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Basal Rate Redux!

Posted Feb 18 2009 11:47am
A few months back I wrote how my basal rate seemed to be continually climbing. In the days preceding the Ironman my basal rates were around 6 units of insulin per day, around Christmas my basal rate shot up to around 16 units of insulin per day. After 2 months of marathon training and getting back to my training diet my basal rate has been reduced to 11.5 units of insulin per day.

The magnitude of the swings due to diet and exercise has been striking. During the first semester at Darden my eating patterns were sporadic, workouts infrequent and stress was at an all time high. I would regularly skip lunch, get take out from Chipotle or take in a free lunch provided by a company hosting an information session. The stress level of the case studies caused me to sleep less and travel to interviews took up a ton of time. The combination of all that took away from the consistency needed for good blood sugar control and added 13 lbs to my frame from the 183 I weighed right before the Ironman. A quick Google search suggested that children require about .5 units of insulin per pound; using this logic, my 13 lbs weight gain probably accounted for about 5 units of my basal rate gain.

The rest of the basal rate increase was probably due to the higher fat content of the food I was eating and the slow down in my metabolic rate due to less workouts. This has really made apparently how cumulative diabetes care is. What we did yesterday affects our blood sugar rates a week from now; I now view diet and exercise as a glucose management bank. Increased exercise allows a few more "cheat" meals without having to do with an insulin resistant high; while a healthier diet makes insulin more effective in general. My new endocrinologist - Dr. Kirk at UVA is doing empirical research on physiology and insulin transport. One of the things I have learned from her is that 6 to 8 hours after exercise your insulin sensitivity is increased dramatically. Therefore, the more exercise you put into that glucose management bank, the more affective insulin is going to be. This is no way in saying that exercise is going to eliminate the need for insulin since Type 1's produce it - the glucose management bank is just another tool in our quest for a healthy A1c.
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