Type 1 Cycling

Type 1 Cycling

Tuesday, October 30, 2012

New Stack Exchange Q and A site for Diabetes

I proposed a new Q and A site on Stack Exchange about Diabetes.  Come show your support.  I need people to follow its progress and propose and vote for questions that are suitable for the site in order to get it off the ground.

Joining is easy if you are not a member and if this is something that you could get more involved in let me know.  If you don't know about Stack Exchange check it out. stackexchange.com is a network of Q and A sites that allow people to ask questions and get answers from other people who are either experts or have been in a similar situation.  Their biggest sites are centred around technology but there are site for many other topics.  I am involved in stackoverflow (the original site for programmers) and bicycles.  Now I want to create a new site for diabetics to get help too.

The goal is to bring together a community of people who have diabetes, are related to someone with diabetes or are a medical professional with who works in the field of diabetic care.  It will become an important resource for anyone wanting information on this disease.  It is my hope that it will provide invaluable information for people who have this condition and lead to better control and management so that everyone can learn to live life as normal.

Monday, October 29, 2012

Hill climbing repeats

Today I did some hill climbing repeats as suggested by this answer on Stack Exchange.  I did not have much time so I thought this would be a good exercise for training.  My hill climbing is terrible.  Looking at previous climbs I can go hard on the flat and descend with the best of them.  My hill climbing however is slow compared to other riders who I can keep up with on the flat.

My max speed from last weeks ride.  I am a bit of a demon descender!

Even the slightest incline can see me dropping off the pace.  So my goals were to do this hill (a category 4, 2KM climb) in under 6 mins and to see if I can manage my sugar better to avoid the huge swings I am getting after intensive training.  In case you don't want to read on I did not achieve either goal.  I did cut my best time for the hill down to 6:12, 24 seconds better than my previous best, and I climbed the hill 7 times in total in under and hour and a half.  So that being said it wasn't a total bust of a day.

The past two weeks have been a similar pattern.  Fine during the ride, and blood sugar rising fast after the ride.  I make the same mistake both times, over compensating for the hyper by taking too much insulin and have a low blood sugar episode sometime later that day.  From the previous ride until this one my blood sugar control has been really good.  The raise in metabolic rate as a result of my exercise seems to be keeping everything else in check.

In More Detail

The night before the the ride we went out for dinner.   I always find this a little tricky.  I have learned not to take my short term insulin before I get my main course or at least until the first course arrives if it is accompanied by bread.  The reason being if I take my bolus when I sit down and there is a delay in getting the food then I will have a hypo before I get to eat anything and that will be dinner ruined.  Inevitably service was very slow, the staff were great, and we were given a number of complimentary dishes.  They were mainly deserts so I missed out on that somewhat, but thankful as every that I waited to take my insulin.  The other tricky part is I never know how much food I am going to get (unless I have been to the restaurant and ordered the exact same dish before).  So I wait until I can see my food to do a better estimate of how much insulin I need.

I took 2/3 my normal dose of long term insulin (20units) and lowered my bolus a few units as well.  I probably should have skipped the alcohol, but it was only a glass and a half of wine, not like a serious binge. After dinner I was out playing poker with some friends until 2am.  Whilst I have done this before I am pretty sure I would have a better performance if I had 2 or 3 extra hours sleep the night before.  I do not believe however that it makes much difference to my diabetic control.  I woke up with higher than normal blood sugar as expected.  I decided this time not to eat substantially before riding.  So I had a cup of coffee and a granola bar on the drive to the area where I was riding.

After a little warm up I started the repetitions.  I checked my blood sugar after a few repetitions and ate an energy gel and a granola bar during the training period.  As usual after the training my blood sugar started to rise.  After I returned home I ate and had some insulin to try to bring my blood sugar down.  This was fine, but I found myself a little later at a picnic and eating again.  I only ate a small amount and the additional bolus was unnecessary less than 3 hours after my previous one.  As a result later that afternoon I had a serious hypo, which while resolved was unpleasant.  I made sure to go to bed with high blood sugar and the following morning I was fine.

