The Rule of Half

This past Saturday, I ran my second Get in Gear 10K (that’s 6.2 miles) in Minneapolis. Unlike last year, my blood sugars at the beginning of the race were much better, but I’ve had a recurring problem over the past few weeks where my blood sugar plummets about three or four miles into my run. In the past, I’ve gone for my runs after a meal, using a half bolus to keep my blood sugar afloat. But not even that has been working lately! It’s been very frustrating as I’m trying to train for a number of races this summer.

I had an endo appointment last week, although this time I met with the physician’s assistant because I had to reschedule my appointment and my endo wasn’t available for a number of weeks. Anyway, the PA was nice enough (although I prefer my endo) but I did talk to her about my consistent lows, just to see if she had any ideas. I’d thought about emailing my CDE (Jenny Smith at Integrated Diabetes Services) but since I already had this appointment I figured I’d see what she had to say. This PA suggested that I also cut my basal which I have always, always been super nervous about because 1) I never really believed that cutting basal started up quickly enough for a run and 2) I don’t like dealing with high blood sugars from cutting insulin hours down the road.

But I decided that it couldn’t hurt to try since my usual course of action wasn’t really panning out.

When I woke up on Saturday morning at 7:30, I was 223 mg/dl. I decided to take half a correction, because I didn’t want my blood sugar to continue to rise. Good performance in athletics requires the same balance as everyday life — you don’t want to be too high or too low. For breakfast, I had a simple piece of toast with jam (needs to digest quickly) and some coffee, and I took half a bolus. Now typically this is where it would all stop for me, but this time I decided to cut my basal in half for 2 hours — from 8am (one hour before the race started) to 10am, which is about 20-30 minutes before I expected to finish running.

Erik dropped me off at the starting line and I did another BG check — 221 mg/dl. I was stable and steady. Awesome! Now you might be wondering about the Dexcom. I’m sort of taking a Dexcom break right now, but more importantly, I have never really found the Dexcom to be terribly useful for exercise. I know, it sucks, and I’ve complained to everyone and anyone at Dexcom who will listen to me. I’ve had it tell me I was dropping when I wasn’t, and I’ve had it tell me I was staying steady when I was rising dramatically. It’s irritating as hell, so I tend to just run based on feeling and fueling at appropriate intervals. So far, it seems to work pretty well for me.

During the run, I took one GU at the water stop, which was located at the halfway mark. I was struggling physically because I started out too fast, but I was confident that my fatigue was from over exerting myself and not because I had a low blood sugar.

When I finished the 10K, I headed over to the car and tested my blood sugar — 180 mg/dl. Perfect! Not too high, not too low. Well, I suppose it would have been better to be just a bit lower than that, but I thought that was a pretty decent number to finish at.

Overall, I think the rule of half (half correction, half bolus, half basal) worked out pretty well for me and I think I’m going to continue a similar routine moving forward. Of course, it may not always end up with the same results, but it’s a place to start!

One thought on “The Rule of Half

  1. Congratulations on getting the strategy right! I’ve noticed that once I reach a certain level of fitness, my overall basal requirements go way down. I’m a big temp basal person during exercise. Of course, Your Diabetes May Vary. Good luck with your other races this year.

Leave a Reply

Fill in your details below or click an icon to log in:

Gravatar Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s