That’s why you are dropping so much, the basal is the same. Are you still doing one Lantus shot, or are you on two? If you are doing one, try doing the Lantus right AFTER practice. That way, you will have the smallest possible Lantus on board for the next day’s practice (because you will be at 22-23 hours).
You can drop 50 points if you want, but you don’t have to. That seems risky to me. You either have to start much higher, or you risk going low. Working with the timing of the Lantus shots would be helpful.
That’s clear. But, short of being able to keep a daily practice time every day, there is nothing you can do about it I think.
For us, for instance, we have 3-5 practices a week, and meets 2x per month on weekends. Practice times are different for every day, and even don’t repeat from week to week. Practice duration is different for every day of the week. And the kind of effort required makes radical changes to insulin needs as well: a 2-hour long lap-only practice is insulin intensive, while a 1.5 hour turns & starts practice is light on insulin.
This kind of variability is just too much for MDI, I think. A stable basal rate is the only option we have.
We are doing two, a lower amount in the morning and a higher one in the evening, to try and minimize the effect of exercise during the day - but the result is marginal at best. And practice time changes daily.
eric, i do use what it gives me. i dont think i would be doing a tri or running mountain races if i hadnt been diagnosed as t1. i happily ran 5 and ten km races for like 20 years without considering doing anything much else. since diagnosis 5 years ago, proving to myself i can do different things with my body, just like anyone else, has become very important to me, for some weird reason.
ok, here are the answers:[quote=“Eric, post:19, topic:163”]
ow long have you been diabetic? Is it T1, and your body is not making any insulin?
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ive been T1D since 11/11, age 36. had a very long honeymoon, about 18 months, very minimal basal and bolus. i dont know if my body is making insulin anymore. it definitely was when i was honeymooning, and things were much easier.
i do all of my training in the morning, as i work in the afternoon and evenings. the time varies, but its always the morning. i never have any bolus in me when i swim, usually dont need to bolus for brekkie. if i do, i wait at least 2 or three hours to head out to the gym. (it is a different beast in the week before my period , as i am insulin resistant-then i need bolus for brekkie). for brekkie i have an omelette with veg and cheese and coffee with milk. i also have wasa krispbread with butter and a square of dark chocolate, as i know i will need to be a bit high to swim. my breakfast is btwn 1 to 2 hours before i swim usually. i cycle to the gym, about 15 min. before leaving my house, i always check bg. if it i need a boost, i will have a full fat greek yogurt. as i write this, i really think i must still be making some insulin…i dont think its too much basal, because i need the rest of it throughout the day.
i do my swimming before levemir.
i suppose i can try levemir the night before a bit earlier. [quote=“Eric, post:19, topic:163”]
How are you injecting Apidra?
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i have a pen. i got a junior one from my endo with half units, as im quite insulin sensitive. this seems to work really well for me. im sure a pump would be better but socialized medicine in economic crisis does not permit it. micro-dosing, my doc was like like, lets not get crazy…
total tdd: 22units levemir (11 and 11) and apidra, depends on day. pms week, maybe like 5 units a day, regular weeks, maybe 2 or 3.
correction factor: 1 unit will bring me down about 75 points, or whatever you want to call them.
ooh, sont know. after i do my swim, which includes horrible drills of just kicking for 3,948 meters, i go into the hidromassage pool and then the sauna. i dont really keep track of the time. i have no idea! but its a short distance, so it doesnt take very much time.
Ok, so you are swimming 2 hours after breakfast, not taking insulin for your breakfast, and then dropping that much. That sounds like either too much basal for the exercise, or you are making insulin.
Let’s see if we can work through the swimming and morning first. I assume the race will be in the morning? Most of them are.
Have you tried doing a single Levemir shot in the morning instead of two? In your case, if you did the Levemir after your morning workout, and only took a single shot, the next morning you would have minimal basal. I know Levemir is tricky for doing 1 shot a day, but it might be a worthwhile experiment. Of course, you would have to take more, but it would be after the morning swim.
If you are only taking 2-5 units of Apidra a day, you have to be able to micro-dose that. Think about it. Right now, if you are taking 2 units in a day, the smallest increment you can give is 1/4 of your total rapid insulin.
Am I understanding your numbers correctly?
Let’s look at this as a comparison…
Imagine if there was a guy who took 40 units of Apidra a day for meals. And the smallest dose he could give himself was 10 units (1/4 of his total dose, just like you). He goes to the doctor, and says he wants to be able to dose a smaller amount, like only 1 unit. And the doctor says “lets not get crazy…”. That’s seems about like what the numbers are to you. 1/4 of your total meal bolus amount is a bunch of insulin to take.
Am I understanding this?
I can get you going with micro-dosing. You don’t need anything but saline, empty vials, and some syringes which do not need a prescription (at least not here). On Amazon you can buy syringes with no prescription in the U.S. Can you do that in Spain?
Is the Apidra pen the disposable type (where you throw the whole pen out), or does it have a disposable cartridge?
All the stuff you need for micro-dosing is non-prescription (other than the insulin, which you already have), so I can legally send you the rest of what you need.
That is a big number. Even more reason to micro-dose.
Spend a few minutes thinking about what it would be like to take 1/10 of a unit whenever you wanted. How your level of control can improve, especially when it comes to exercise.
Just to make sure I understand, your total dose for everything on days you take the most insulin, is 27 units, right? 22 of Levemir and 5 of Apidra?
Are you on a low carb diet? What is your total carbs for a day?
Also, have you done a test for your basal amount to make sure the basal is not covering meal carbs?
The reason I ask is that your numbers show a basal/bolus ratio of about 80% - 20% to 90% - 10%. If that is the correct ratio for you, that is fine. But it’s important to know if those basal units are covering some of the meal carbs. If they are, you need to adjust that to help with exercise blood sugar management.
If you were to go a whole day without eating anything, and started with level blood sugar and kept the the two 11/11 Levemir doses, what would happen to your blood sugar? Would it stay level?
Just read that and laughed. I’m certainly no athlete, but it makes me feel kinda proud of myself to have pretty much professionally outlasted the majority of my dental school classmates.
I’ve been practicing dentistry for forty years, and I’ll probably go for at least fifty. I want to be the last member of my dental school class to still be practicing, all with this “D malarchy”.
@Gus, would you consider writing a post that gives your thoughts and lessons learned on triathlon training for people with diabetes?
We could have it permanently linked through our navigation pages to important topics.
Possibly you could separate, in two different posts, general lessons learned that apply to all athletes with diabetes, and those that are specific to using Afrezza in triathlon training?
Full disclosure: my 12-year-old son has talked to me about wanting to eventually train for triathlon someday
You should look into some of your local events, they have shortened version for the kids to learn, and they are really cheap to boot. My kids did quite a few when they were 5-8 years old. They are short enough that you don’t need to train very hard, but they give the kids the bug.
Thanks for the offering Michel. Though not sure how much could I add on the injected / pump side. Lots of really savvy people on this thread. There is also some interesting books on this topic, I liked the diabetic’s athlete handbook.
In summary, with injected for me it was all about minimizing IOB. Especially when I was on a pump. So super tuned basal, low carb diet except immediately after exercise, etc. If I had to go back to injected for meals/corrections, I would avoid the pump because rapid as basal for me its to much risk. I would do injected basal, and a very low carb diet. As I said on another thread, being on Afrezza made me realize that for me all those crazy custom basals where mainly because of IOB/stacking. So no need for a pump. God forbid I never have to go back to that though.
Congrats on your son’s interest to do a triathlon. Its a lot of fun, and very addictive!
I will try to write something up if you think that will be useful for people.