Friday evening
23:39 - 254mg/dL
02:02 - 228mg/dL

Saturday morning
06:48 - 157mg/dL, - leaving the house
07:39 - 196mg/dL,Granola bar - before exercise
08:49 - 166mg/dL, Energy gel, Granola bar - during exercise
09:36 - 249mg/dL, after exercise
10:21 - 279mg/dL, back at home
11:25 - 313mg/dL,Hafouch. Tuna toast, Insulin 14units
12:48 - 256mg/dL,Some pita and humous, Insulin 6units
17:08 - 41mg/dL,Cookies, 1 piece of toast.
17:36 - 99mg/dL
20:03 - 234mg/dL
20:32 - 253mg/dL,Beet tart (pastry) with goats cheese, Insulin 10units
22:46 - 306mg/dL

Sunday morning
07:19 - 136mg/dL
08:13 - 126mg/dL

Monday, October 22, 2012

Hard day in the saddle (cont.)

We arrived at the zimmer around sun down, having checked the location of start.  It was just a few flat kilometers from where we were staying.  A nice little warm up.  The zimmer was comfortable and spacious.  It had a nice size hottub and a little kitchenette.  We relaxed, made dinner and had a quite evening while I prepared for the bike ride the following day.

In preparation for my ride I put some tape on my bike with a message saying that I have Type 1 diabetes and if there are any problems / emergencies call my wife.  I tried to stick the same message to my jersey but without success so that went on the back of my phone instead.

I am going to try the following format for these blogs where by I list my sugars what I ate and how I felt in the run up to, during and after a big bike ride.  It maybe dull, but this is how I manage my life on a daily basis.  Other diabetics maybe able to learn something, or possibly help me out by commenting on my results.

Bare in mind my usual dose of long term is 30 units and short term is 4 units per 15g of carbohydrate at breakfast or lunch, plus 1 unit for every 25 I am over 100mg/dL and in the evening 3 units per 15g carbohydrate and 1 unit for every 30 I am over 150mg/dL.  Usually I reduce my long term before and after a ride to 20 - 24.  I also reduce my short term insulin for the evening and morning meals before a ride and the meal immediate after too.

The night before the ride I had a relaxing evening and an early night.  Dinner was pasta with tomato sauce cheese and tuna, I took a reduced dose of both long and short term insulin.  Woke up before the ride with slightly elevated blood sugar, ate and had a small amount of insulin in order to continue raising my blood sugar.   I filled up two water bottles with water and electrolyte powder, almost 1.7l in total.  I took in my pockets my tester, glucagon hypokit, phone, insulin pen, 5 granola bar and 5 energy gels.  By the time I started the ride I was pretty high.  I ate and drank when I could en route, when ever there was a stop I checked my blood sugar.  I finished with acceptable blood sugar, which then rose to unacceptable levels followed by dropping to hypoglycemic levels.  All leveled out in the evening and the following day my sugars were great all day.  Below is a more detailed diary of my sugars and food intake.

After such a hard ride I was expecting to have worse cramp than I did.  This may have been prevented by drinking water with electrolytes instead of plain water.  I think I need to eat more often on the ride than I did.  I am worried about my huge swings after my rides and I think I would benefit from a continuous glucometer. I am also worried as I have been training reasonably seriously since the end of august and my Hba1c which I did 3 days before this bike ride came back at 7.4%, which is much higher than I was hoping for.

Arriving at the start
What a lovely place to start a bike ride
It's gonna be a warm one
Me and my Merckx EMX-1 before the ride
Some other riders relaxing before the start
lining up on the start line
The start and the Lebanese border
Me getting ready for the off.
Lining up to go

resting at the midway point
joined by hundreds more at the midway point getting ready to start the rest of the ride
starting the second part of the ride

Friday evening
19:54 - 145mg/dL - Before dinner, 9 units of short term term insulin and 20 units of long term.  Dinner was pasta (two large helpings) with tomato sauce, capers and artichokes, cheese , chopped salad, and a tin of tune for some extra protein.

