titration: (noun) the process of gradually adjusting the dose of a medication until optimal results are reached.
I remember doing titration in high school chemistry class and not really enjoying it. You wait and wait and wait for something to happen while adding more and more and more reagent to a flask in the hopes that it will turn a pretty color. Or rather, after a game of rock-paper-scissors, your lab partner adds the reagent to the flask while you write down measurements and try to stay awake. Even though I loved learning about chemical reactions and trying to recreate some of them at home—how did I not burn the house down playing with purloined magnesium tape?—I think the titration lab was the one where I realized higher-level studies in chemistry weren’t for me.
It feels so similar now as I try to titrate the correct dosage of insulin to give when I exercise. It’s still the process of running multiple experiments involving adding a known amount of chemicals—in this case food and insulin—coupled with a lot of record-keeping. The big differences of course being that (a) I’m the flask to which the chemicals are added, (b) I have to wait a week between experiments, and (c) there are reagent strips I use with my blood glucose meter that together tell me the values and keep track of them for me. And, of course, the really big difference: If I mess up the experiment too badly I can’t just poor the contents of the flask down the lab desk’s drain.
After all this time, I still don’t really like titrating—it’s scarier to mess with insulin than it is to burn magnesium tape—but I also don’t like these other things when I’m training:
- being hungry
- running out of energy
- experiencing hypoglycemia
- having high blood glucose
- not knowing what’s going to happen
Unfortunately, in this lab experiment, each
apparatus person with diabetes is different. Otherwise I would just ask my awesome internet friends. Even I probably won’t give the same results from one week to the next. That being said, last week’s experience of going way up during the first 45 minutes of my long run and then holding steady for the next 45 minutes (eating beforehand and along the way) was the same as today’s.
Next long run (in two weeks) I’m going to add some bolus insulin and see what happens. I’m going to start minutely small and go from there. I have about sixteen weeks until Around the Bay, and I don’t feel any particular need to approach the problem via bisection. I’ll just use the normal titration method, starting small and gradually adding more until I find the “right answer. . .” or something near it.
Today’s run was actually quite good, elevated BGs notwithstanding. The weather was beautiful in the Bay State this weekend, and I got up early enough that I didn’t feel rushed to get home before we went to see the film “Martha Marcy May Marlene.” (It’s good, but bleak. Wicked bleak. “Winter’s Bone” bleak. Life lesson: stay away from John Hawkes.) I picked the 10-mile loop with three mile-or-longer hills, and I threw about fifteen minutes of tempo running into the middle of it. I figure I’ll gradually keep adding longer stretches of high intensity as I add more distance.
And Tuesday I’m going to see a guy about a bike.