First 20 mile run today for the JDRF / AllScripts Tobacco Road Marathon on March 17th. In spite of continued high BG during the run, I kicked T1D butt today and got it in! At mile 14, it was 300 and rising, T1D thought it had me, but by proper use of the CGM, I made the necessary adjustments and turned the tide on my nemesis.
–Now. That is my emotional response to this high blood glucose event. I am proud to say that I was able to finish the workout, but in hindsight, there were a couple of failure points that limited the impact of this workout.
Let me clarify a few things:
1. First 20 miler with a CGM
2. My BG = 60 when I woke up this morning
3. I over treated for my BG, and turned down my basal rate too much
4. My intent in running this marathon is to beat my wife’s time from her last marathon, which I know I am capable of doing, but have never before. This type of training, takes constant focus on BG levels so that I can gain the most out of my workouts.
By the 14 mile mark, my BG was 300 and rising. I had not had any fuel throughout the run. My legs were toast. Here’s why:
I didn’t have enough insulin in my body to transfer the glucose from my blood stream to the muscles to be used as energy. So, the liver starts to break down fat and proteins to be used as energy. This results in excessive acid in the bloodstream and the start to the very dangerous situation of diabetic ketoacidosis (DKA). In 30 years, I haven’t had to deal with DKA, and today wasn’t the day to start.
I had to get fuel in to continue my workout. I had to get my BG down to fuel appropriately. However, I just ran 14 miles, how much insulin to I put in? What do I do with my basal rate?
Extremely important questions, with even more important answers. Here is what I did to get my BG down.
Small. Small changes. Small bolus, and small raise in the basal rate. I kept running and pushed through the dead feeling of not having fueled during the run. More about that shortly. However, soon my BG was leveling off and then slowly dropping.
My fear, after not having fueled during the run, is that I was causing more damage to my muscles than I could recover from before my next workout. I am looking to improve…..not damage beyond repair. So, I fueled during the last 5 miles of my run, after I was sure my BG was dropping. I then had my recovery protein shake when I got back. A recovery shake is supposed to be consumed with 30 minutes, and I made sure I took advantage of that window to get fuel into my muscles.
The failures points from today?
Over reacted to my low BG.
Over compensated before my run with lowering my basal too much.
Not making a basal rate change when the CGM said 264 with an up arrow.
12 Hour Look Back
Success points of the day?
Having confidence that a little bit of insulin would go a long way.
Getting fuel in as soon as I could eat it.
Smart fueling and basal adjustments post run.
Important Notes:
Success is gained from information. Information for a T1D is in more BG readings and the CGM device gives me as much as I want to read. I am extremely fortunate that I have access to the healthcare that allows me to use this device. It is incredible how far T1D care has come with the backing if research by the JDRF. I fought wearing a CGM for years, and now I hope I never have to give it up.
Stay tuned for tomorrow’s post, on the National Day of Service, to see what I plan on doing about the future of T1D.