Write This Down

A key aspect of athletic training is mindfulness. For the most part, you don’t just go at it willy-nilly. You need a well thought out plan in order to progress, and any activity that involves technique or correct form requires paying attention to what you’re doing. [1] So why would I expect that managing my diabetes during exercise, which involves a lot of thinking about where my blood glucose is and where it might go, should be any different?

I’ve never been very good at BG journaling, though. Like many people with diabetes, I’ve started multiple times to write everything down only to quit after a few days. But I’ve been very motivated following the BAA 10K to try for more consistently awesome BGs before, during, and after exercising. Journaling, I suspected, was the only thing that was really going to work.

Having less than stellar BG logging experiences before, I went into the process with my eyes open and my mind working on how to make it successful. The result was that I gave myself four guidelines:

  1. Be focused on what I want to change.
  2. Be free-form.
  3. Record it on the day it happened
  4. Don’t spend too much time (i.e., less than 5 min/day)

So, since June 26th I’ve been writing down all about my BG, insulin, and food during (and before and immediately after) exercise. Each swim, bike, run, and hike gets its own page in a small notepad. Even though they aren’t entered into a form and don’t conform to a rigid pattern, they have the same basic structure:

  • What happened earlier in the day? One or two sentences about BGs and whether I did anything crazy like eating a big-ass burrito for lunch leading me to go wicked high and leading me to decide that this bike ride is going to be all about driving that as close to a perfect 104 as I can in 45 minutes. (Not that such a thing has ever happened . . . within the last few days.)
  • What I set my temp basal rate to and when I did it.
  • Whether I had a snack before going out and how much.
  • A sloppy looking timeline of what my BGs were, when I ate, when I exercised, and whether I bolused at all, etc.

If I’m feeling really ambitious, I might add a “compare/contrast with these dates” section. I’ve really only done that for swimming, when I was making some serious attempts at testing the right time to eat my energy gel before getting in the water.

But that’s it. While I might record a middle of the night BG that I took before an AM run, I try to stay really focused on the period lasting from an hour or two before I start to no more than an hour after my training is over. Anything else is (a) going to take too long to record and (b) isn’t really going to help me look at what’s happening with the exercise.

So far it’s been working well. I’m coming close to nailing down the things that I do a lot: swimming before work, running or biking after work, and long bike rides on weekend mornings. [2]

What do you do to keep track of your diabetes data when you’re trying to improve something that’s not to your liking?

1 — Technique is currently the tricky thing about swimming. Being mindful about how to effeciently move through the water is where I’m putting my mental energy now (instead of worrying about whether I’m going to stay afloat or how long it’s going to take to get back to the beach). Progress! [Back . . .]

2 — Except that today my endocrinologist and I decided we’re going to make lots of changes to my basal rates and bolus ratios to get me to a happier A1c—my last one was 8.3—so I might not have those so well nailed down in a couple weeks. [Back . . .]

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