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Quarterly Diabetes Tracking 6/21/2020-10/5/2020

Disclaimer: I know there is some controversy regarding sharing your medical information/A1c online. In the relatively short time that I’ve been diabetic, I’ve been able to get pretty decent control over my blood sugar and A1c. Since I’m showing you all how I control my BGs during my workouts, I figure it’s only fair to also show you my big picture results for how I’m doing overall when I get my quarterly blood work done. I’m sure that some quarters will be better than others, just like some days are better than others but I believe tracking this information has allowed me to have better control. I hope that by sharing this information and allowing others to follow my data, it may inspire others to track and figure out what works for them as well. 

To be clear, I am NOT saying, do what I do and your problems will be solved*. I AM saying track and experiment and figure out what works for you. I think Chris Ruden (he is a T1 beast!) puts it perfectly in episode #201 of the Juicebox Podcast:

“There is no universal fix for an individual problem.” –Chris Ruden

With all of that said, here is my data for the 6/21/2020-10/5/2020 time frame:

HbA1c = 5.1%

(A1c is in NORMAL range!!!!)

For reference: Normal (not diabetic) is 4-5.7%, Pre-diabetic is 5.7-6.4% and Diabetic is 6.5% or higher. Most endocrinologists recommend their T1 patients try to stay under 7% and when I was diagnosed, my HbA1c was 11% (Yikes!).

Blood work (personal information is redacted)

Time in Range (TIR) = 94%

Since many now consider time in range to be more important than HbA1c, I wanted to include that as well. You can achieve a “great” HbA1c number by having a lot of hypoglycemic incidents, which is actually quite dangerous. The real goal is to get as close to a normal HbA1c while avoiding hypoglycemia (low blood sugar). This is why many who have a CGM (like me) focus more on TIR. This quarter, according to my sensor, I was in target range for 94% of the time, and never below 50 or above 250.

I was ecstatic with my numbers this quarter (again)! I still need to work a bit on my lows a bit but nothing below 50 last quarter so not horrible! I know that technically, this is more than a quarter but with the move and changing insurance/doctors, this was the best I could do. Regardless, both my A1c and TIR were better than last quarter so no complaints here! I really believe the only way to achieve long term success with diabetes, is to work towards daily (or even hourly) wins. Consistency is key!

Stay strong!

#BetterThanYesterday

*Although, if you’re curious to see what has worked for me, feel free to check out my Tips & Tricks page.

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

11/22/2020 – Run

Mid-distance Fun Run

Hilly and snowy run to clear my mind

  • 8:57 am, SG 127, Start Temp Target
  • 10:04 am, SG 123, Start Run, 6g carb
    • 10:45 am, SG 169, End Temp Target
  • 11:25 am, SG: 161, End Run, 0.5 U pre-bolus
    • 11:35 am, SG, 118, 9g protein
  • 11:55 am, SG 118, 30 Minutes Post Workout

Marty and I have been pretty lucky to check off a few big things off our bucket list this year* but recently it got us wondering “What’s next?”. After some discussion and reflection, I realized I’m going to have to find a way to get four more marathons done in the next two years if I want to stay on track to finish 20 marathons in 10 years. When the pandemic started, I swore off virtual races (they just aren’t my thing) because I wanted to achieve my goal only finishing “real races”. If you’ve been following along for a while, you might recall that I was supposed to do a race back in March that got pushed back, went virtual and then I deferred to run it in 2021. Well my friends, we are about 17 weeks out** from race day already and since I haven’t been doing too many long runs recently, I decided it was a good time to start marathon training again. Marty has some bigger goals but more on that to come in future post!

So my husband/coach created a training plan for me for the race and today I had an option. 90 min run, 8 mile run or 90 min hike with the pup. I prefer to run for distance than time*** so I went out for 8 miles. The course was a bit hilly today and I “cheated” and listened to some music today. The temperature was hanging just around freezing, which is great for running and it even started to snow a little for my last two miles. I felt good while running and it felt like I blinked and it was over. You know that feeling when you drive somewhere and arrive without remembering the ride? That was my run today.

