A Couple More Biking Stories

I meant to blog about a bike ride on July 12/12 but I sort of forgot.  I also went biking today so I will share the results of both of these rides.

On the 12th I decided to go for a bike ride after dinner.  At dinner I was a little lower than what was ideal for biking (6.6 mmol/L rather than the usual 10-12 that seems to be safer) so for dinner I ate approximately 100 grams of carbs and did insulin for 15% rather than the usualy 25%.  I did the usual 25% basal running for two hours.

Right away my glucose was higher.  When I started biking it was 18 mmol/L, which is too high.  It went down to 15 mmol/L part way through the bike.  Knowing I was a safe level, I biked much faster for the last few minutes home, bringing my level down to 14mmol/L; about an hour later it was 18 mmol/L, which I decided to correct.  Finally, at 3am I went low (3.4 mmol/L).

Obviously this did not work.  I was too high for the bike ride (when I'm in the high teens I don't feel very good, which makes me not want to move).  It came down a little bit but jumped back up an hour after the bike ride.  Then the correction plus the lingering effect of exercise brought me too low later in the evening.

Even though the numbers were too high, this ride gave me some good information.  For one thing, I saw the same pattern as last time, just higher.  My glucose seems to go up a bit after dinner, come down a few points during the actual ride, then jump back up once I've stopped riding.  This means my glucose is remaining relatively stable, which is great during the ride.

I've also found that going faster means my glucose level drops faster.  I know this isn't rocket science, but there seems to be a significant drop if I'm exerting more energy.  That's something that I'll have to be very aware of (and which may lessen if I keep at this).

So now for today's ride.  Today I was heading to a friend's house.  I knew I wouldn't be active while hanging out there so I decided to bike there and home.  My friend lives a significant ways away from home; I was guessing it would take me 30-45 minutes to get there.  It ended up 45 minutes including two stops (the first stop was to check my glucose about 15 minutes in.  The second one was to check my glucose and to catch my breath from a hill that really killed me going up!)  This ended up a little further than I've gone this summer, plus it was uphill part of the way.  The other couple of rides I've done were mainly flat.  The other significant difference was that I would be biking home as well.  Going down the hill would be faster than up, but I expected another 30-40 minute ride anyway, making the total time spent biking potentially 80-85 minutes, split in two.

I had a really rough start to my day.  At 8am I was 4.1 mmol/L.  I had some skittles and a power bar at that time then slept for a few more hours.  I was planning on getting up to check on my glucose around 11:30am but that didn't happen; I got up at 1:30pm ish and was luckily 10.5 mmol/L.  That meant my glucose would be high enough to attempt this.

I ate two toasts with peanut butter and banana, which was more than I normally eat at that time but is carb heavy.  I did a bolus for 25% of that food, and started a 25% basal around that time (running for two hours).  I made sure I had some food with me (skittles, power bars and some goldfish crackers), as well as liquids (both water and juice).  I made sure someone would be able to come and get me if something went wrong somewhere along the way (thank goodness for cell phones!) and headed out at 3pm.  As I already mentioned it took me 45 minutes with two stops to get there.  But my glucose held just fine, being 13.0 mmol/L when I started, 15.1 mmol/L at the first stop, 14.7 mmol/L at the second and 12.5 mmol/L when I got there.  I checked again a couple of hours later and had gone up quite drastically to 19.4 mmol/L (although I had eaten a doughnut or two during that time which I may not have bolused correctly for.  Plus I may have had sugar on my fingers, which in hindsight I should have made sure they were clean!)  Anyway, as you can tell, other than the high a couple of hours later, this ride was a success.

Of course, I had to get home as well. 

I had thought we might get food at some point, but other than the doughnuts, no such luck.  So even though it was a bit late (almost 9pm when I left), I decided to bike and stop at Subway on my way home.  There's two Subways on the route I was going to use and one of them just happened to be right where I stopped the second time on my way there (making it only a 15 minute ride from my friend's house).  I was 12.4 mmol/L before I left.  I started my basal (25% again) about 30-40 minutes before heading out.  I got to Subway, ordered my sub, and was packing everything into my backpack, ready for the next part of my ride when I did glucose: 5.0 mmol/L.

At this point, I still had about a half hour ride to go.  A 5.0 mmol/L would not hold me.  If I ate the sub my glucose would go up but it would take quite a while, time I did not really have because it was late and the sun was slowly setting (I don't have a light for my bike).  So I called for someone to come and get me, sad the whole time because I didn't get to go down that stupid hill that killed me on the way there.

While getting home wasn't exactly a success story, it did give me incredibly important imformation: I can't go biking without eating some sort of meal beforehand.  If I'd picked up a sub on the way to my friend's house (say when I stopped beside the Subway to catch my breath) and eaten a bit before heading home I probably would have made it without a problem.  I would have had to do the same 25% bolus/25% basal and my glucose would have held.  But because I didn't have that carb-heavy meal, my glucose plummeted.  Next time I'll be more prepared.

Biking During Highschool: Why it was Easier to Exercise Then

As I promised, I am going to give my best explanation for why I was able to bike when I was in high school but have had lots of trouble in more recent years.

I mentioned part of the reason before, but I will repeat it here again:

My brother also thinks that as I build up my endurance, my body should adapt and my glucose might not drop as drastically as it has.

I should probably mention that my brother is a pharmacist who has studied diabetes and so he knows what he is talking about.  And at least for me, his advice rings true.  When I was in high school I was on the bike team and was in general much more active than I was during university.  When university happened, I always felt too busy to be working out.  This was especially true during my final years as a MA student.  So it is quite probable that as my fitness level has plummented, my body's ability to exercise without going low has similarly plummented.

