I’ve always said that triathlon is more than three disciplines. Beyond swimming, cycling, and running, you have to be good at transitions, nutrition, and recovery. And for some of us, there’s also diabetes.
I have a training plan with very exact instructions of what to do for the three athletic events, and I’ve been practicing my nutrition and transition strategies. Recovery is a little harder to actively manage, but I take lower-intensity rest weeks, use a foam roller, stretch, and try to stick to my plan. Diabetes has been much more ad hoc for me, though.
I was thinking on my way back from Minnesota after the big ride about insulin and exercise. This was not the first time where I’ve needed to give myself insulin during the event, despite my best efforts to avoid doing so. It’s also about the millionth time that I have not eaten (much) before some serious exertion because I didn’t know how much insulin to give to prevent low or high blood sugar.
Basically, I’m a big baby, but I have grown tired of being afraid of insulin and not knowing how to harness its power to prevent lows. And I want to figure out how to use it so that I can eat enough beforehand to prevent hitting the wall during my races, training outings, and long rides.
In order to gain the mental toughness to use insulin effectively—to no longer be afraid of it—I explicitly need to work insulin into my training plan and make it just as rigorous as the swim, bike, or run parts. This involves setting myself some goals and giving myself some concrete tasks to do.
Over the last couple weeks, I have taken some premeditated steps to experiment actively with diabetes before my swim, testing whether it was still right to turn my basal rate off 45-60 minutes before swimming, which I had been doing for most of the last year. I had noticed my BGs going up during my intense “strength” and “speed” workouts—which happens to many people—so I wanted to see if it was my basal rate or the anaerobic nature of the training. I also wanted to see what would happen if I ate something and took some insulin before my long Sunday ride (scary). And I set out to look very carefully at (a) what I need to do to get my BGs down before my afternoon workouts and (b) what happens during those workouts. Each workout at the pool is a chance to make a small change in a safe environment (cloudiness notwithstanding) before I try it at the lake.
It’s been interesting. I’ve done one long ride, three swims, a ride and a run. And, of course, I’ve kept notes the whole time.
Swim #1 — The plan: Swim 1800 yards without reducing my basal rate beforehand (i.e., use my normal, pre-dawn 0.9 u/hr rate). Food: Nope. Insulin on board: A bit (I wrote it down somewhere). The result: Down from 221 to 81.
Swim #2 — The plan: Swim 2 sets of 4×50 sprints (plus 10:00 of warmup and cool-down) without using a temp basal rate. Food: Nope. Insulin on board: Nope. The result: 5:00=123. Before @ 5:45=124. After @ 6:20=115.
Swim #3 — The plan: Swim 1000 yards without using a temp basal rate. Food: Nope. Insulin on board: Nope. The result: 5:10=165. Before @ 5:45=157. After @ 6:20 = 111.
Next up on the plan: another high-intensity workout without a temp basal rate reduction. Let’s see if the endurance workouts need a reduction and the strength/speed workouts don’t. And then, work on finding the right basal reduction for the long, aerobic swims.
50-Mile Bike Ride + 20-Minute Run — The plan: Eat something before starting a ride and take a small fraction of the recommended insulin. See what happens. Temp basal: 70%. Insulin on board: 0.5u @ 4:30. Food before: Clif Bar (39g). Insulin: 0.6u (not very much). Other food during the ride: 3 gels (25g each), 1 pack of Clif Bloks (40g), 60 oz of water. The result: 4:30=215. Before @ 6:50=171. 7:50=159. 8:40=130. 9:10=146. 9:45=172. Start of run @ 10:15=158. After @ 10:45=146.
Well, that could work. Next time, we’ll see what happens when the insulin on board is different.
There’s more data, but I’ll stop there. I’m off to figure out what diabetes experiments to do during the next few workouts. Stay tuned!