Thursday, November 8, 2012

How complex is diabetes?

This is definitely not that of medical opinion. Mainly because I don't know anything about medicine. Only what I observe through my own body. Just attempt to follow.

Recently I've been having these high blood sugars at night. I can see it on my continuous glucose monitor as I sleep. My blood sugar creeps up and up and up. I've also noticed it during the day but that's harder to measure because there is always food on board or insulin on board.

At first, this perplexed me. "My workouts are hard, my training hours are long, how could the insulin be going into my system not be keeping my blood sugars down". At first I blamed it on my insulin pump. Then I blamed eating too much at night. Even with these high blood sugars I was never tired during the day.

Once I figured out it wasn't the pump and it wasn't food at night (because nothing had really changed in my eating habits other than being hungry all the time from long training). I started to think about how I wasn't as tired as I thought I should have been for this happening. I started to think about a lot of the nutrition articles I've read. How the body becomes more efficient with carbohydrates, insulin, food. Is this what was happening? Was my body simply better able to handle the training and use the carbohydrates more efficiently thus my same training insulin doses were to....low?

It was the opposite effect of everything in my mind. Train hard, insulin sensitivity goes up, use less insulin. 

It was almost hard to accept because this is why I love the training so much; the diabetes is so forgiving. I realized I had broken through a wall where my body is more efficient. I'm sure it happened slowly but the wall felt sudden.

As Cliff Scherb told me in an email when I consulted him, "it's a positive development, most likely it means that you are recovering well and topping off your glycogen stores appropriately from one workout to the next".

I made the crude drawing to the right. Basically as your fitness level goes up so does your insulin sensitivity. The red line is the wall I feel I broke through. This is the point where my basal (background insulin) needed to be increased because I was recovering so well that the extra insulin was needed again (much like a person not exercising would need more insulin than a person exercising).

This is almost the advantage of having diabetes (ya right, like there is one). Most people would have no idea their body was all of the sudden more efficient with the food. I, on the other hand, could literally see/feel this happening. 

Wow, I bet none of this makes any sense. And I don't know if it's anywhere near correct from a medical standpoint.

Let me sum it up in layman's terms; last Sunday I went for a 100 mile bike ride. After I didn't feel that tired. I didn't even have to lower my insulin ratio's the way I have in the past. I'm physically ready to do this Ironman. The end.


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