I think its super helpful to see whatever else we have similar trends with (I need to bolus for protein and fats, for example, while others don’t)
so the knowledge that YDMV is very useful and pertinant to always keep in mind.
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I’m not sure I understand the question. The spikes started happening last winter sort of out of the blue. after many years of running. I’d run the same exact route, same pace, etc. Previously, I’d start to go low with this route and would need a snack.But for a few months, those lows had turned into spikes!! Then they sort of stopped out of the blue, too. Of course, during all of this time I was tweaking my running protocol.
Yes, I’m still running! Not everyday though due to my work/travel schedule. My preference is to run outdoors on trails so I’m pretty limited if I don’t have enough time to drive to the trails!
Good luck getting the spikes under control!
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Is aerobic capacity just like how much my heart and lungs can put up with for how long?
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Too funny! And true…mine’s having a fit today…and yesterday. Wish she would settle down! 
I think I’m going to name my diabetes “Charlene”. “Simmer down, Charlene! We know you’re there!”
Love your thread and project! Thank you for sharing!
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O no, did I steal @Eric’s opportunity on this one??
Jolene Charlene by Dolly Parton Me!
Charlene, Charlene, Charlene, Charlene
I’m begging of you please don’t drop me, man
Charlene, Charlene, Charlene, Charlene
Please don’t rise me just because you can!
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I love it!! I actually know that one! I never know @Eric’s song references…
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OMG!! Larissa! My evil twin!
I humbly abdicate the throne to you, young lady. The crown is now yours!
The king is dead! Long live the king!
You have a responsibility to sing to @T1Allison at least once per week. I have already covered this week though, so you can start next week.
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@Eric - how frequently should I aim to be taking in carbs for fueling while running? On my long runs, I can notice how big a difference it makes taking in gels for fuel for later miles - makes it a lot easier and I feel a lot more energetic!
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It is very important to jump in it early so you don’t get too far behind. I always feel better when I have some carbs early and often, rather than waiting.
Sometimes the idea of maintaining a flat BG works against you. You might be flat at 90 and think, “There is no way I want to mess up this flat BG now, I will skip the fueling and insulin…” That ends up costing you!!
Let’s be aggressive with fueling. As shown in the chat minutes below, 30-60 grams per hour, get on it within the first 30 minutes!
I think the creation of a running basal profile - with preset times and the continually declining basal rate - seems like a good idea to work on in coming months.
40%, 30%, 20% of your normal basal amount, decreasing by each successive hour… Something like that. Discussion to be continued. Will want to talk through this to make sure we are on the same page.
Here are the notes from the recent discussion Doctor Larissa and I had. I thought it would be good to share here for everyone.
Minutes from 12/30 call…
Fueling
Let’s work on fueling. Target 30-60 grams per hour.
Maybe try more insulin up front at the beginning of the run and try to hit the initial carbs at 30 minutes. Stay on top of fueling. Don’t get too far behind. Get on it early!
Try to hit a downward slope with carbs around 70ish. Test a bit later, if you still dropping, add more carbs. If you are rising, try to curve it back down around 100 or so with another bolus. You might need to bolus right when you do your carbs. It just takes practice to get a handle on it. This is classic sugar surfing. You don’t need to stay perfectly flat on the long runs. Instead, try to create fueling opportunities with well-timed boluses of the proper amount.
[SNIP]
You can try feeding basal instead of dosing. Or perhaps in addition to dosing, a combination. Feeding basal is okay too, as long as the amount is correct and does not cause drops. It is a bit tougher for me, but you can try it. Maybe going at 50% instead of 40%?
As the run progresses, you may need less insulin. Like maybe (example only!) if you need 0.50 units for a gel pack early in the run, maybe 0.25 units might be enough after 2 hours. Just be aware of that concept. You will find the right dosing numbers once you get into longer runs.
A very general guideline - the longer you are running, the less insulin you will probably need to cover carbs…
Try the Gatorade Prime liquid mixed with water in your water bottles. Or just plain Gatorade. That might be an easier way to fuel a few grams every few minutes. Smaller than the 23 gram gel packs or the 15 gram Transcends.
