Questions on half ironman / multiple daily insulins - Triathlon Week

08-23-2004, 07:09 PM

I'm in my 3rd year of doing triathlons, but only contracted diabetes
and started needing insulin about 1 year ago. I was training for what
would have been my first half iron man at the time, but that was shot
down by several weeks of no training / not eating. Since then, I've
done just as well or better in races ranging from 5k runs up to
olympic distance triathlons. When I train at lower intensities and
especially over the 2 hour mark (as required for half ironman), I get
serious problems with low blood sugars and basal insulins peaking way
sooner than they normally do. At the higher intensities at which I've
been training, my own body generates enough blood sugar (from
adrenaline and stuff) that I don't have to eat a whole lot or adjust
my basal injections in order to avoid low blood sugars. This is
especially true of swimming, where I usually do intervals up to 500
yards. When I train at the lower intensity / longer distance, that
balance gets all screwed up and I end up having to eat very shortly
after I start.

I currently use ultralente twice a day for basal insulin. On
mornings when I go on long bike rides or long runs, I have been
experimenting with reducing the morning ultralente dose, by anywhere
from 15 - 40%. Every time, in spite of this, I've still either ended
up with either repeat episodes of telltale low blood sugar symptom -
things in front of me start looking as if I've been staring at the sun
and the lights have been dimmed or else I end up eating enough gels
and granola bars to gag me. Obviously, either scenario is
unacceptable for an actual half ironman race in which I'll have paid
in excess of $100 to enter. If I don't get this problem figured out
by the early registration deadline, I'm going to say screw it,
especially if it means killing a bunch of time during the race
checking and correcting low blood sugars. I wonder if Lantus would be
any better in terms of not having its concentrations affected by
exercise. Any suggestions?