So, to today, as the title suggests, I corrected my morning dosages
based on what I’ve learned so far, went out on my ride with no problems, and
then while I was out shopping before lunch it all went a bit wrong really, but
that’s just another learning opportunity.
Let’s begin at the beginning, as with all good stories, and in
this case the beginning is breakfast.
Waking blood sugars this morning of 5.4, right on the button, a nice
breakfast of porridge and stewed plums spiced with cardamom, cinnamon and star
anise for a total of about 40g of carbs.
My normal dosages in the morning would be 6 units of basal and 2 units
of rapid acting for that much carb, but knowing what was to come with an
extended exercise session less than 2 hours after eating, that was taken down
to 3 units basal and 1 unit rapid acting for the mealtime bolus. The expectation
here is that the blood sugars will rise towards the high end of my target range
before I set out but that the exercise will deal with that.
So far, so good.
The ride itself went almost perfectly. The weather was ideal, overcast, slightly on the
cool side but warm enough for short sleeves and enough sun to keep you warmed
up, light winds and light traffic. What
more could you ask for?
And how did the blood sugars behave, I hear you ask? Pretty dammned good is the answer, until I
got off the bike. The strategy was to test every half an hour (I’ve got no idea
how Team Novo Nordisk does this and still races) and to feed in the carbs as
necessary, cutting back if the levels went too high, adding more if it looked
like they were dropping. To cut a long
story short it went a bit like this.
Time
(mins)
|
BG
(mmol/l)
|
Carbs
(g)
|
0
|
7.4
|
0
|
30
|
4.2
|
30
|
45
|
15
|
|
60
|
6.1
|
15
|
75
|
15
|
|
90
|
7.9
|
15
|
105
|
15
|
|
126
|
7.2
|
25
|
Overall my stats for the ride were 2hr 6min, 62.04km, 29.5 ave speed, 37.6 max
speed, AHR 136, MHR 149, so a nice steady training ride, getting a bit of time
in the saddle. The only fly in the ointment there was my left ITB starting to
ache about 90 mins in, that’s a reminder of the knee that took me out of Grim,
so I need to get that dealt with.
One thing to also note is that I’d be continuing to burn carbs after I
stopped, to replenish the glycogen in the muscles, so to take care of that I
had another 25gr carbs before my shower.
A quick cup of coffee and a shower later and I was ready to go out into
town, to the farmer’s market and pick up a few bits and pieces, taking my son
Rohan with me. Some time together and a
bit of fresh air for him. As usual, and being
a good diabetic I tested before I drove, 8.9,a bit high, but that’s the extra
25g carbs kicking in, at least I’m good to drive. Off we go, a few stalls into the market,
local eggs, tomatoes, a nice sour dough rye bread and look at the next stall as
my head is beginning to go a bit fuzzy and sparkly lights appear in my eyes!
Time to test I think – 3.7, not technically a hypo, but getting there and a
massively rapid drop. That insulin sensitivity
really giving me a kick up the arse. Like
a good T1 I had my test kit and snacks with me at all times, so 20 g carbs and
5 minutes later while also trying to stop Rohan wandering off (special needs and
doesn’t sit still easily while I’m testing and eating) and I’m feeling Ok
again. Drop a few things at the car and
restest, back up to 4.8, good. Even so,
I snuck in a couple of garibaldi while walking around Waitrose and paid for the
opened packet at the till as I left, just to make sure I stayed OK to drive.
So back home, anticipating that I would stay insulin sensitive for some
time, I cut a generous slice of that fresh sourdough rye bread, toasted that
with a pile of eggs and some smoked mackerel.
Very tasty. Overall this bit
looks like this.
Time
(mins)
|
BG
(mmol/l)
|
Carbs
(g)
|
Notes
|
150
|
8.9
|
0
|
+30
mins, after shower
|
210
|
3.7
|
20
|
+90
mins
|
240
|
4.7
|
15
|
+2hrs
|
280
|
6.1
|
60
|
lunch,
1 unit novorapid
|
As you can see I only had 1 unit of bolus with my
lunch. Normally that much carb would mop
up 3 units. And for the record, my +2hr
reading was 6.3, a perfect score when you’re aiming for a post-meal rise of no
more than 2mmol at +2hours.
Put this lot on a graph and it looks pretty cool.
I
think that shows the roller coaster pretty well.
Taking
a step back though, what does this all mean?
Well looking at the insulin profiles, all my breakfast bolus would have
been well out of my system when I had the post ride crash, so two things spring
to mind; 1) extreme insulin sensitivity and the GLUT4 receptors also playing a
role in depleting my cisrulating carbs with the post ride walking around 2) I
need to cut the background dose a bit more to account for the post ride insulin
sensitivity, Maybe down to 2 units. Only further experimentation will tell.
I
can definitely say though, that this was a good learning day.
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