For my blood sugar management, it was super simple today. Not my best line but still 100% in range so I’ll take it. I woke up late at night to prevent a low (which I did catch in time, luckily) but waking up jacked my sleep up a bit so I slept in this morning. I felt pretty awful when I finally got up, but surprisingly, my blood sugar was behaving so I leisurely sipped my coffee, set my temp target, and moseyed around the apartment getting ready to run. As I was getting ready, I realized I was almost out of running fuel/emergency food (guess I’m going to the store today). I did happen to stumble upon some mints and jolly ranchers so I figured that would do.

When I started running, I popped a jolly rancher and that lasted me the whole run. It’s so nice when I get to just run and not have to micromanage BGs. My line wasn’t ideal and looked a bit like my elevation. About half way through, I ended my temp target to get some insulin flowing and then right when I finished, I did a quick breakfast pre-bolus since I was still running higher than I like. Shortly after, I started to drop quickly (before I was ready to eat breakfast) so I had some protein coffee**** to prevent a low. My BGs leveled off nice and steady after that, even with breakfast thrown in the mix. Some days, it feels like you can’t do anything right and then you have days like today and it all balances out! Happy Sunday (and Go Birds!*****).

*Marty ran almost 60 miles to raise money for T1D, we moved to our favorite part of the world, and we started a business!

**Most marathon training plans are 16 weeks long.

***Running for distance means I’m having a good day, I can finish my run faster than if I were running for time and if I’m not, I don’t cut the distance short because I hit a time goal running slowly.There are benefits to training by time too, it’s just generally not my preference.

****Which is just coffee with unflavored collagen powder. It is pure protein but it always gives my BGs a small spike. I love it as a non-carb way to prevent a low.

*****Can’t beat blogging and watching football! E-A-G-L-E-S, Eagles!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

11/15/2020 – “33 Death Workout”

A special challenge for my 33rd birthday

Run & Strength

  • 6:12 am, SG 237, Start Challenge, Part A
    • 3.33 Mile Run,
      • 16g carb @ mile 2, Set Temp Target
    • 33 Squat Jacks
    • 33 Jump Lunges
    • 33 Burpees
    • 7:16 am, SG 127, 3.33 Mile Run
      • 6g carb @ mile 1.5
      • 6g carb @ mile 2.25
      • 6g carb @ mile 3.33
    • 33 Squat Jacks
      • 6g carb
    • 33 Jump Lunges
    • 33 Burpees
      • 6g carb
    • 8:18 am, SG 90, 3.33 Mile Run
      • 8:37 am, End Temp Target
    • 0.02 Mile Run (to officially hit 10 miles), 0.3 U correction
    • 33 Squat Jacks
    • 33 Jump Lunges
    • 33 Burpees
      • 6g carb
  • 9:16 am, SG 80, Start Challenge, Part B
    • 11 DB close grip pushups
    • 16 DB thrusters
    • 11 DB bicep curl
    • 16 DB bent over high row
      • 2 min rest
    • 11 DB close grip pushups
    • 16 DB thrusters
    • 11 DB bicep curl
    • 16 DB bent over high row
      • 2 min rest
    • 11 DB close grip pushups
    • 16 DB thrusters
    • 11 DB bicep curl
    • 16 DB bent over high row
  • 9:30 am, SG 118, Start Challenge, Part C
    • 33 table top crunch
    • 33 reverse crunch
    • 11 weighted crunch
    • 16 bicycle crunch
    • 33 sec alt forearm plank
      • 2 min rest
    • 33 table top crunch
    • 33 reverse crunch
    • 11 weighted crunch
    • 16 bicycle crunch
    • 33 sec alt forearm plank
      • 2 min rest
    • 33 table top crunch
    • 33 reverse crunch
    • 11 weighted crunch
    • 16 bicycle crunch
    • 33 sec alt forearm plank
  • 9:48 am, SG 144, Start Challenge, Finisher
    • 11 Ab Rollouts
  • 9:49 am, SG 144, Finish Workout, 0.6 U correction
  • 10:19 am, SG 135, 30 Mins Post Workout, Exit Automode

Tomorrow is my 33rd birthday and because I’m completely out of my mind, I asked Marty to make me a workout to celebrate (tomorrow is a pretty busy day for me so I tackled it a day early). Marty really puts a lot of thought into his workout plans so you’ll notice everything ties to 33 (my age), 11 (the month I was born) or 16 (the day I was born). It was also a killer workout (see above). I was talking to my brother about it yesterday and I said, “I think Marty is trying to kill me.” This morning, he texted me,

“Have fun with your death workout!”

