How has basketball been going?
I usually get to the gym on Tuesdays & Thursdays for a couple hours during the lunch period. On Tuesday of last week I got stuck in a meeting at noon (who in their right mind schedules a meeting at NOON?) and wasn't able to go.
On Thursday I was a bit late leaving the office, but was still able to go. I stopped at the store between there and the YMCA to get some gatorade, then headed to the Y. Still a bit late, but not doing too bad. On my way to the locker room I peeked into the gym. The guys had started playing and I was anxious to join them. I go into the locker room to start changing, only to find that I had not grabbed a pair of my shorts, but rather my some of wife's sweat pants!!!
After some initial swearing and cursing, I found myself looking down at her sweats considering if there was any way I could make it work. I decided against the highwater spandex look and was so upset that I headed to Perkins for a high calorie fat filled lunch. Oh well - that'll teach me! Nothing like planning to burn a couple thousand calories but ending up consuming a bunch instead.
Okay - on to the diabetes stuff!!
I'm still experimenting with all of this, but the last couple times out I have done REALLY well. I'm able to get my bloodsugars right around 120 or so before starting (that in itself is a miracle!). An hour before playing I start a temporary basal rate of 25% for two hours. The thought behind this is after some time playing I will have exhausted my stores of glucose and will start burning fat at an aggressive rate, spilling ketones and raising my resistance to insulin. So having my basal rate jump back to my regular rate, which would normally be MUCH higher than what I need for exercise, will be enough to balance that insulin resistance from the ketones.
Before playing I also eat/drink something with decent protein and carbs, not bolusing for the carbs. I've tried a slim fast shake (about 24g carbs and 10g protein) as well as some type of protein bar (17g carbs and 15g protein). All three times I've started right around 120, and after 45 minutes or so I'm very close to that number (give or take 10 points - amazing!).
As I play I've also been drinking gatorade, trying to take in some calories and carbs to avoid the ketones. All three times I've kept my blood sugar incredibly stable. That in itself is so amazing to me! I'm playing intensive full court basketball for a little more than two hours, and am able to keep my numbers in target. It's almost inconceivable.
After playing basketball my numbers start to rise. Two out of three times I've tested positive for ketones, once large and the other time small to moderate (it's always hard to match colors exactly - remember when we tested our sugar that way?!). The one time I did not show any ketones I was very confused because my blood sugars were on the rise and my muscles felt the same way they do when I'm spilling ketones. Maybe they were there and I couldn't catch them by testing urine. It would have been nice to have the meter that can test the blood for ketones.
Either way, it's a pretty clear sign that I had been burning fat at a high rate. It's a matter of fuel, and the body will convert the fat after it runs out of the regular (and usually available) sources. I wore my heart rate monitor once when playing, and over the course of those two hours I burned over 2000 calories. That is a crazy amount of calories to burn in such a short period. With that high calorie output it is almost impossible to provide that many calories beforehand - besides, if I did that I would not lose any weight! So, if ketones are a part of burning fat, and burning fat is the goal, I want to learn how to keep myself safe during that process. Both in terms of blood sugar control AND the bodies acid balance (or imbalance with ketones).
I have not noticed any lows later in the day/night or next morning, so that is good.
I'm very happy with how well it's been going, but am also a little frustrated that I have to do all this extra stuff & plan ahead so much. We have such a complex system that deals with intensive exercise like that, and people without diabetes don't have to deal with any of it - it just happens automatically! It's a lot of energy for me to plan and prepare for the fact that I have to manually adjust a couple pieces of the puzzle.
How in the heck did I survive my active high school years when I played basketball all the time? Although during those years I was still doing shots of regular and NPH - which is a very different scenario. Heck, I can hardly remember back that far.