Type 1 Cycling

Type 1 Cycling

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!

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