Well, it didn’t kill me so I guess Marty will have to try harder next year. When I started the first run this morning, it was 30 degrees out and raining. Then I ran back up the two flights of stairs to our apartment and did my squat jacks, jump lunges and burpees. When I went out for my second run, the rain had stopped but the wind picked up. It felt much better than the first run even though the route had a lot more hills. When I finished, I ran back up the stairs of our apartment again for more squat jacks, jump lunges and burpees. By the time I left for run number three, the temperature had risen to 40 degrees but the wind had really picked up (14 mph)! My cheeks were bright red from wind burn by the time I was done running. I stopped my watch to make sure it read 3.33 and then started it again for a few more steps to make sure I got credit for running 10 miles today on my Garmin. Then I did another round of squat jacks, jump lunges and burpees, which were getting pretty tough by the end.

After I finished that part of the workout, Marty planned a strength set, an ab set and a finisher. That is when things really started moving. I finished those sections relatively quickly compared to the first but I’m guessing the second two will likely be the cause of any muscle soreness I feel tomorrow. All in all, definitely a fun one to conquer and celebrate my birthday!

My blood sugar was a bit of a rollercoaster today but almost completely in range during my workout. I did spike high while I was sleeping last night so technically I was out of range when I started the workout but it came down quickly (a little too quickly) as soon as I started running (and stayed in range for the rest of the workout. When I was 2 miles in, I saw 145 with three arrows down. I knew I needed enough carbs to slow the drop and fuel the rest of my workout so I had 16 jellybeans. Yes, 16, in one shot*, which is way more than I normally do at one time but I factored in a few things. I knew I would be working out for a few more hours. I knew I needed extra to prevent a low and funish my current run. I also knew automode had increased (and maxed out) my basal rate for the past few hours so I had extra basal insulin dropping me even more. Also, it was at this point I remembered to set my temp target.

For the rest of the workout, I just had a few jellybeans whenever I started trending down or preemptively to fuel upcoming cardio. I ended my temp target when I was done with the cardio and exited automode after my post workout shower to prepare for lunch and the rest of my birthday festivities we have planned for today. Working out with T1 isn’t always easy, but you can always make adjustments to make it work.

Happy Sunday Diabuddies! Stay Strong!

*I had 52g of carb to fuel today’s workout. Often I hear other T1s complain ‘why bother working out if you have to eat all of those calories to maintain normal blood sugar levels?’ Im going to ignore all of the other benefits to exercise for a moment and just focus on calories/weight loss. Using today as an example, I ate roughly 234 calories to keep my BGs stable. According to my Garmin, I burned over 1,400 calories during my workout today. Not bad math in my opinion! 😉

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

10/25/2020 – Run

Another Goggins Challenge

Run & Push ups

  • 7:16 am, SG 158, Start Walk
  • 7:30 am, SG 159, End Walk
  • 8:45 am, SG 113, Start Challenge
    • 0.5 Mile Run, 5g carb
    • 25 Push Ups
    • 0.5 Mile Run (1 Mile total)
    • 25 Push Ups (50 Push Ups total)
    • 0.5 Mile Run (1.5 Miles total)
    • 25 Push Ups (75 Push Ups total)
    • 0.5 Mile Run (2 Miles total)
    • 25 Push Ups (100 Push Ups total)
    • 0.5 Mile Run (2.5 Miles total)
    • 25 Push Ups (125 Push Ups total)
    • 0.5 Mile Run (3 Miles total)
    • 25 Push Ups (150 Push Ups total)
    • 0.5 Mile Run (3.5 Miles total), 4g carb
    • 25 Push Ups (175 Push Ups total)
    • 0.5 Mile Run (4 Miles total), 4g carb
    • 25 Push Ups (200 Push Ups total)
    • 0.5 Mile Run (4.5 Miles total), 8g carb
    • 25 Push Ups (225 Push Ups total)
    • 0.5 Mile Run (5 Miles total)
    • 25 Push Ups (250 Push Ups total)
    • 0.5 Mile Run (5.5 Miles total)
    • 25 Push Ups (275 Push Ups total)
    • 0.5 Mile Run (6 Miles total), 0.4 U pre-bolus
    • 25 Push Ups (300 Push Ups total)
  • 10:15 am, SG: 90, End Challenge
    • 400 meter “just to air it out”
  • 10:17 am, SG: 90, End Run
    • 10:30 am, SG: 87, 2g carb
  • 10:50 am, SG 91, 30 Minutes Post Workout

