One of my goals for this year is to be in good enough shape to be able to compete in the Tough Mudder that is occurring in October here in central Texas.  I put my money where my mouth is and signed up for it.  Now I’ve got to put the pedal to the metal and get myself in enough shape to run it.

For me it is more of a two-fold exercise; first, I have to get into that shape and second, I have to not die while getting into that shape.  As you might already know, being a Type I Diabetic means I have to be a heck of a lot more careful when exercising because I could end up having my blood sugar drop to dangerous levels and end up dying or in coma if I’m not very careful.  However, challenges are fun and interesting and proof that I can do it despite whatever is holding me back so I think it’ll be a blast getting myself into the right shape to do it.  Anyway, back to the task at hand: getting in shape.  I wasn’t in the best physical shape thanks to stress and some long hours at work and school but it wasn’t the worst shape I’d even been in.. and I’ve got nine months to get into that good shape.

I initially thought about doing P90X and Insanity again, but having done those I was into doing something a little different; perhaps going outside for a change, especially since the tough mudder is a 12 mile obstacle course.  I need to get some running into my routine.  Working out with my friends from work would help me get into a routine, however, I was really looking for something that could turn fitness into a game.  And that is when I was introduced to Fitocracy.

Fitocracy makes fitness a social game.  Sign up for it with your friends, follow each other and Fitocracy assigns points to the exercises that you do and scores you.  As you do more exercises you’ll level up (just like a real-life RPG!) and open up quests and achievements along the way.  I’ve found that the more exercises I do the likely I am to look and see that I’m really close to finishing another quest so I go ahead and muscle ahead and complete the few exercises that I need to complete the quest.  Hopefully way before the Tough Mudder date I’ll be in great shape and I’ll be able to run through Tough Mudder like Arnuld through bad guys in Commando and I’ll look a heck of a lot better than I have in a long time (I don’t look that bad now, but you know, it always helps to look better :)).

Diabetic Book Reviews

After leaving work at little early on Friday after not feeling the greatest and suffering some of the effects of high-blood sugar associated with Type 1 Diabetes, I decided it’d be very beneficial to me to read some book out there on the subject and see what I could learn.  I read Diabetic Athlete’s Handbook, Dr. Bernstein’s Diabetes Solution, Pumping Insulin: 4th Edition, and Think Like a Pancreas from Friday afternoon to Sunday morning.  Yes, this was a heck of a lot of reading, but when things concern your well-being, you tend to be able to maintain more focus than what you think you can.  All the books offer some great advice, some good advice, and some advice you’re just not going to take.

Diabetic Athlete’s Handbook is a great book discussing what changes a diabetic would need to make in order to perform at their peak during a given athletic activity.  The first seven chapters describe the basics of exercise, fitness, insulin, blood sugar control and other related subjects.  I’ll admit I found them very interesting since they describe in layman’s terms what is going on in the body when you exercise and how to best control your blood sugars.  The second section of the book is really what you want the book for.  This section provides guidelines on preventing low blood sugars while partaking in your particular athletic endeavor.  The book covers everything from gardening to football (both American and the rest-of-the-world) to motorcycle and off-road racing.  I found it worthwhile since I enjoy working out, mountain biking, and doing day hikes and nature trails.  This book has exactly what I need to do in order to remain safe without me having to go out there and find out for myself how to best handle it.

The next book, Dr. Bernstein’s Diabetes Solution is billed as ‘The Complete Guide to Achieving Normal Blood Sugars.”  I won’t disagree with the title, the book is very thorough on what exactly Dr. Bernstein does with all of his patients from how to draw insulin correctly to what diet you should eat.  Although he never comes out and says anything he doesn’t seem to be a fan of Insulin pumps which I think are wonderful things (thanks to my severe hypoglycemic reactions to the long lasting insulins like Lantus); however, the advice can still be followed by pump users even if you have to modify some of his advice.  Personally, I’m not a fan of his diet routine described in the book, but, I see where he is coming from and do intend to integrate some of his ideas into my diet.  I am also very big on his idea of getting all diabetics down to normal blood sugar levels seen by non-diabetic people, even if it will take them a little bit of time to drop their blood sugars and feel comfortable in doing it.  The section devoted to supplies that all diabetics should have is complete and matches almost exactly what I was told when I first visited my endocrinologist.  In fact, many of his ideas were used by my endocrinologist and diabetes educator so it was almost like redoing the first few visits at the doctor’s office.

