I have always had a lot of trouble maintaining my BGLs when I am training in the afternoon. No matter how much I lower my basal insulin or how many carbs I consume, I always seem to end up having a sharp BGL drop during the session and if not that, then I end up with stomach issues from eating too much before/during the session. The combination of consuming carbs before/during a 1-1.5hr session and also reducing basal insulin, ultimately leads to a spike in BGLs after the session. Adding all of this up it’s 4hrs of worrying about BGLs every afternoon as I prepare, train and then recover.
Especially with triathlon training where you need to squeeze in swim, ride and run sessions along with strength and recovery, you need to utilise all available sessions which including afternoons/evenings. With my challenges training in the afternoon I try to plan my sessions to get the most important ones in the morning (run and bike) and do other sessions in the evening (strength, swim plus lighter runs/rides). It takes some effort to get my planning right needing to consider; diabetes (am/pm), session requirements (hard/easy/length), pool availability, recovery time between sessions, weather and other personal commitments. Even so, but with a little stress, I manage to get 15 hours of training in most weeks.
So even though it’s a real challenge, I prepare myself most afternoons to head out and complete a training session know full well that there’s a high chance I’ll have a hypo. Recently I have had some success, my BGLs have been fairly stable and I’ve been able to complete some really good afternoon running sessions. The things which I am doing at the moment to give myself the best chance to complete these sessions include:
- Reduce basal insulin 2 hours before training session and maintain reduced basal for first half of session. I need to reduce my basal rate by 70% for swimming and running session, and 50% for bike sessions in the afternoon. I do not require a reduction for strength sessions.
- I do not start my session until after 2 hours post reducing my basal insulin rate to ensure that insulin levels in my system are reduced.
- I try to start my sessions with BGLs around 10.0 mmol/l knowing that they will drop within the first 15 minutes
- Consume between 20 and 40 grams of carbs about 30 minutes before the start of the session. This will usually be a supplement like Endura Optimizer or Hammer Recoverite mixed with water. I find that I respond well to these carb sources and they do no upset my stomach.
- During a 1 hour session I will consume 25 grams of carbs at around the 30 minutes and this is usually a sports gel. It is important that whatever I consume does not upset my stomach and I also need to be able to carry it when running. When swimming or riding liquid carb sources are also an option.
- I check my levels every 15 minutes during the session to make sure my levels are tracking OK and I can adjust things if needed. This does seem like a lot of testing but my levels are drop very quickly and when you are covering a kilometre in around 4 minutes it can be a long walk home if you’ve missed a hypo!
- I plan my sessions so that if something does go wrong, most likely a hypo and needing to walk back to the start, I am not too far away. A 20 minute loop is a good option and also provide for keeping provisions in your car for easy access.
I really work hard to get the most out of all of my training sessions and I do get upset when things don’t go to plan. I try to not let these incidents get to me but when you are trying your best and things still go wrong it is challenging to remain positive. Nevertheless, after many many incidents I continue to train and continue to work to get my diabetes management as close to perfect as possible. I know from experience that this will never be possible but the most important thing is to continue to strive to be better and in the end be healthy. Two afternoon run sessions week, one successful and one included a 20 minute walk back to the car in the rain, luckily I’m running first thing in the morning tomorrow!