- 4:30 AM: PureFit bar + banana, full bolus, basals 100%
- 7:00-7:10 AM: 25-g GU + 10-15 g Vitalyte, got nervous and had another squirt of chocolate GU, basals still 100%
- 7:33 AM: swim start, BG on the rise, left basals at 100%
- 8:33 AM: with a BG of 149 (yay!), programmed 2.3-U extended bolus, 5%/95% spread over 2.5 hours. Ate 300 calories/hour using Perpetuum (135 g total) and 25 g GU/Luna moons per hour. Corrected with 0.3 U when I saw my BG was rising rapidly and took a small bolus for the first 25-g snack. I also ended up eating a chocolate GU (20 g) in the last few miles of the bike since I was on the bike longer than my estimated 3 hours. Perpetuum had 4 scoops of Hammer electrolyte powder mixed in and I had drunk about half a water bottle by each aid station.
- 10:30 AM: basal rate reduced to 0.35 U/hr (78%)
- 11:30 AM: basal rate reduced to 0.25 U/hr (55%)
- 11:46 AM: start the run, meter had "hi temp" reading so had to wait to test
- 11:55 AM: BG 118, ate some Sports Beans and continued to drink Gatorade (1-2 gulps) at every mile and 5 GU's total along the way. I was really nervous having my BG hovering around 100 the whole time, afraid that I would drop if I weren't vigilant. When my BG dropped to 86 I turned the pump off for 30 minutes. I felt like I was eating a lot to keep my BG high enough. Although the GU's were not appetizing, I ate them anyway and washed them down with some water. I did not have any GI discomfort except temporarily after eating/drinking carb's, which was resolved by drinking more water.
- 12:30 PM: pump off 30 minutes
- 1:00 PM: pump, on, basal rate 0.25 U/hr but at this point, this is 83% of my normal rate of 0.3 U/hr.
- 1:46 PM: pump off 30 minutes
- 1:55 PM: finished race in 6:22, feeling strong through the finish.
- Perhaps increase basal rate towards the end of the swim to offset the spike I get in the first 1-2 hours on the bike. Or, include a correction bolus in anticipation of the spike immediately after the swim.
- Reduce basal rate more on the run, and try to keep BG around 120-130 instead of 100. I wasn't comfortable at that level and had to eat too much (400+ calories/hr) to keep my BG up; although I did not feel any GI discomfort eating that much food, and did feel better after eating each GU. Perhaps I should keep the basal rate reduction to about 50-60% so that it goes down even more at 1:00 PM (when my basal normally goes down). Maybe reduce the basal rate to 0.2 once I'm on the run?
Above is a chart of the day. Additional details can be seen on my sugarstats page. I am also very happy about the post-race management. I usually have horrible highs after the race and even the next day, but avoided that this year. I think it helped that my BG's were better managed during the race, and that I took quite a bit of insulin right after to correct for my pump being off for a bit and for those 3 pieces of pizza I ate. I also turned my basals up 40% for about an hour when I saw my BG climbing rapidly. It worked out really well, and my recovery has been great. I went out running this morning for 40 minutes, and felt comfortable.
The better BG management is also thanks to the eating strategy given to me by Rick Crawford at Diabetes Training Camp. It is very exciting for me to see "140" on the meter and think, "I had better correct for that--a little high." I am looking forward to my next A1c check.