Pumping Insulin: 4th Edition is nothing like Pumping Iron with Arnold Schwarzenegger unless pushing a button on a pump is like doing bench presses :).  Pumping Insulin is probably the best book for general information I read this weekend.  It goes into detail on everything needed to adjust and determine initial bolus and basal doses as well as carb to insulin ratios and correction factors when using a pump.  If you’re on an insulin pump or thinking of going onto one, this book is worth getting.

Think Like a Pancreas sounds like a children’s book, but it is most definitely not.  I was amazed that this book covered situations that occur in the real world and doesn’t tell you to just “don’t do it.”  For instance, drinking alcohol; most diabetic books will say never drink it, this one says, you can drink it, and here is how to make sure you don’t suffer from the low blood sugars afterward.  Of course, one still needs to exercise some form of discretion because getting hammered isn’t going to help you adjust your pump and there aren’t many people I’d trust to adjust settings on my pump.  This book in content is much like Pumping Insulin and covers most of what Pumping Insulin covers, just sometimes not as in as much detail.

If you’re looking for a good general reference book I think Dr. Bernstein’ book is the best bet.  If you’re looking for information on helping you adjust to a pump and are an adult Think Like a Pancreas is better than Pumping Insulin, but if you’re prone to forgetting things, Pumping Insulin is better.  Finally, if you’re an athlete or like to think of yourself as one; Diabetic Athlete’s Handbook is worth the purchase.

And now… the Diabetic Internet Meme (because every disease needs at least one)

After seeing this, I decided I’ll follow the crowd and join in on the diabetes meme.

What type of diabetes do you have: Type 1

When were you diagnosed: When I was 27 (I was fashionably late to the Type 1 Diabetes party).

What’s your current blood sugar: 100 mg/dL before breakfast

What kind of meter do you use: The Lifestyle one built into my OmniPod and the Dexcom Seven+ when I’m not completely ticked off at it.

How many times a day do you test your blood sugar: At least 7 times (pre- and post-meals, and bedtime) and sometimes up to 11 times a day depending on how I’m feeling.

What’s a “high” number for you: For resting anything over 110 mg/dL, for post meal, anything over 160mg/dL

What do you consider “low”: Anything below 75 mg/dL, I feel it

What’s your favorite low blood sugar reaction treater: Some sort of candy like Skittles or M&Ms

Describe your dream endocrinologist: Not having one :), but since that isn’t the case right now, I really like the one I have.  They allow me to have a lot of say in what I am prescribed and explain everything to me.

What’s your biggest diabetic achievement: Not getting completely down about having it, especially after knowing what it’s like to not have it.

What’s your biggest diabetes-related fear: Amputation of a body part and/or failure of a vital organ (other than the pancreas).

Who’s on your support team: Parents, family, close friends, and my dog.

Do you think there will be a cure in your lifetime: Honestly, no, there needs to be a shift in the way diabetes is viewed.  We’re controlling the symptoms and not the cause.  I know some people are working on the cause, but I believe there are going to be many reasons why the auto-immune system decides we don’t really need beta cells.

What is a “cure” to you: Having my body go back to how it was before I was diabetic.  Otherwise, I’d like to see the loop close between the CGMS and Insulin Pumps.

The most annoying thing people say to you about your diabetes is: Did you eat a lot of sugar as a kid?  (What person DIDN’T inhale massive amounts of sugar as a kid?)

What is the most common misconception about diabetes: That type 1 can be controlled through diet and exercise like type 2.  This is just a problem of both types being called “diabetes” and then when newscasters and articles talk about “diabetes” they really mean “type 2 diabetes.”