There are few things that get me more excited to workout than a good challenge. Historically, I’ve used races as my motivation to keep up with my training and fitness but with the current state of the world, I’ve been resorting to other kinds of challenges. Earlier this week, Marty suggested that we try David Goggins‘ run-push up-run challenge. The workout is a 6-mile run, however each time you complete half a mile, you stop and do 25 push ups. That’s a total of 300 push ups by the time you finish all 6 miles. Additionally, you have to run each mile 10 seconds faster than the previous mile. I just can’t help myself so today we went to the track to give it a shot.

I was so excited when we got to the track, I completely forgot to check my blood sugar before we started the first half mile. Earlier in the morning, the Dawn Phenomenon had me running a bit high (but still in normal range). I took Miles for a walk which knocked it down a bit but I was still hanging in the 150 range. I wasn’t really concerned about creeping a bit higher or lower before my run since I knew the run could bring it back down or I could boost it with some carbs. After the first half mile, I realized my basal had finally started to bring me back down and I would need some carbs to sustain the rest of the workout.

At mile 3, I saw I was trending down again and thought to myself, okay more carbs after the push ups. Again, I got so wrapped up in the challenge and the pacing that I started my next half mile before I ate. Whoops! I should have stopped for carbs after I realized but I thought ‘it’s only a half mile, I’ll fix it after’. I had some carbs at 3.5 and 4 but it wasn’t soon enough and I ended up dropping down to 60 before it started to come back up and level out. That is the hardest thing about running with diabetes in my opinion, it’s easy to forget to keep monitoring it when you find yourself in a run induced flow state. Luckily, this time I caught it quickly (and before I was actually low) and was only low (below 70) for about 5 minutes or so.

The running itself wasn’t bad at all for me, which probably means I should have started at a faster pace. Today, it was the push ups that became really challenging by the end. Of course, Marty kept me honest. He started to put his fist under my chest and told me to make sure I was tapping it on each rep to ensure I was doing the full movement and not “cheating” on the reps. He is lucky I love him! 😉 After we finished, Marty suggested doing one more lap, just to air it out and get the legs turning over quickly. I figured, ‘why not’ so we tacked on an extra lap. All in all we had a blast and got in a workout that I’m sure my pecs will be sore from tomorrow.

Let me know if you try this workout in the comments or if you have any suggestions for future workout challenges! Happy Sunday Diabuddies! Stay Strong!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

10/18/2020 – Run

Tour the Town & Trail Run

& sweets for breakfast!

  • 6:59 am, SG 226, Start Walk
  • 7:43 am, SG 170, End Walk
  • 7:53 am, SG 169, Start Temp Target
  • 8:32 am, SG 167, Start Run
    • Mile 1, 4g carb
    • Mile 2.5, 8g carb
    • Mile 3.5, 4g carb
    • Mile 4.75, 8g carb
    • Mile 5.25, 8g carb
    • 9:45 am, SG 85, End Temp Target ~Mile 6
    • 9:55 am, SG 95, 0.5 U Pre-bolus ~Mile 7
    • 10:02 am, SG 106, 0.5 U Pre-bolus ~Mile 8
  • 10:25 am, SG: 84, End run
    • 10:35 am, 6.1 U Pre-bolus for breakfast
  • 10:52 am, BG: 86, SG: 78 ~30 Minutes Post Workout
    • 10:53 am, BG 86, maybe 60ish? carbs, (Pumpkin scones & pumpkin coffee!)

Today I slept in a bit which turned out to be a mistake. I must have slept through some pump alarms because by the time I woke up, my BG was already over 200 (and had been for some time). Luckily, Miles is always down for a good long walk. Miles and I walked until my BG came down, which took about 2 miles. It was a beautiful, crisp fall morning in central New York so when Miles and I got back, Marty and I decided to run together and enjoy the lovely weather. Before we left, we had half a cup of coffee and planned our route. There is a beautiful short trail nearby that we recently found so we decided to run through town to the trail head, run the trail, run down to the lake and then back through town to our home. Since Marty and I don’t run the same pace (he is much faster), he sprinted ahead every once in a while and then ran back to me to “recover” and run at my pace. It makes for a nice relaxed run for me and serious intervals for him. I ended up with 10 miles and he ran 11.25 miles by the time we got home (just to give you an idea of how much faster than me he actually is).