Fueling note - the 2:1 ratio of Glucose to Fructose is ideal for most efficient carb absorption. We can thank Dr. Asker Jeukendrup for info like that! Huma gels have that 2:1 ratio!
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Wow, didn’t know either of these! I like the idea of adding water to Gatorade. But I really like the idea of Huma gels having the 2:1 ratio. I’ll have to Google Dr. Asker Jeukendrup to find out why that’s ideal!
I’m using Huma these days. It took me a long time to feel comfortable taking so many carbs (21g) all at once, but it works! I usually take the whole gel at the start of the run, or if I’m on the high side, I run 30 - 40 mins 'til I see a downward trend, then take it. I don’t take a bolus for it, but Loop gives me a high temp for a short bit 'til my BG is stable. That seems to work pretty well so far. And yes, I do notice having the carbs give me more energy during the run!!!
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I’ve told Eric that if I’m not retaining running stuff he’s telling me it’s because this song is blaring on repeat in my head
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This is a bit to get into, but there are a few things to talk about on the ideal ratio.
Glucose uses SGLT1 (sodium-glucose linked transporter 1) for absorption. And fructose uses the GLUT5 transporter.
Because they use different transporters, consuming both glucose and fructose allows more carbs to get absorbed faster than if you were only consuming one carb source. (Like having two exit doors in the theater instead of only one door, people can leave faster.)
But…the faster absorption is not seen as much at lower levels of consumption. Your body can process a small amount of glucose just fine. It is when you start to get to larger amounts that using the different carb sources provides a bigger absorption speed benefit.
However, there is another factor to consider.
Fructose is processed and stored in the liver and does not need insulin. Once it is in the liver, it can be returned to your blood for fuel.
Once you get into those 10+ mile runs, your liver glycogen can become somewhat depleted (depending on your pace). So replenishing liver glycogen is a great thing to do.
So while the 2:1 ratio is most advantageous for when you are consuming larger amounts of carbs, I think there is a great benefit even for lower amounts of carb consumption, because of the liver glycogen replenishment. And I think this can be particularly helpful for diabetics.
I have mentioned before how the Transcend gels - which are all glucose - are much faster at raising BG than the 2:1 Huma gels. But the Huma gels provide a longer lasting carb source because of the liver glycogen replenishment, in addition to the BG (glucose) fuel.
So a lot of this comes down to whether you are looking for a quick BG fix (use Transcend gels) or a longer lasting fuel (use Huma gels).
I hope I made sense of this and did not confuse it even more. Feel free to ask questions on it.
Now I just gotta get the Baby Yoda musical ear worm out of my head.
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This makes sense. No wonder I am able to take a full Huma gel without a bolus while running, and why I do indeed, feel more energetic. A big help from just taking one fruit jelly (Swedish Fish) like I used to which basically kept me low. I haven’t tried the Transcend gels but I think the Huma are right for me. I do tend, but not always, have a spike after the run. But then, that has always been the case even before I used Huma.
Thanks, Eric. No, not confusing. This is the first time I really thought about the difference between glucose and fructose. I instinctively felt the fructose was good for me but I didn’t know why!!
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Thanks for explaining @Eric! I’ve got to buy some of the Gatorade primes to try them out. My mom swears by diluted Gatorade for long runs (but she’s not diabetic) so maybe it’s in my genes that that could work out 
I do like the idea of feeding basal because I’m most comfortable with that, at least for the first part of long runs.
For the long run this week, I’ll try to be aggressive with fueling and see how many grams I can hit while trying to stay in range. I’ll try out the Huma gels this week, but the larger amount of carbs is a little intimidating. So we will see! I’m pretty comfortable at this point with using the transcend gels and bolusing for them while running, so I’m hoping I can apply that knowledge with the humas.
I also want to keep an eye out for my insulin sensitivity towards the end of the run and see how that compares to the start of it.
