Diabetes observations in this one again. As mentioned before, don’t hold me to it. I am probably sitting in a mountain cave, making this up.

The second brevet this year was supposed to be a longer distance. I had skipped the 300km one due to family obligations (they did not want to postpone the wedding so I could go cycling *sigh*). The results were “interesting(tm)”.

The start was set for Friday evening (20.10h), and the time limit for the 400km is 27 hours. Which meant that even the slowest cyclists have to be back at the start by 23.00h Saturdays – in time to catch the last train to civilisation and allowing the organizing people to actually go to bed eventually. The weather forecast said “cloudy, likelyhood of rain 60%” – which technically only applied to the location of the start/finish and the distance was too long to check everything in advance. So I packed a jacket and some spare socks.

As the Friday was a normal work-day for me, blood glucose and insulin both were “normal”. My lunch meal still had the normal bolus. The goal: a normal blood glucose level for the starting time and then a large dinner before heading out [1]. Interesting (and I still don’t know what happened there) was the train trip to the start (leaving home around 18.00h). Blood glucose kept rising without additional carbohydrates. When I arrived, I had a blood glucose of 420mg/dl (23.3mmol/l) – which is not what usually happens on Friday evenings. Honest! I check! I can only hazard a guess: Stress, because of the unusual event caused my sugar to rise. Which would fit the previous event.

The first order of business was a correction dose of insulin then (6 I.E. for the theoretical reduction of 420->120 mg/dl (23.3->6.7mmol/l)). I obviously didn’t skip the dinner at the start (Spaghetti), but I used only 50% of the normal bolus for the carbs. The evening injection of Levemir (new insulin compared to last time – this one has an operating life of approximately 14 hours) was also on time – and I reduced it to 70% of normal (slightly less than last times 75% basal rate, which is mostly due to “even numbers only by pen”). All this lead to a remarkable 530mg/dl (29.4mmol/l) at the starting time – no ketones, so I did the same as last time and ignored it.

Abendradeln

The start was brilliant. I found a group of fit road bikers, who dragged me along in their slipstream. The first 65km (40 miles) flew past at a speed that was apparently too high for me. At the first hill after that I got dropped. Hard. My puls was too high, my strength was gone and I bonked. As the group reached the top of the hill by the time I thought “oh my, this is steep”, I thought this would be a good time to test. Blood glucose at a near-perfect 130mg/dl (7.2mmol/l). After one hour, 45 minutes. So I started to eat and drink (which I may possibly have neglected in the previous 2 hours – and which sufficiently explains the bonking [2]).

Unfortunately the lack of liquids lead to problems on the next 60km (40 miles). Cramps in the calves and thighs, lack of power and generally not feeling well. See [2], really. I can do better. Someone caught me up, though, and gave me some help and tips (like: the water on graveyards in Germany is drinking quality and can refresh both flowers and cyclists. Especially at 02.00h in the night in the middle of the countryside, where pubs are … sparse). The two of us plodded on for a bit – noticeably slower than with the original group, but apparently much better suited to my speed. We caught up to a recumbent and a HPV on a long hill, but unsurprisingly lost them again in the following descent and never saw them again.

In total darkness I finished the first 200km (125 miles).  After 120km (75miles) and 200km (125miles) my blood glucose was in the range of 100-130mg/dl (5.6-7.2mmol/l). Provided I was continuously feeding myself with bananas. And drinking. The night had gotten quite cold, but I still managed to soak the softshell jacket through.

A fabulous stop at the 200km control: We got to a small McDonalds on the side of a motorway (by the back entrance – we didn’t cycle on the motorway!). They had two people manning the restaurant in the early morning hours (we arrived around 05.00h). Around 100 cyclists, clad in various amounts of lycra, sweating and hungry, arrived over a few hours. The group of 20 (or so) arriving with me reached the till and asked for fries with lots of salt, and the girl at the till showed proper foresight, looked at the rest of the group queueing to the outside and flipped on all the deep-friers.

With the break of dawn we reached the Frankonian hills. My morning basal rate (Levemir) was reduced to 75% (again – a problem with the units in a pen) [3]. I didn’t need any bolus insulin any more, though. With a relatively constant blood glucose I continued till the early afternoon. Two more stops at another McDonalds (not pretty, but always conveniently open) and a petrol station offered savoury foods. Breakfast with salty eggs and salami rolls in this case. No bolus for either.

After about 18 hours I had to give up (kilometer 360 (225miles)). Apparently I lost so many minerals during the night/day, that I started getting cramps again – and eventually my brain decided that enough was enough [4].

Interestingly, the recovery was not as pronounced this time. I reduced the basal rate to 70% in the evening but already woke up with a slightly raised blood sugar the morning after. Definitely better than a night-time low, though.

Good things, though – the DNF was not due to my diabetes (which is nice), but due to over-excertion on the first part and not enough drinks while cycling. Could have happened to anyone.

The highlight were without a doubt the 1000g of carbohydrates that I got to eat without injections. In retrospect this obviously means that my basal rate was way too high. As the sore muscles have returned to normal, I’m looking forward to the next event, though.

[1] This still sounds like a good idea. I don’t need highs during the day before that reduce my power and send me to the loo all the time.
[2] Due to my lack of experience with long distance cycling, I’d say. All of this was new for me this year and I make mistakes. Stupid mistakes, but mistakes.
[3] I normally use 4 I.E. in the morning. 2 seemed too low, 3 is a bit too much. The new pump will make everything better. Room for improvement, though.
[4] “I do not want to cycle up that hill” and “I’m slowing down my group – they are all much fitter than I am” was what I was mainly thinking. A long break at this point would probably have done (and in fact I felt much better by the time my summoned sag wagon (i.e. my wife) arrived). However, the little village we were in at the time when I stopped wanting to go on didn’t even have a restaurant/pub/anything. It would only have been 10 more miles to the next control with a large spread of food. I need to work on mental toughness, it would appear.