Diabetes reversal became my goal. I tried to maintain a bike ride 4-6 times per week. They consisted of hard sessions (intervals, hills), endurance sessions (80km+) or shorter recovery rides in between. I eventually stopped logging my food. I was dropping weight fast and I was getting very good at knowing what foods had carbs and what sort of portions I should be able to eat. I treated most of my time on the bike like a training session; I'd extend the endurance rides further and the high intensity I would ride harder. My old endurance distances started to become my current recovery ride distance.
A few months (and 40 pounds) later, I was back getting another A1C. The doctor was really happy with my progress, my A1C had dropped to a 6.3%. I was a bit disappointed as I had expected more results from my hard work. But the doctor really helped me put it into perspective; she reminded me I did it on half of my oral dose. She confirmed that this was a pre-diabetic level and she was taking me off all the oral medication. I had already achieved my goal of diabetes reversal!
This wasn't the end though, not by a long shot. There's a reason why they call it "reversal" and not "cure". It's because there is no cure. You can reverse the progress of type 2 diabetes but the disease is a progressive one. It meant I would have to continue riding my bike harder and faster and maintaining my good eating habits. But in my mind this is perfectly fine; I knew no matter what, diabetes would bring lifestyle changes. In my case I had just made very healthy lifestyle choices. It doesn't hurt that I love cycling too.
So my next goal became more of the same, lower A1C numbers and continuing my diabetes reversal. I made sure to continue extending the intensity of my hard rides and the distance of my long rides. Times when I was grimacing in pain, I would visualize that pain being inflicted on my diabetes. The thought would turn my exercise-induced grimace into a very broad smile.
It was definitely having a big change on my physique. My weight loss slowed but was easily explained by the muscles; my quads started becoming quite large. My waist size continued to shrink. I was still pretty doughy on top, but south of my waist line I had the appearance of an athlete. I only lost ten pounds but felt like I had lost another 40!
When winter started making things difficult, I executed my contingency plans. My road bike was put on a trainer and used at an indoor class; Project: SubZero would be my experiment riding out doors. I also had a stationary bike if the indoor class didn't work out. I've been so busy with the first two I have only had one opportunity to use the stationary at home.
So recently I went back for another A1C. I was expecting a small drop like last time. So you can imagine my surprise when my reading was 5.7%! My doctor was very congratulatory and pointed out this last drop was done with no oral medication at all. Her suggestion was I continue exactly what I had been doing, as it was obviously very successful.
So I continue to progress against this progressive disease. I do this by constantly extending my goals. My A1C goal is to be lower than 5.7% next time. My weight goal is to lose another 50 lbs. While indoor cycling I'm hoping to increase my functional threshold power an additional 15%. This coming spring I am looking into a 200km brevet. As the saying goes, get busy living or get busy dying.
Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts
Friday, 26 December 2014
Sunday, 7 December 2014
My Fight Against Diabetes Part 2 - Diet and Exercise
When I first started cycling I knew that the hardest thing would be figuring out nutrition. I wanted to avoid the dreaded bonk. When I went online, again I found a lot of conflicting information. Everything from no carbs to low carbs, to high carbs.... Not very helpful! I realized that many people were at different stages with their diabetes, and some people were probably following misinformation.
So instead I opted to do a bit of field research. I brought my glucose meter with me and took readings at set intervals. I'd bring food of varying carbohydrates and GI and see what worked best. I felt that this was the best way to cut through the misinformation and to give me readings specific for me. Don't worry, I cleared things with my doctor first; if you are reading this wanting to do the same thing, always keep your doctor in the loop!
What I found was very surprising. Most of the time my blood sugar was at the bottom end. I started to consume more glucose with a higher glycemic index and it would still be borderline low. Eventually I tried very high glucose with high GI, gels and energy drinks. The stuff that's normally considered poison for a diabetic. I found on very long rides (3+ hours) I could have a gel or an energy drink every hour and my blood sugar was optimum.
If you read about dieting and exercise to manage type 2 diabetes, you'll see they recommend aerobic exercise and strength training. Both activities make your body more sensitive to insulin. In addition, while you are exercising, your muscles use up glucose; the bigger your muscles and harder the activity, the more glucose they burn. This is why cycling is so effective for managing diabetes; you can easily vary your ride experience; riding hard and doing intervals is strength training.
So instead I opted to do a bit of field research. I brought my glucose meter with me and took readings at set intervals. I'd bring food of varying carbohydrates and GI and see what worked best. I felt that this was the best way to cut through the misinformation and to give me readings specific for me. Don't worry, I cleared things with my doctor first; if you are reading this wanting to do the same thing, always keep your doctor in the loop!
What I found was very surprising. Most of the time my blood sugar was at the bottom end. I started to consume more glucose with a higher glycemic index and it would still be borderline low. Eventually I tried very high glucose with high GI, gels and energy drinks. The stuff that's normally considered poison for a diabetic. I found on very long rides (3+ hours) I could have a gel or an energy drink every hour and my blood sugar was optimum.
If you read about dieting and exercise to manage type 2 diabetes, you'll see they recommend aerobic exercise and strength training. Both activities make your body more sensitive to insulin. In addition, while you are exercising, your muscles use up glucose; the bigger your muscles and harder the activity, the more glucose they burn. This is why cycling is so effective for managing diabetes; you can easily vary your ride experience; riding hard and doing intervals is strength training.
One of the newer tests to diagnose and monitor diabetes is called HbA1C; or hemoglobin A1C. The test gives an average of your blood sugar over the previous 2 or 3 months. For a person without diabetes their value should be in the 4%-5.6%. If you test between 5.7%-6.4% you are considered at risk of diabetes. A reading of 6.5% or higher is considered diabetes. At 7% it indicates poor control of blood sugar; 8-10% is considered very poor control and a much higher risk for diabetes complications.