There were lots of things to consider with my BG management this morning so bear with me here. I wanted to have coffee, run and then have a pumpkin scone with pumpkin coffee for breakfast* and when I woke up, the Dawn Phenomenon was kicking my butt! I didn’t want any active insulin on my run, I wanted it to be leisurely and enjoyable** and Marty was still sleeping so a walk with Miles was the perfect solution to my dawn phenomenon problem. Since I knew I wanted to go for a longer run, I knew I would also need to set a temp target/reduced basal and have some carbs during the run. Afterwards, I knew that I would need some basal and active insulin working before I ate breakfast and a large bolus for an extra carby one.

To manage all of this, I had some extra carbs a bit earlier in my run than I normally would. This allowed me to avoid a low at the end of my run, while ending my temp target a bit after the half way point and pre-bolus twice for breakfast while I was still running***. This can be a dangerous thing to do and I wouldn’t recommend it if you are new to running, new to diabetes or new to running with diabetes. I don’t ever do this unless I have enough extra carbs on me while running to cover my per-bolus and then some in case I miscalculate/mistime something or my BGs do something unexpected. Safety first! Today, it mostly worked out and even though I dipped into the 60s before the scone carbs kicked in, I topped out at 144 after the spike. Not too shabby****! Happy Sunday and Go Birds!!

*There is an awesome bakery nearby that makes these. This was definitely a special occasion kind of treat!

**Sunday long runs are supposed to be fun and I don’t find running to bring my blood sugar down to be relaxing or fun.

***Pre-bolusing is huge for managing blood sugar and absolutely critical for anything with a lot of high GI carbs.

****After a high carb anything where I’m guessing on the carb count, I bump and nudge with insulin and lower carb healthier snacks to avoid going too high or low in the following hours. Today that included some cottage cheese, celery and a little bit of popcorn. Automode can help here too, when it works. 🙂 It is a whole lot of work and monitoring for a small treat. This is why most of the time, I stick to a low carb diet. Also, when I do have a high carb treat, I do it early in the day so it doesn’t mess with my sleep.

With the new job, the new business, house hunting and hosting friends and family, I haven’t had a ton of time to blog about my workouts recently. Sorry about that! It doesn’t mean I haven’t been working out though! It’s a bit disheartening that most races are still cancelled but maintaining functional strength and overall heath isn’t any less important in a pandemic. If you fall off the wagon or miss a day, get back up and get on it. You don’t fail until you stop trying! Stay strong diabuddies!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

How do you lose weight with diabetes?

Something I don’t like to talk about much, is that I gained about 30+ lbs in the months following when I was first diagnosed. Some of this was really positive since I had lost so much weight prior to being diagnosed. Unfortunately, a lot of what I had lost was muscle because my body was so starved for sugar that it was breaking down anything it could for fuel. Looking like a skeleton is not anyone’s idea of healthy or attractive*.

Once I was diagnosed and began injecting insulin, I quickly gained all of the weight back and then some. Some of it was because I was re-hydrating, after weeks of chronic dehydration. Some of it was just because my body could process food properly again but some of it was also because I was having multiple lows per day. I was treating my lows and eating a bunch of extra calories in emergency food every day. It was awful. Looking back, I know that this was just because my doctor and I were trying to figure out my correct dosage. But at the time, I was scared that this disease would make me fat and there was nothing I could do about it. As usual, I was wrong but I know many diabetics who feel this way, especially early on in their T1 journey.

The first step to getting back to a healthy weight for me was getting better blood sugar control.

Let me repeat that; it isn’t about a specific diet or workout, to get to and maintain a healthy weight, getting good control over blood sugar is priority number one!

Once blood sugar is well controlled**, T1 diabetics gain and lose weight the same way people without diabetes do. We also gain and lose strength, speed and power the way they do. Now I’m going to remind you all that I’m not a doctor, nutritionist, personal trainer or any other type of formal expert. I’m just someone who does a lot of research and experimentation to find what works for me and while I’m happy to share my own findings, I’m not suggesting anyone do what I do or that what works for me will work for anyone else.