But there's another piece to this puzzle that my brother's advice does not account for: puberty.  Puberty is a time when glucose levels tend to be hard to control thanks to all of the crazy hormones that are adjusting during that time.  I know, looking back, that my hemoglobin A1C's were much higher than they are now.  So it's also possible that during puberty, I was running higher in general, so it was a little easier to exercise.  Once puberty stopped, the strategies that worked back then stopped working as well.  I've had to find new strategies that work for me.  It's taken some time, but it's starting to look like I may be on my way to regaining my fitness level.

Biking Success!!!!

Today was my first time biking this summer!  Well, I think I biked to work once a few months back but that doesn't really count - I was working at a place that's only a few minutes from my house (as I tell people, I can bike there in the same amount of time as it takes me to drive my car).  No, today I went on an actual bike ride that lasted forty minutes.  I took a few breaks to check my glucose (which is not counted in the forty minutes - those minutes were spent actually biking).  And more importantly: I didn't go low at all!!!!

I was really worried that I wouldn't be able to go biking at all tonight.  When I got off of work today I was 2.7 mmol/L.  But I managed to bring that up to 13.6 mmol/L by dinner.  As I had requested, we had a carb heavy dinner of perogies.  I did a bolus of 30% of the insulin I would normally have done and got a 25% basal going at about 6:45pm.  We were ready to go biking an hour later so I did glucose and was dismayed to see it had actually dropped a couple of points to 10.7 mmol/L.  But I decided to go anyway.

The goal was to see how my glucose would fare if I biked to another place that I work at, which is about a twenty minute bike ride away if you aren't going fast.  I was feeling fine when I got there, and my glucose confirmed that: it was 10.6 mmol/L!  We stopped for a few minutes at this time, then started biking back.  About half way home I stopped again, just to see how things were going and for some reason my glucose level had actually gone up for some reason to 12.0 mmol/L.  I'm honestly not sure why that happened when it did, but I knew I'd safely make it home.  For the last little stretch (just a few minutes of biking), I decided to go as fast as I could in an effort to start building up some endurance.  Back in high school when I was on the bike team (I'm not entirely sure how I managed it seeing all the trouble I've had with strenuous exercise lately - I'll explain my best guess in another post!), the coach suggested that when you're out riding you should go for ten minutes biking at a normal pace, then go really fast for about a minute; doing so will build your endurance.  And it really does work!  So anyway, I decided to go fast for a minute or two, knowing my glucose would hold me.  When I got home, my glucose had dropped to 9.2 mmol/L, suggesting that it will not hold at that speed. 

As a side note, when I went fast was the first time in a long time that my body started telling me it couldn't really do this not because my blood sugar was low but because I need to build up my endurance.  I also had that happen a few times when I was successful skiing this past winter.  It's a different feeling from when you don't have enough sugar in your blood and it was rather a good feeling; I'm actually able to start building up my endurance!

So after cooling down and hanging out reading on the deck for about an hour, I did glucose again and found I was 13.6 mmol/L (conveniently the same level I was when I started cutting back insulin at dinner).  At that time I did a correction (although not as much as my pump suggested because I know exercise often stays with you and affects your glucose level long after you're finished) and ate a snack.  I'll be checking again in a little while before I get some sleep.

The strategy that I used is the same one that worked for me while skiing.  I thought it should work for biking as well and it looks like I'm right (so long as I don't bike super fast the entire time!)  So now to start building up that endurance...

July 2

Today is a special day.  Today is the anniversary of when I was diagnosed with diabetes.  And as of today, that was exactly 20 years ago.

A lot has happened in 20 years.  When I was first diagnosed I was on two injections of insulin a day.  I had to mix both Toronto/Regular (it was the same insulin, but it had different names) and NPH into a syringe.  When I was first diagnosed I was too young to do this myself so my parents had to do it.  I think I also did glucose only two times a day, plus any time I needed to because I was feeling weird.

Eventually I moved to four injections a day, three of Humalog and one of NPH at night.  This was supposed to provide me with more control, but it was also done while I was going through puberty, which meant that hormones made control much more difficult.

Finally I switched to the insulin pump, which has made my life much, much easier.  I can eat whenever I'm hungry, rather than being stuck with specific meal times; this has been great for university when I didn't have a set daily schedule the way I did in high school.  I also do exactly the amount of insulin I need for what I eat, rather than having to guess how much I was going to eat with the Toronto/Regular (you had to inject it 30 minutes before you ate to give it time to work; Humalog and the Novorapid I use now are much faster).

During this time I've also used many, many glucometers.  My original meter, a One Touch 2, died and was replaced by a One Touch Profile.  I've used most of the One Touch meters, and several meters from other brands (I can't even remember them all now!).  Originally I had to wait 45seconds to a minute for my results; now the new meters finish the test in 5 seconds or less.

As you can tell, these last twenty years have seen a lot of change.  Sadly, the one change I would really like to see is still years in the future: a cure.  When I was first diagnosed I was told that a cure would be coming within ten years; that date passed us by ten years ago.

But today is not a day for being angry that a cure hasn't come yet.  Today is a day of celebration.  Look at how far we've come!  And so far, (touch wood!) I've managed to remain healthy.  Sure, diabetes is a constant, every day challenge.  But thanks to living when I do, I've managed to lead a relatively normal life.  Sure, there are things that are unique to me that a person without diabetes doesn't need to worry about.  But I am still able to get out and enjoy myself.  So what if I have to bring Skittles and a Power Bar with me to do so?