If you could say one thing to your pancreas what would it be: It’s not your fault my auto-immune system hates you.  Then I’d need to have a sit down talk with my auto-immune system and figure out what it doesn’t like about my pancreas.

Dying OmniPod PDM

I always love getting woken up by a loud annoying beep in the middle of the night.  It is even better when it is the device that sends commands to the insulin pump currently attached to your body.  And… it gets even better when it decides that it has had a massive error and gives you the option to reset it or continue listening to the annoying beep.  So, I reset it.  Which then becomes even cooler, because it makes me remove the Insulin pod I was wearing for some reason unknown to me but known to the device.  So I pull off the insulin pod, reset it and go to back to sleep.

When I wake up, I found out the PDM (Personal Diabetes Manager) has decided to die again — for about the tenth time in the past few days.. while on fresh batteries.  This necessitates a call into Insulet’s (the makers of the OmniPod) tech support.  After a few simple questions they decide to overnight a new PDM along with a return label for the one I have that doesn’t want to work.  Which is completely awesome.  However, (no fault of Insulet’s) I’m stuck using insulin pens for today and maybe some of tomorrow.  I’m really not a fan of sticking myself 4+ times a day in the gut.  Just really doesn’t seem like the best insulin delivery system.

Back to the Insanity!

As you may have noticed I haven’t updated about the Insanity workout for the past few weeks.  It wasn’t because I gave up on it.  It is for some other reasons that I had to take a break.  First, I came off of my second type I diabetic honeymoon (meaning the insulin production of my islet cells has reduced to the point where I need the insulin pump again) and secondly, I pulled a calf muscle while doing one of the exercises in the rest week workout.

I’ve managed to get my blood glucose levels back under tight control for breakfast to bedtime, however I need to work on the night time routine now.  The night time routine shouldn’t be that hard however, I’ll just need to wake up around 1am, 2am, 3am, 4am, and 5am across the week (like one blood glucose test a night.. not all in one night) and figure out the pattern and adjust my insulin pump to prevent having a morning blood glucose high.

Two weeks of rest did a good job healing my calf muscle, however, it does lead me to question why Insanity lacks any sort of calf muscle stretch in their stretching routine.  I guess I’ll have to give a quick calf stretch near the end of the stretching so I won’t be having those problems anymore.

I look forward to finishing off Insanity across the next four weeks and then start up on P90X.  Then I’ll start attacking a P90X / Insanity hybrid where I’ll insert Insanity’s plyometrics and cardio workout routines in place of P90X’s versions.

As a side note, I did attempt the first workout routine of Insanity’s second month and that is when I realized I was off the type 1 honeymoon…  I did manage to burn over 1000 calories and maintain a high heart rate throughout the workout.  It is definitely a whole different level of intensity compared to the first month — and I love it.

Random Type 1 Diabetes News

I was going through my back log of Diabetes Forecast magazines and stumbled upon some interesting articles and facts and I’ve collected them here in a nice bullet point list.

  • Scientists are now able to take skin cells from Type 1 patients, convert them to stem cells, then convert them into insulin producing cells.  These cells are believed to be very similar to the pancreatic beta cells.
  • Young children with high blood glucose levels have a much greater risk for tuberculosis, so having blood glucose levels under control can help reduce the susceptibility of children to TB.
  • People with Type 1 diabetes are at an increased risk for celiac disease, however, in a recent study it was found that half the people with diabetes had an abnormal immune response to wheat proteins but not due to the gene associated with celiac disease but with a Type I gene instead.
  • Chocolate can promote heart health as long as you eat some at least twice a week (God, I love the Journal of Internal Medicine)
  • Resveratrol (a chemical in Red Wine) has been found to reduce blood glucose levels and it’s anti-diabetic active comes straight from the brain.  Now I have an even better excuse for drinking red wine with every meal… it’s a medical condition.
  • Alzheimer’s progresses more slowly in diabetics than non-diabetics.
  • Veggies are good for you (no, really, they did a study and it is true)

And there you go, a whole bunch of random facts about what is going on in the world of Diabetes research.