For me, once my blood sugar control improved, I started working out and running again.  It was a big help to get my weight back to where I felt healthy and I’ve been slowly working on building my strength and speed back ever since. Progress isn’t a straight line. It’s full of ups and downs but if you’re consistent, you’ll begin to see results!

“But what do you eat?!?!”

I get asked this all of the time. Most days, I eat pretty low carb but this is mostly to make blood sugar control easier. I try to eat as many whole, unprocessed foods as possible. When it comes to macros, I often do high protein but will have some high fat days and some low fat days. However, I don’t have any real hard and fast rules. I usually even do a high carb day once per week or so. I treat myself on occasion and sometimes this means making a low carb substitute*** for something I love. Sometimes I eat normal pizza, ice cream, cereal, nachos or whatever other junk food I’m craving. If I know, I’m going to have a “cheat day” or “cheat meal”, I try to do it on a hard workout day. Other than that, there isn’t anything special about what I do to lose/maintain a healthy weight but I’ll list some of my favorite resources below. These guys are the true experts in T1 nutrition, fitness and blood sugar control. Feel free to check them out if you want to learn more about this topic. 

*I mean, I was in my friend’s wedding a bit over a month before and I was afraid my size 0 strapless bridesmaid dress was going to fall off. Not a good look!

**No one is perfect so don’t beat yourself up but I mean in range most of the time.

***See my recipes page for examples of my favorite treats.

  • The Juicebox Podcast– For learning how to control blood sugar, the Pro Tips are life changing.
  • Chris Ruden & Ben Tzeel– T1 trainer/nutritionist. Periodically, they pair up and do a weight loss/strength building coaching program specifically for people with T1D
  • FTF Warrior– Another T1 trainer/nutritionist who shares a lot of great content and works with people with T1D
  • Dr. Bernstein– His book “Dr. Bernstein’s Diabetes Solution” was the first thing that helped me gain control over my blood sugar. I don’t follow his low carb diet to the letter but sticking close to it has really helped me immensely! The law of small numbers was life changing for me.
  • Mastering Diabetes– I tried their recommended diet and it didn’t work well for me. What I liked about this book was the section on intermittent fasting but I have heard other diabetics say their diet works for them.

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

What can I have that won’t affect my blood sugar?

In my diabetes groups, it seems like everyone is always asking, “What can I eat/drink that won’t affect my blood sugar?”

Almost every time, someone provides my favorite answer…

“Water!”

Water is essential for life and humans can only live for about three to four days without it. So all sarcasm aside, it is certainly important for everyone. What could be wrong with that answer? Well, I hate to be the bearer of bad news, but even water will affect blood sugar! 

Specifically, how hydrated you are will affect how well your cells are able to absorb insulin. Dehydration has been shown to cause insulin resistance, meaning you will need more insulin if you are dehydrated. Therefore, if you become dehydrated, you will likely see your blood sugar rise independent of other factors.

Interestingly, high blood sugar can also cause you to become dehydrated. When we have too much sugar in our blood stream, our bodies try to filter it out through our kidneys and it exits our bodies in our urine*. Meaning we pee more and become dehydrated.  This is part of the reason many medical professionals recommend drinking water and rehydrating when we are having a high blood sugar. It will help clear the excess sugar and help our cells absorb the insulin better.

As an athlete, proper hydration is even more important. It affects everything from our blood volume, to muscle function, to digestion and brain function. If you’re used to working out, I’m sure you’ve noticed the thirst you inevitably feel during a tough workout. You may have also felt the “drag” of trying to workout while dehydrated. 

I’m certainly no expert on water but if it is going to help me train better, perform better and keep healthier blood sugars, I say bottoms up**! 

For more on water, Dr. Steven Gundry has a great podcast episode that I found to be really interesting. He talks about tap vs bottled, sparkling, raw, alkalinity and fasting among other things.

*This is why drinking/peeing is a symptom of undiagnosed diabetes.

**Overhydration is also a thing and can be just as dangerous as dehydration. As with most things in life, balance and moderation are ideal!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

What is your target range?

When I was in school, I hated math and most things that involved numbers. I was good enough to get by but I definitely focused my efforts a whole lot more in the areas of art and science. Fast forward to now and numbers have come back into my life, whether I like it or not*.  Aside from the fact that my job forces me to be involved in payroll and budgeting, I feel like living with diabetes forces us to do calculations all day everyday. 

