The quest for blood glucose control continues…

Ironman Athlete Andy Holder Type 1 DiabeticWhen I ended my last blog, I said I would share more about my nutrition plan and early successes I have had using Extend Nutrition as my main source of fuel during Ironman training. Before I do there are a few things I need to explain, and I will try hard to keep it basic as to not put anyone to sleep with a lot of science.

When you have type 1 diabetes, your pancreas no longer produces insulin; therefore you have to either wear an insulin pump or give yourself daily multiple injections of insulin. It is the job of insulin to escort blood glucose (broken down carbohydrates) out of the bloodstream and into the cells to be used for energy. If glucose remains in the bloodstream, complications arise and can eventually be fatal. On a lighter note, not having the ability to convert carbohydrates into energy is problematic for a person who swims, bikes and runs as much as I do.

There are many factors that will have an affect on the absorption rate of insulin: the amount of insulin you are administering, the type of insulin, location of the injection site, exercise and food. I will be focusing on the last two – exercise and food.

Exercise increases insulin sensitivity. Meaning the more you exercise, the less insulin you need. This is good news for a person who has type 2 diabetes, because their body still produces insulin, but it’s either not enough and/or it’s not working effectively. But for someone like me who has type 1 diabetes and is giving myself insulin manually, exercise has the potential to cause my blood glucose to drop too low. So, I have to be extremely diligent in the planning and preparation around my training routines and my insulin therapy.

The other very important factor is food – more specifically the type of food one eats. A snack or a meal that has a high glycemic index will be absorbed quickly and will raise blood glucose if insulin has not had time to enter the bloodstream (blood glucose SPIKE). On the contrary, foods that are high in fat will be absorbed slowly and there is the potential for insulin to win that race and cause blood sugar to drop.

Enter Extend Nutrition.

I am swimming, biking and running for 20 hours per week on average. I am taking in a lot of carbohydrates to fuel those workouts. When you factor in the effect exercise has on insulin, the intensity and duration of the workouts, the amount of times I have to test my blood glucose while biking and running (it would be a little difficult to test my blood glucose while swimming), you can see how I would latch on to any variable that is somewhat predictable.

Diabetic Athlete Ironman Andy HolderIn the past I have desperately tried to do this with my nutrition. I have tried to find consistency with the type of carbohydrates I eat, the timing of when I eat (pre-workout, during, post, etc.) and also the amount and timing of insulin I give myself to cover the carbs. This has caused not only a great deal of mental energy and stress, but at times has had an adverse effect on training and race results.

I have only been using Extend nutrition for a few months, and it being early in my triathlon season I have not had many long workouts.

What I have found thus far with Extend’s unique formula that uses a combination of proteins, fats and complex carbohydrates; is that for short workouts of one hour or less I have been able to maintain a consistent glucose level during and after each workout.

Here is an example...

If I am going to swim, bike or run for an hour – I will have an Extend Bar thirty minutes prior to the workout and I WILL NOT give myself any insulin to cover those carbs. Assuming I have a healthy glucose level at the start – I am able to maintain a fairly level blood glucose throughout the entire workout. In addition, I am not experiencing the post work out spikes I used to in the past.

Previously, I would eat a pre-workout snack and give myself a small percentage of the insulin that would under non-exercise scenarios be enough to cover the carbs. I would give myself less because the exercise increases insulin sensitivity. But what would end up happening is I would go low during the workout, I would then have to correct the low with more carbs to get through the workout. Then, post workout my blood glucose would spike and I would spend the next few hours chasing it back down.

It is this type of guess-work and inconsistency that has driven me crazy these past few years. But from what I can tell after just a few months using Extend, I will have more consistency in my nutrition plan – leading to less during workout lows, and less post workout spikes…neither of which lead to optimal performance!

Andy Holder, aka Iron Andy, is an 8-time Ironman Finisher, co-founder of http://www.insulinnation .com and President of the Iron Andy Foundation. You can follow him on Twitter @ironandy.