June 2nd, 2010
Since the Olympics I have been formulating a plan to prepare my insulin dosing stategy for 30k and 50k races. I decided that the best way to do this was to do four to five time-trials over the course of the off-season. The first timetrial was two days ago in Bend Oregon. I set my basal insulin at my current resting rate which is .5 units per hour. For reference the basal rate I used at the Olympics was 2 units per hour, or four times the dose I just tested. I planned to ski 30k with the first 20k at just above threshold with maximal effort over the last 10k. The effort I put in was reflected by my lactates. My heart-rates were very low due to suppression from heavy training. My hypothesis was that my blood glucose would remain constant for the first 20k and then rise over the last 10k due to the anaerobic nature of a maximal effort. To my surprise my glucose remained constant throughout the effort. I fed an average of 10 ounces of Gatorade per 5ks. Throughout the test I also compared the data that my new continuous glucose monitor (cgm) gave me to the results I got from my blood testing Lifescan glucose monitor. The numbers were close enough that I am now confident in the use of the cgm during races. All of the data from the test can be found below.
I skied thee 7k loops followed by four 3k loops. I stopped at the end of each loop for blood testing.
May 31, 2010 Bend, Oregon
44 F, Light rain
30km Pursuit TT
Kris Freeman
KM, Time In, Time out, Split, HR, CGM, BG, Lactate, Feed
Start 106, 100
7km, 18.11 19.41, 18.11, 146, 88, 105, 5.6, 10 oz
14km, 37.11 39.12, 17.30, 155, 84, 119, 6.7, 11 oz
21km, 57.01 58.31, 17.39, 152, 96, 107, 5.8, 5 oz
24km, 1.06.30 1.08.06, 7.59, 155, 89, 108, 9.0, 7 oz
27km, 1.15.23 1.16.50, 7.17, 156, 96, 112, 8.9, 12 oz
30km, 1.24.26 1.25.56, 7.36, 157, 100 100, 9.1, 12 oz
33km, 1.33.17 7.21, 160, 105 125, 10.3
Switched to skate at 14km
June 3rd, 2010 at 10:06 am
awesome dude! Good to hear you’re working it out. What is the lag time for the CGM you’re using? Is small enough to allow you to prevent a crash. Also, are the cgm and your insulin pump able to communicate to dose insulin based on your blood glucose levels?
Keep on kickin’ ass.
June 5th, 2010 at 7:29 am
As I am a Type 1 diabetic that ski races, it’s excellent to see your record keeping that you’ll use for future race planning & prep. … however, I was shocked to read you used 2 units / hr as your basal rate in Vancouver. I would have expected to read you used 0.5 u/hr or even less (as your basal) during race days and managed your carbohydrate intake through bolus injections (or ‘additions’ via your insulin pump).
With a basal rate of 2 u/hr in Vancouver, I can only imagine the downward stress on your blood glucose during the races.
Good luck with your training and racing. Many young (and… not so young) diabetic ski racers are keenly watching your progress.
June 6th, 2010 at 4:43 pm
Finding the proper basal dose for various distances is not an easy process. For instance when I race 15k timetrial I use a basal rate of 7 units per hour. I used this rate at the world championships when I was 4th and in both top ten world cup finishes I had last year. What makes it difficult is what I call the “tipping point.” When I am aerobic my blood sugar is used up faster as I accelerate and ski near my threshold. As soon as I cross over my aerobic threshold and go anaerobic my body starts dumping sugar into my system raising my glucose levels. In a 15k I am anaerobic for nearly the whole race which is why I use 7 units of insulin. In a 30k mass start event the pace is dictated by the leaders. I anticipated that the Olympic 30k race would go out at an anaerobic effort. It actually went out at a very unimpressive pace thus I was aerobic and my blood sugar dropped. In the future I will take more authority in the pacing of 30ks to avoid conflicts with my planned insulin dosage
June 14th, 2010 at 7:18 pm
Just wanted to let you know how important your work with kids is. My 8 year old son and I have been following your blog since the olympics. Josh loves sports, and at times gets dscouraged because of his type 1 diabetes(DX 1 year ago). When I read you letter through Lilly, I was excited to hear your dvd would be seen at his camp. You see, he was very angry with me for putting him in diabetes camp. He prefers sports. When I picked him up today and heard you visited his camp, I was so excited. I asked him what it was like meeting you. He said, that wasn’t really Kris Freeman, he wouldn’t come to see me. “Why would he fly all the way from Canada?” I informed him you are actually from NH. After much discussion, he finally believes it was you. I can’t tell you how excited he was sharing your story of your run at the Olympics at the dinner table.
He is hesitating playing football this fall, even though a year ago he was sure he was going to be pro. He is afraid his pod will get hit. I am hoping your determination to overcome obstacles will give him the strength to not let fears get in the way of him accomplishing his dreams. Thank you for making you message real by taking the time to come all the way from “Canada”.tikiwood1@gmail.com
June 24th, 2010 at 6:30 pm
Kris – I just wanted to say hello and let you know that it’s great to read about your training, blood sugars, thoughts, and more. I have heard of you and your brother for quite some time now, from different people in the Sant Bani community who I know. My dad, Peter, has lived there for over 10 years. I’m still out in Northern California. I’ve had type 1 since I was 12 (diagnosed 20 years ago). I’m training for a few triathlons and runs, and your comments around the anaerobic versus aerobic pace are super interesting. Anyhow, I just wanted to say hello and that it’s good to finally ‘meet’ you.
October 6th, 2010 at 11:21 am
Kris – I’m an elite marathon runner and was recently diagnosed with type I. This last weekend I competed in the U.S. Marathon Championships and had to drop out because my BG level dropped too low. I was leading the race and felt like I could have won. It cost me a possible spot on the world championship team and a lot of money. I’m wondering if I could get in contact with you to talk about some of the specifics of competing with type I. This is the second U.S. championship race that I’ve had to drop out of because of low blood sugar, so I’m desperate for some help. My email address is sethpilk@yahoo.com. I appreciate any help that you might be able to offer.