Sunday, 16 June 2013

Even bigger changes afoot - how to live with Type 1 diabetes

Well, funny things happen don't they.

On the monday after my fell race (did I tell you about that? 23 miles, mostly off road, 1200m elevation gain, in 4hr 25, came in 35th) I went to see the doctor about soem symptoms I'd been having since mid-Feb after a bout of flu.
  • Rapid weight loss, going from 65-67kg to 60-61kg, and still dropping
  • night sweats and cramps
  • extreme thirst, extreme hunger
  • feeling hot all the time
  • dry skin
  • fatigue
  • painful eyes
  • insomnia
  • feeling like I'd massively overdosed on caffiene
I put it down to a possible thyroid problem, but the doctor thought otherwise.  Blood tests the next morning, phone call on Wednesday telling me to get into the surgery urgently, and then down to the hospital where I was kept in overnight to have my blood sugars stabilised before being discharged as a fully fledged type 1, insulin dependant diabetic.

The training plan starts here, two months out from a 70-miler.

The first week I was advised not to do anything strenuous, so for the third year in a row I missed my cycling club open time trial, and for the first time in a long while I left my trainers at home when I went to Aberdeen for a week.

I walked though.  At my pace of around 10min/km unladen, walking to the offices and back and then an evening stroll racked up a good 21km for the week.

Different this week though; starting to both research and get into the practicalities of managing the exercise/insulin/carbs equation.

So far managed a 6.5k run in 33:13 / 5:05 per km / AHR 147 / MHR 153 / BG at start 5.7 / BG at end 4.3.

That drop is a bit too close for comfort as 4.0 is a technical hypoglycaemia.

Tonight 10km / 53:13 / 5:09 per km / AHR 136 / MHR 157
BG at start 14.8 / 6km 7.0 / end 4.3

What I haven't done yet is to start adjusting my insulin bolus at the pre-exercise meal.  The reason this is necessary is that when you exercise you become more insulin sensitive, so that you move glucose from the bloodstream to the exercising muscles more efficintly.  With a working pancreas you natually reduce your insulin output to compensate.  With a fixed dose going in, you can't do that and your blood sugar can consequently drop like a stone.

I have a consultant's appointment tomorrow, and need to discuss this, but I'm thinking I need to drop my dosage by a unit at the meal before exercise in the evening.  The morning is a different ball game with no insulin bolus, but overnight blood sugar depletion I may need a snack before running.

Only time will tell.

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