21:26 - 111mg/dL, I was surprised at how low I was here

22:10 - 144mg/dL, as my sugar was head in the right direction I was less worried

22:37 - 172mg/dL, this is about right before bed

Saturday morning
06:35 - 158mg/dL - Coffee with milk, bread roll with peanut butter, 400ml of orange juice. 4 units of short term insulin.  I was expecting to be higher after taking less insulin and eating a lot.  I would not start a bike ride without eating something.  My usual calculation is 180-200mg/dL before heavy exercise for 45-75 mins, where I would not expect to eat during.

06:57 - 161mg/dL, last check before leaving for the start line.

07:29 - 238mg/dL - granola bar

energy gel during the ride, not sure when exactly I took this, I think I should have had another one, I felt extreme tired going up hill and it felt like I was pedaling squares it is possible that I bonked (hit the wall).

09:45 first stopping point - 175mb/dL - granola bar, 2 minute break at the top of the big climb, blood sugar ok, supplemented food to keep me going for the next bit of descents and climbs.

10:31 second stopping point - 149mg/dL - energy gel and granola bar.  I had pretty much finished my water by this point so it was a good chance to drink and fill up my bottles.  I felt that considering my earlier test and that I had eaten 45 mins earlier that my blood sugar was coming down hard.  I wanted to avoid dropping any lower.

10:47 just before leaving stopping point - 252mg/dL, mission accomplished, sugar on the way up, enough to last me to the end of the ride (30km more predominantly down hill)

12:10 at end of ride after 70KM - 184mg/dL, I was happy with this blood sugar, high enough that I would not be dropping low any time soon, but no too high either.  My worry was that it was going to go up from here as it often does after exercise.

couple of small protein snacks when I got back to the zimmer

12:57 - 281mg/dL, this rise could not solely be due to the snacks.  This is my body breaking down glycogen and fat (hopefully).  The result very high blood sugar.

13:12 - 298mg/dL, that takes a while to go down

shower and a lie down

15:04 - 265mg/dL - 10units of short term insulin, cheese sandwich, salad, pickled herring.  This is the point where I must be most careful.  Too much insulin and when my body stops breaking things down my blood sugar will drop fast.

16:04 - 301mg/dL - apple 6 units of short term insulin.  I felt that I had misjudged how much insulin to take to bring my high sugar down gently.  I may have taken too much here.

16:44 - 260mg/dL - cafe latte, trying to stay awake for the drive home.  Normally I estimate this as 15g of sugar or 3/4 units of short term insulin but as I had just taken 16 units in the previous 2 hours I did not think it was necessary to add more

back home
18:28 - 120mg/dL, though normally I would be happy with this I felt that my blood sugar may be dropping too fast, as I found out later I was correct.

19:35 -  53mg/dL - 3 cookies, this is usually about right to sort me out when I am low.  I know it wont make me too high afterwards.

21:01 - 159mg/dL - dinner, roast beef sandwich, mashed potato, 1 pint of beer. 9 units short term, 24 units long term.

23:11 191mg/dL - On my way up after dinner.

00:13 - 238mg/dL - just before bed. A little higher that I would like on a normal day but probably the right amount to avoid over night lows.

07:30 - 120mg/dL - just after wake up. Perfect!

Saturday, October 20, 2012

Hard day in the saddle

I did it.  That was a hard 70KM.  I had nothing left in the tank at the end.  Brutal climbs over the first 28KM.  But then some really nice descents afterwards.  The ride was really well organised.  Just sorry I didn't do it last year when Alberto Contador came over with Team Saxo Bank and rode the course too!

More details to come tomorrow.

Friday, October 19, 2012


Excited! tomorrow I am doing this bike ride.  We have taken a zimmer (bed and breakfast) for the night packed up some food snacks and my new Merckx EMX1 and taking a road trip up north.

Strange way to start a blog I know.  But that's the way it goes I am documenting my rides with respect to my improvement in training and most importantly the management of my diabetes before during and after training.

Dinner tonight will be pasta, some fruit and cheese.  I will lower my long term Insulin from 30 to 20 and take about 2/3 the amount of short term insulin for the evening meal.

wish me luck