Friday, 3 June 2016

Run sick-boy run!

There is a stigma around type 1 diabetics... that they can't do much, can't do some exercise, can't be left alone, can't eat anything, can't look after themselves, .. they are sick... very sick... I mean, they have to take injections every day to stay alive. Well, I'm a type 1 diabetic (T1D) and I want to tell you this stigma is all wrong. Yes, we do need extra management 24/7, but that makes us smarter and stronger. My pancreas is not producing any insulin, but that is not going to stop me from living an active healthy life.

My brother and sister-in-law ran the two oceans ultra marathon twice and did well in the Comrades marathon. Inspired by them and Val Opperman (Also a T1D) who ran the Comrades and the great wall of China marathon, I decided to start with a bit of running. I started off not very fit, the last time I seriously ran was way back in 1997. Other than that I just did a bit of hiking and lawn mowing. You can follow my running adventure on strava where I will be giving my T1D details for each activity. I don't know the answer to all T1D exercise questions and will be learning on the go.

Some of the challenges for a T1D before/during/after exercise:
  • Any injected insulin on board the body can not be removed and can cause a rapid fall in BG while exercising. Hypoglycaemia can make you unable to think or move. Even the long acting insulin can cause hypo's during exercise. 
  • Without insulin production, an adrenalin rush will spike blood glucose (BG) quickly to extremely high values.
  • After exercise BG can keep on falling for hours and hours.
  • So, a T1D needs insulin, even during exercise, but it gets tricky to manage. Everyone differs and what works for one might not work for another.
  • It seems that carbs need to be consumed at regular (15-30 minute) intervals during exercise to keep BG stable.


My T1D survival running equipment can be seen in the image, which adds another few kilograms to my weight that I need to carry with me on the road:

A. Dexcom sensor. Inserted in my upper arm.
B. Dexcom transmitter. Connects to the sensor and retrieves a BG value every 5 minutes.
C. xBridge device. Captures the signals transmitted by the transmitter and sends it to my cellphone.
D. Cellphone. Retrieves the BG values from the xBridge device. Reads out the BG values with maximum volume and uploads the values and my location to the internet. I use xDrip+.
E. Emergency power bank in case of any flat battery issues.
F. LifeQ wrist based sensor. Logging raw data and things like spo2, vo2, epoc, blood lactate, ...
G. Garmin watch. Keeping track of my location, pace, distance, cadence, ...
H. Chest strap heart rate monitor. Connects to the Garmin watch.
I. Camelbak dart 1.5l hydration backpack. All the other items are placed inside the pockets of this backpack.
J. Energy bar. Placed in a pocket of the backpack that can be easily reached while running.
K. DexD tablets. Fast acting glucose tablets.
L. Camelbak bladder. Filled up with an energy drink like powerade, energade or lucozade. Can easily take a few sips without stopping. Keep my hands free.
Z. Things not shown in the image. Insulin pen if I need to inject for some reason and glucagon kit in case I can't get my BG up.

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