Food. Can't live without it. Can't shoot it!
I have pretty much lived a very low carb lifestyle for years in order to control my type 2 diabetes. It has worked well, for the most part. I have managed to keep most of the weight off and keep my A1C below 6.5. I have been able to cycle a lot and ride many endurance events, such as Colorado's Triple Bypass Bicycle Tour and the Copper Triangle Bicycle Tour.
Now I am extending myself into uncharted waters. Competitive cycling. Yes, this fat old guy is going to throw down with the young fit studs in bicycle races throughout Colorado's front range racing scene. Racing in the local amateur scene is part of my training plan for the BIG DADDY race at the end of June. Race Across America (RAAM) is sure to be challenging and an experience of a lifetime.
To fuel my body for training and ultimately for racing, I have had to begin eating more carbs. Eating more carbs raises blood glucose levels. Which in normal people would not be excessive. But for someone with diabetes, the level of blood glucose often exceeds healthy norms.
I have seen my waking blood glucose go from 100-110mg/dl up to 130-160mg/dl since I changed my carb intake. I used to see 2 hour post meal blood glucose levels of 140-150mg/dl with a few complex carbs.
This morning my 2 hour post meal reading was 241mg/dl having eaten 1 cup of oatmeal with a small banana. Post glucose dropped down to 126mg/dl after my 66 minute bike commute to work of 15 miles with an average heart rate of 136bpm. Still high.
My 7 day average blood glucose used to be 110mg/dl. Today that average has increased to 132mg/dl. Not acceptable in my book. But is this trend something to worry about? YES! Since taking my health and specifically my diabetes control seriously, I have prided myself on good blood glucose CONTROL!
I am having trouble regulating my blood glucose as I have to increase fuel. Plain and simple. I have been revisiting my plan for controlling my blood glucose given this general upturn in my averages. My current Internist is a great doctor. However he, as with many in his specialty, do not seem to listen to his patients. I think this is partly due to generalizations that type 2s are not proactive in their treatment. Nor are they athletic.
At the recommendation of several of my Team Type 1 teammates and friends with type 1, I have placed a call to the University of Colorado Barbara Davis Center to see about getting an appointment with an Endocrinologist who works closely with diabetic athletes. I am hopeful that I will be given the opportunity for an appointment, even though I was told they do not normally see patients with type 2 diabetes. This seems to be yet another gap in the healthcare system in which I seem to fall. These gaps are a topic for another post.
The lesson I want anyone reading this to come away with is simple. YOU are ultimately responsible for YOUR care. YOUR treatment plan. And control of YOUR diabetes. Educate yourself. Your family. If necessary, your doctor as to what IS or IS NOT working in your treatment plan. It is only through an active partnership between YOU and your health care team that you can realize a plan that works for YOU.
Finally, if you make substantial life or behavioral changes, be sure to revisit your treatment plan as I am doing now.
February 4, 2009 - 6:08pm
#2
Great question, Craig. The frequency of my training has increased considerably. Not a lot of long hard efforts, but enough for me to need to fuel differently. You see, normally I would consume 25g of carbs or less daily on non-ride days. On days where I would bike commute, I would increase that to 40-50g. Then, a low carb, low fat, high protein dinner like chicken breast and veggies.
Now, I am doing 2 hours ride time pretty much 5 days per week of varying intensity levels. At my low carb intake levels, I currently bonk on the ride days with that low level of carb intake.
The experiment continues.
One thing was missing from your description of your training - how have you increased your training? You mentioned taking on more food, but from what I can tell, the additional food should be before and after a very hard training ride or race. I have the luxury of giving more insulin to counteract more carbs that I take on when doing significant efforts (wow, a benefit of being type 1 versus type 2). If your morning ride is no harder than you always have ridden, then no need to take on more food.
Post-ride (assuming hard efforts) you will want to get carbs and protein into your system within 30 to 45 minutes because your body is more efficient at using the food to start repairing itself when you take the food within that timeframe. I, like you, am always looking for tips and helpful hints in how to get my body to perform better when it does not make/use insulin in the manner that it should. I am now trying to figure out how to take insulin and food before a race to be better fueled during the race. I still have not got it dialed in and it is a work in progress.