It makes us consider crazy questions like….

“If I gave myself x number of units, y number of mins ago, and ate z, can I go for a run 30 mins from now?”

Yes, it sounds like the math test questions from our collective nightmares and yet it’s what we do all day, everyday. Then we layer on things like target ranges**, basal rates, minutes of exercise and the list goes on. Out of all of the number nonsense, the target range is something I think is worth paying attention to. 

According to Web MD, “Normal blood sugar levels are less than 100 mg/dL after not eating (fasting) for at least eight hours. And they’re less than 140 mg/dL two hours after eating.

During the day, levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dL. For some people, 60 is normal; for others, 90 is the norm.”

According to the CDC, “These are typical targets:

  • Before a meal: 80 to 130 mg/dL.
  • Two hours after the start of a meal: Less than 180 mg/dL.”

I’ve also talked to a number of Type 1 diabetics and it seems many of us have vastly different target ranges. For example, during my CGM training, when the diabetes educator was discussing setting up the alarms she said something like, “Don’t set it too low or you’ll be waking up every hour. 200-250 is reasonable”. For reference, 200-250 is DEFINITELY way out of normal range but I thought to myself, “Sleep is important! I don’t want to be waking up multiple times per night!” So initially, I thought I was being conservative setting my pump to wake me up at 170. 

Now, I laugh at how naive I was back then. If you’re wondering about my targets, I now have them set to this schedule:

  • 100-120 from 8:00pm-4:00am
  • 70-90 from 4:00am-8:00pm
  • 120 in automode***
  • 150 for an automode temp target

Many diabetics ask me why I have such tight target ranges but the way I see it…

You can fix a low at 80 before you go low or at 60, once you’re already low. You can fix a high at 100 or you can wait until 150, 180 or 250. In my mind, If I fix it at 100 or even 120, I’m much more likely to stay in range than if I don’t take any action until it hits 150, 180 or 250. Remember my “fast acting” insulin takes 20-30 minutes before it starts to take effect and 2 hours before it is at peak strength. If I’m not starting to do a correction dose until I’m at 250, how high will my blood sugar go before it starts to come down? If I give a small correction at 120, I will likely avoid reaching 180 altogether and probably won’t go low either. 

I’m also asked frequently…

“Isn’t your pump buzzing all the time?”

I honestly can say that I don’t think it alarms any more than when I had a wider range. What I can say is that my bloodwork, including A1c, is much better, than before. Since A1c is reflective of your average blood sugar over a 90 day period, generally, more time in range will give you a better A1c. 

Another important consideration related to target range is standard deviation.**** If you’re swinging from 40 to 200 regularly, you can still end up with a decent A1c if your average blood sugar is normal. For example, (40+200)/2 = 120 average. 120 itself is fine but obviously, swinging from 40 to 200 and back wouldn’t be an ideal, let alone safe situation.

Most medical professionals I’ve spoken with agree that a more stable average blood sugar is preferable, even if it is slightly higher. This would mean a lower standard deviation aka flatter CGM lines would generally be better and hopefully lower the risk of the complications associated with having diabetes for a long period of time.

Ideally, I want to stay healthy well into old age and that is why I keep such narrow target ranges. I don’t always hitman targets but I figure even if I just get close, I’ll be better off. If you look at my most recent Quarterly Diabetes Tracking Post, you’ll see my average sensor glucose was 117 with a standard deviation of 30. This means my typical range was 87-147 in that timeframe. Clearly off from my targets but not too far off “normal”. 

So what is your target range? How do you adjust it for time of day, workouts or anything else?

*Okay, so I am a closet personal finance nerd and I might enjoy numbers when I see my bank account growing. 

**For my non-T1 friends, target range is the range you try to keep your blood sugar in.

***These are standard automode settings that can’t be changed but I also fuss with my pump in automode so I’m typically hanging at lower number, even in automode.

****Now, I’m really taking you back to math class. The standard deviation is a measure of the amount of variation of a set of values. A low standard deviation indicates that the values tend to be close to the mean (average) of the set, while a high standard deviation indicates that the values are spread out over a wider range.

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

9/2/2020 – Run

Track Run & BG Fail

Some days you do everything “right” and it doesn’t matter!

