Thanks for the suggestion. It crossed my mind about the "dawn phenomenon". But the other reason I think I'm producing less is I'm seeing a little bit higher BG # throughout the day and seem to be more carb sensitive. Actually having to use Humalog 3 times a day now



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [Delmonsta] [ In reply to ]
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Delmonsta wrote:
Vinnie I'm coming for that record.

Diagnosed at 17 im 28 now. A1c of 6.3. I do use a Pump of straight humalog and CGM. During a race I find the CGM doesnt work for the exact number you are at, but you can see if you are trending up or down. Raced only sprints and olympics moving up distance next year. I will be the fastest diabetic by 2015 no doubt if I can get sponsors.

I do fairly well on a lower carb diet for a better A1c, but I found I lacked that extra gear I needed for high instensity stuff. So I stick with medium carbs and try to get my body to mostly burn fat during normal training sessions.

As for taking insulin racing, If youre doing anything above olympic, I just dont see how you can run strictly off basal and consume that amount of calories and not go high. Unless maybe your just kicking it in zone 2 all day

Response to Delmon:

Some diabetics can and do. I've had diabetes for 23 years and been involved with either swimming, rugby or triathlons for all of that time.

Only time I will go high when I am above 'zone 2' (whatever that means) is for either racing with its adrenaline (happens often) or really high intensity stuff in training where there is an adrenaline response (which rarely happens to me in training, never happened to me in swimming when we often did 25m sprints in training)..altho it can and does depends on the time of day, eg at night I don't need much if any carbs since my long acting is starting to run out.

Response in general:

I also do not really need to adjust my lantus for exercise that is to come (whereas for humulin n I did), rather I adjust it for what I have already done.

Diabetics are different in the way they respond to different things.

Also trying to get an awesome A1c carries with it a higher risk of a serious hypo...which can be a killer.
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Good graph and it does prove the point of "low is better" -- each to his own, but I would compromise certain foods and maybe some performance if that means I can cut in a FIFTH my chances of going blind by maintaining a 5.5% A1C compared to 7.5%, I will happily do that, thank you.

What I also find interesting is that most people here are opposite to very low carb without even trying! This part is beyong my understanding. The number of severe lows and shaking has dropped in my experience and others on a VLC that I talk to. Guys, I've done the other way, raced fast and trained hard on "higher" carbs (150g on an easy training day and 250+ on a tough training day)

In the end we are NOT healthy as people make it sound, this is a very, very serious and deadly disease, either you take full on control and bring your levels to normal, or wait a couple decades (at a best case scenario) and pay the price. If you want to speed the learning process go and see a dialisys clinic, every second person has diabetes, plus is the leading cause for blindness in the US among young people.

Take this serious, you can still race triathlon fast, but performance should be secondary to health.

Vinnie





jamesstout wrote:
type 1 diagnosed 2005

i've cycled all over the world, continental level so UCI races, i'm by no means a TDF winner but i can get out of my own way on a bike
I'm on levemir and novorapid and holes in my finger and on my bike a lot. I have used a CGM, it's too much diabetes and a bit of a waste of time, test lots in training and when you're racing just get on with it!

FWIW i don't think that, below 7.5 hba1c has that much meaning and some of the people i know who suffer most from diabetes do so in order to maintain a stupidly low a1c. the risk of complications comes at much higher a1c (above 8) (see below) and i don't believe a low carb diet is necessary or beneficial

i run a project workign with cycling and type 2 diabetes in a native American community in Tucson http://www.facebook.com/pascuayaquibike and i'm happy to help anyone who has any questions but don't you dare whine about your diabetes! if you're able to access the internet you're (on a global scale) pretty rich, people in sub saharan Africa die within 12 months of diagnosis, for them diabetes is a burden and a problem for us fortunate few it's a t most a hindrance and for me it's the reason i am able to maintain the (admittedly mediocre) career i've had at the top level of the sport.

--
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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I just wanted to thank all of you who answered. I am not diabetic but I have a friend who is (actually several) and I know he will find this thread very interesting.

John
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