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Me too, typically! Regardless if I take any carbs while running sometimes. @Eric had a really awesome and comprehensive write up on this that I’m pasting below if anyone’s reading through this thread and is also curious about that rise after finishing running
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I’m only a week late on posting what I found from last week’s long run 
. I don’t plan on sharing my BGs all the time, but I’ll post last weeks run to help explain some of my takeaways.
-20min: 72mg/dL, 5g Gatorade. -10min: .5u.
Start: 76mg/dL,
mi1.25: 59mg/dL, 15g transcend. oops, realized here that I forgot to start a temp basal. turned basal IQ off and set basal -60%
mi2: .5u.
mi2.5: 75mg/dL
mi3: .5u
mi3.5: 66mg/dL, huma lemonade 22g
mi5.25: 63mg/dL, .38u, huma apple 22g
mi6.5: 47mg/dL, transcend 15g
mi8: 51mg/dL, huma raspberries 21g, suspended all insulin
mi8.5: 59mg/dL
mi10, end: 61mg/dL
I hope that isn’t too hard to read and follow. I would love to plot it against my dexcom data from the run since dexcom was comically off
So I really hated the texture of the huma gels. I totally wasn’t expecting it 
. The apple flavor one was the best of the three I tried. I’ve ordered stinger gels to try out, and I’m thinking of trying out tailwind to see which I like best! I love transcends, but I would like to get another fuel source that has the more complex glucose:fructose ratio.
I was a little too aggressive with my boluses throughout the run. I would’ve preferred to be higher than I was the whole run, but that aggression allowed me to take in so many carbs. This week’s long run I will still aim to get as much fuel as I can, but I will back off a little bit to try to hang out closer to 90.
I definitely think that I need to pay more attention to my insulin sensitivity in the later miles because my numbers from last week suggest I get way more sensitive as the run goes on. That is something I want to pay attention to for figuring out basal adjustments as well as fueling boluses. I wish I could pinpoint a marker where the sensitivity hikes up, like does it really start around mi5?? Of course this is silly wishing since it depends on the tons of other factors I walk into the run with, and the run itself! But it’d be nice to be able to have milestone in my head.
In other news, I’m getting much better at opening gel packs without getting gel all over my testing hand and face 
Never knew that feeding myself was something I needed to practice!!
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You saw my comment for that run last week, - I loved the carb total you got, and I loved fueling opportunities!!
Just think of it as a positive. Fueling opportunities! Every low or drop is a chance to give your body what it needs. Those are great things.
A flat 90 gives you less of a chance to do that! 
We don’t want it to be a crazy spiky up and down rollercoaster, but a nice gentle slope up and slope down. Every “up” is a chance to take a small bolus, and every “down” is a chance to take carbs.
Awesome! You are totally normal!!
And I am so excited to read your comment there! You have figured it out!!!
IC’s get crazy when running!
Yesterday my IC was 164. Some days it is 200+. For very long races it goes over 300. There are days when it was infinite, I kept taking carbs with no insulin for 20 miles.
Quick tangent, very useful to read!!
See reference post! ===> contraction mediated pathway.
This 
one post is a good one to read, @LarissaW!
As a general rule, you should try to find the starting point for bolusing while running, like after 1 or 2 miles, and then just start reducing it each few subsequent miles.
It is not an exact calculation, just an estimate.
As you said, it won’t always be consistent, but just find the initial amount that works and then take less and less for subsequent carbs the longer you run.
So just as an example, if your first few miles you take 0.50 units for 20 grams, then after 3 more miles, maybe you would take 0.40 units. Then a few miles later you would take 0.30 units, and on and on like that.
If you hit it too hard after 2-3 miles, the next adjustment would reduce it more. If you hit it too soft after 2-3 miles, the next adjustment reduces it less.
Analyze and adjust for each run.
All make sense?
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O! Yay! Wait, figured out what? Had I not figured out insulin sensitivity changes before??
But yup, all makes sense! I hope I have enough long runs to figure it all out, or enough to feel comfortable, before the marathon