Problems & Solutions of a #Diabetic Athlete

As a diabetic I run into some problems unique to us, or just me, while running. Some of them just stumped me how obvious the solution was, others I am still throwing darts in the dark at sometimes, others I am following the clues.

  1. Hypoglycemia while running – Before I had a pump I would have to eat quite a bit before, without bolus, and during a run else my glucose levels would drop and I would become hypoglycemic. Currently, I use a pump and I reduce my basal to 25% of normal 90 minutes before I start. This will usually keep it dropping a little but I do not need a lot of carbohydrates during and none before the run. I try to keep my glucose between 5.5mmol/L(100mg/dL) to 8mmol/L(150mg/dL) as I seem to work best there. Another benefit of the temp basal is that if I run out or forget carbohydrates I can just stop or walk slowly and my blood sugar will rise back to normal. I don’t usually go running within 4hrs of a bolus so the only insulin working is the basal and at the low effort it will become inadequate
  2. Pump site falls out – This one threw me for a bit. I tried just Skinprep, Skintac, and Tegaderm but it did not stay stuck when I got hot and sweaty. I found a product called Mastisol that along with a Skinprep application seems to mostly work. But not always, so in long races, especially in the U.S. where a Canadian is hard pressed to get coverage, I will wear or bring a spare site with me. I do this when I’m back country trail running too
  3. Hyperglycemia after running – This one isn’t as common but I know other endurance athletes that deal with it, it generally affects those doing short high intensity workouts. For me, pretty much every time I run it will happen. I am still working on this one and there have not been a lot of guidelines to help me. Currently I am retuning my temp basal to normal about 20min prior to stopping and bolusing for the insulin that I will be missing in my basal for the next 2hrs. My temp basal is 25% of normal and say I was using 1unit/hr normally. That leaves me needing an extra 1.5units to cover the gap. I suspect I will need to add more but have not tested yet; the liver is still pushing out a lot of glucose at the end of a run. I try not to eat a lot of high GI foods for a few hours after too.
  4. Dropping a high blood sugar quickly – I have been able to text and figure out how fast my blood sugar drops with a normal basal. Currently about 20mmol/L(360mg/dL) in 30min. If I have a large high sugar level that I let slip by, instead of waiting for insulin to work over hours I will go for a 20-30minute run. It seems to work well and I carry lots of carbohydrates and watch the CGM. I like this because I can just go run not planning it for 90min and take control of he high sugar

That is about all I can think of now. I will add more blog entries as more problems come up or I think of others.

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