Another marathon down(my third)! And a new personal record! My time of 3:47 at the Philadelphia Marathon was a two minute improvement.
This race is an important point in my 2012 Quantified Self project. In order to best learn from the day, I carried a total of 8 devices with me: an insulin pump, 2 continuous glucose monitors (CGM) (a Dexcom 7 and my newly arrived Dexcom Gen4), a standard blood glucose monitor, a Garmin heart race monitor chest strap and GPS watch, an iPhone, Nike FuelBand and FitBit. I’ll talk more about these later.
As for my diabetes, managing my blood sugars on the day of the race turned out to be more of a challenge than I was hoping for. During my two previous marathons, I saw my blood sugars spike in the hours before the race, both from being anxious and from how i managed my meal dosages. I was determined to prevent that from happening again this year. I had a normal breakfast (an english muffin with almond butter and a banana) very early in the morning at 5am in order to get to the start line on time. I took a dose of insulin that I would normally take assuming I wasn’t about to exercise. I then had another half of an english muffin at 6am. I took a smaller dose for this, hoping that my blood sugars would start going up a bit closer to the 7am start time (they had been at about 145). I also began a temp basal rate at 6am, setting it to 20% my normal rate for 3 1/2 hours.
Waiting for the start along with Ann, my friend and running companion. We ran the Paris Marathon together back in 2010.
Last week, I was able to get my hands on a Nike+ Fuelband to try out for a few weeks. I have to say, it is quite impressive. The hardware, the software, the whole experience is very well done.
I reached my 2,000 fuel points goal after doing a morning run. The light start with a single red dot in the morning and are added as you approach your goal, a blinking green dot (on the left).
As part of my grad school work at ITP, I recently completed a project called “Ready to Start” for my Collective Storytelling class. “Ready to Start” tells the stories of athlete’s first long-distance race, be it a marathon or a triathlon. It focuses on the motivating factor for people to take on this challenge, dedicating both the time and energy needed to train and complete it. In total we conducted nine interviews, three of whom are patients with diabetes (including myself). For a longer description of the project, please see my ITP blog post. Or just jump to interviews with my inspiring fellow type-1 patients Rachelle Glantz and Jen Davino.
I recently got a quarterly check-up and A1c. I was quite interested in seeing the results since I have begun this project and been so focused on my data. My A1c has stayed at 6.4 for the last few years. That has been my best result ever. For about the last decade, it has slowly dropped from about the 6.7 range.
So I was quite shocked and excited to get a result of 5.6! Not only is it my best ever, but it is a significant drop in 3 months. In addition to a close focus on my data, I think a low-carb diet was also helpful. In particular, I have been trying to my lunchtime insulin dosages from the 7.5 u range down closer to 2.5 u. I’ve seen much less of a spike in blood sugars in the early afternoon as a result.
It’s also obviously been helpful to be running a lot lately. I’ve made a weekend long run of 10-13 miles my norm and tried to get in another 2-3 5 mile runs during the week. It’s been helpful in lowering my insulin pump basal rates and also given me a lot of energy.
With the exercise and diet changes, I was also able to drop 12 lbs. and drop my cholesterol over 20%. Hopefully I can maintain and build on these successes.
In preparation for a 14 mile run on a Saturday morning a few weeks ago, I broke from my normal low-carb diet the night before and decided to carb load. The week before, I had lost energy the last few miles of a 13+ mile run. I wanted to see whether a change in my diet could help.
I ended up getting fluctuations in my blood sugar in really unexpected ways. For the entire 2 hour run, I struggled to get my blood sugar up to normal levels despite eating massive amounts of carbs along the way.
Lately I have been doing some runs with a friend that are longer than my average 5 mile loop. These have averaged between 10 and 14 miles. The exercise has been feeling great. But I find it trickier to manage my blood sugar for runs of this length.
A nice run hitting Prospect Heights, Clinton Hill, Williamsburg, the Lower East Side, Chinatown, Dumbo, Brooklyn Heights, Cobble Hill, Carroll Gardens and Park Slope.
I have decided to add a FitBit to my routine of self-monitoring, making it the 5th mobile device collecting data for this project (insulin pump, CGM, blood glucose monitor, iPhone, FitBit).
The FitBit Ultra costs about $100 and contains an accelerometer to measure the number of steps a person takes throughout the day. An altimeter measures change in elevation, meaning that the device can also measure how many floors of stairs you climb. The internal stopwatch can be used to measure sleep and, combined with your activity overnight, gauge the quality of your rest.
Today, my blood sugar was a little high when I woke up. Normally I would simply take more insulin to bring it down. But I knew I wanted to go for a run soon. Working off my past experiences, I thought about how to strike the right balance of insulin, food and exercise in relation to my blood sugar. It would be great to have a system for managing this situation that removes the guesswork for patients.
The challenge of keeping my blood sugar under control during exercise.