  • 5:03 am, BG 166, Start run
    • 5:08 am, BG 170, 0.3 U correction
    • 5:19 am, BG 184, 0.3 U correction
    • 5:23 am, BG 192, 0.1 U correction
    • 5:35 am, BG 197, 1.4 U correction
  • 5:37 am, BG: 194, End run
    • 5:53 am, BG 206, 0.5 U correction, Automode Exit
    • 5:58 am, BG 208, 2.2 U correction/Pre-bolus, Automode Exit
  • 6:07 am, BG: 216, 30 Minutes Post Workout, 0.5 U correction
  • 6:32 am, BG: 174, 60 Minutes Post Workout

Often I hear other diabetics shrug and say “that’s diabetes”. Usually, what they mean is ‘there is nothing I can do to control my blood sugar’. I believe there is a lot you can do but I have to admit, that no matter how good you are at managing, there will always be a wonky situation every once in a while. Today the dawn phenomenon hit me and hit me hard. Since I want to share all of my experiences good, bad and ugly, today we’re going a little ugly.

This morning when I woke up, the dawn phenomenon was already raging but I wanted to do some track work and I try to avoid active insulin onboard for pretty much all of my running. When I finished my warm-up and saw 170, I knew I would need more than just running to bring down my BGs this morning so I let automode dictate my correction and monitored during my workout. As my BGs continued to climb, I continued to do micro-corrections, since I knew I would want to have coffee and breakfast with Marty after my workout and before I went to work.

I knew it would take 20-30 minutes for any of my micro corrections to hit so I was encouraged when I saw my BG go from 197 to 194 at the end of the workout. “The insulin is starting to hit, should be back in range in no time” I thought. Boy was I pissed when I saw 206 a few minutes later. My micro-doses were starting to take effect, I hadn’t eaten anything and my BGs were rising anyway! I gave myself a half a unit correction and then thought about what I wanted to eat for breakfast and gave myself a nice pre-bolus. Then after I showered, I gave myself another half a unit for good measure, knowing I could “catch it with food” before I went low two hours from then (which I did) when all of the insulin was peaking. Topped out at 216 this morning and was out of range for about 75 minutes but got it back and had a nice day after that.

Oh yea, the run itself was nice too! I was done before the sun came up which was fun. I admittedly felt like sludge due to my high blood sugar and there was a pretty strong headwind but I got it done and was able to conquer the rest of the day. Hope your BGs are more like the second half of my day as opposed to my morning! Happy hump day friends!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

Cheese Crusted Taco Egg Cups

Low Carb Egg Meal Prep

Fun and spicy breakfast with a crispy cheesy bottom

Ingredients:

  • 14 Egg Whites
  • 1 Egg
  • 4 TBSP Taco Seasoning
  • 24 tsp Parmesan Cheese
  • 1/2c Jalapeno Peppers
  • 2.5c Kale
  • 12 Cherry Tomatoes (sliced in half)
  • 2 sticks Mozzarella String Cheese (sliced into 6 pieces each)

Directions:

  1. Preheat the oven to 450 degrees F. A non-stick muffin pan is recommended.
  2. In a blender, combine egg whites, egg, and taco seasoning.
  3. Pour just enough parmesan cheese in each muffin cavity to cover the bottom (about 1 tsp)*.
  4. Bake 1-2 mins.
  5. Remove pan from the oven (cheese should just be starting to bubble). Add kale to each muffin cavity.
  6. Pour the egg mixture over the kale and garish with tomatoes and jalapenos**. Sprinkle an additional 1 tsp of parmesan cheese over each cup and add string cheese slices on top.
  7. Bake for 15-20 minutes, until egg is firm and string cheese is just starting to brown.
  8. Allow cups to cool slightly before serving. You can also refrigerate or freeze and heat in the microwave later for an easy morning meal prep! Enjoy!

*This seems to make them easier to remove from the pan and gives it a delicious crispy bottom.

**Feel free to use more or less jalapenos depending on how spicy you like your food!

Nutrition:

1 egg cup has roughly 71 calories, 3.1g carbs, 3g fat and 8.2g protein. This is an estimate and based off my entry of the ingredients into My Fitness Pal.

Looking for more recipes? Check out my T1 Recipe page here!

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The content on this site is not intended to be medical advice. Always consult your doctor before beginning a fitness regimen or adjusting your diabetes management strategy.

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