My type 2 diabetes diagnosis was indicated by an A1C of 7.3%. I was started on some oral medication and an appointment was set with the diabetes education centre. Before I got talking to them, I decided to start exercising; the one thing I knew about diabetes was losing weight helped. And I was massively overweight, I'm pretty sure I was in the obese range. I couldn't even ride a bicycle properly then. I just started by walking. Walking longer distances, harder and faster each time. It helped me lose enough weight and gain enough strength to start riding my hybrid.
My next appointment with the doctor was a big eye opener. My A1C reading was 6.5%. Since I was logging all my food and using apps to track my exercise activity, my doctor was able to review the data with a high level of confidence and no worries about exaggeration. What she said surprised me. She told me to cut my oral dosage in half and told me, "If you keep this up you could reverse your diabetes."
REVERSE?!
There is no cure for diabetes but in some rare cases a type 2 diabetic can "reverse" the condition. It involves a lot of work but you can bring your numbers down to the point where you no longer need medication to manage your diabetes. It's not a cure because you are basically locked in a battle with a progressive disease; it constantly fights your attempts to control it.
To be continued in part 3 where I work hard at my new goal of diabetes reversal.
My next appointment with the doctor was a big eye opener. My A1C reading was 6.5%. Since I was logging all my food and using apps to track my exercise activity, my doctor was able to review the data with a high level of confidence and no worries about exaggeration. What she said surprised me. She told me to cut my oral dosage in half and told me, "If you keep this up you could reverse your diabetes."
REVERSE?!
There is no cure for diabetes but in some rare cases a type 2 diabetic can "reverse" the condition. It involves a lot of work but you can bring your numbers down to the point where you no longer need medication to manage your diabetes. It's not a cure because you are basically locked in a battle with a progressive disease; it constantly fights your attempts to control it.
To be continued in part 3 where I work hard at my new goal of diabetes reversal.
Friday, 5 December 2014
My Fight Against Diabetes Part 1 - Diabetes Education
I still remember my doctor telling me not to make any big changes and to get educated about diabetes first. My instinct was the complete opposite. I didn't want to wait three weeks until the diabetes centre had an opening. I needed to deal with this NOW! But I fought the instinct and took my doctor's advice.
Now I know why she told me to do that. There are a lot of myths out there regarding diabetes and there are also a lot of unaware people have adopted this bad information as gospel. So you will be hearing this bad advice from people you love, people you trust and fellow diabetics; all of which are just trying to be helpful. The diabetes centre was great for debunking this bad information.
For example, lots of people (including many diabetics) would give me advice about carbohydrates. Most of it consisted of how you should be cutting it drastically from your diet Yes, too many carbs is bad; but too little carbs is bad too. It's kind of like suggesting the best way to avoid drowning is to never drink water again.
People will tell you what you can and can't eat. Sometimes this is framed as "helpful advice" but I've even had people literally say "You can't eat that," in a restaurant. They just saw carbs as some kind of poison. They don't care about the glycemic index or how much of the carbs are dietary fiber. Or how many there were in the meal.
The truth of the matter is, your body needs carbohydrates; moderation is the key. For each meal I would have anywhere between 45-90 grams of carbs. For a snack I would allow up to 30 grams of carbs
The other thing the diabetic centre made me aware of was the glycemic index. Foods high on the index release glucose more rapidly; foods lower on the index release more slowly. So for regular food I tried to stick with lower GI foods.
People will tell you what you can and can't eat. Sometimes this is framed as "helpful advice" but I've even had people literally say "You can't eat that," in a restaurant. They just saw carbs as some kind of poison. They don't care about the glycemic index or how much of the carbs are dietary fiber. Or how many there were in the meal.
The truth of the matter is, your body needs carbohydrates; moderation is the key. For each meal I would have anywhere between 45-90 grams of carbs. For a snack I would allow up to 30 grams of carbs
The other thing the diabetic centre made me aware of was the glycemic index. Foods high on the index release glucose more rapidly; foods lower on the index release more slowly. So for regular food I tried to stick with lower GI foods.
The centre also encouraged me to exercise, which is one of the best ways to manage type-2 diabetes. They recommended both aerobic and strength training. They gave me great information to help me along my journey; for example how to count net carbs properly (subtract dietary fiber from total carbohydrate count).
To be continued in part 2 where I will discuss my exercise and the impact of nutrition on cycling.
To be continued in part 2 where I will discuss my exercise and the impact of nutrition on cycling.
Wednesday, 26 November 2014
Android Apps for Cycling
Sometimes I feel like the best modern invention for cycling is the smart phone. When I re-ignited my passion for cycling, I had an Android phone. I was hoping there would be a program that could make use of the phone's sensors and give me a good guess as to my speed. Today I have a variety of apps that enhance my cycling experience.
Note: I will probably do some reviews of these in the future, which is why I don't want to go too in-depth with each app. I will post examples that I have used in the past. This is why you'll see sometimes I only have one example to offer up.
I'm going to stick with an Android perspective since it's what I know and use.
Activity Tracking
When I was first exposed to an activity tracking app, I thought it was a great idea. It would be able to tell me how fast I was going and show me the map of where I went. I also like to joke that certain attributes (speed, distance time) are like scores on a game. You've got to beat your old score! Some trackers take this very literally and make your ride into a game.
Note: I will probably do some reviews of these in the future, which is why I don't want to go too in-depth with each app. I will post examples that I have used in the past. This is why you'll see sometimes I only have one example to offer up.
I'm going to stick with an Android perspective since it's what I know and use.
Activity Tracking
 |
| Strava screen. No map as this activity was indoors (no GPS). |
It also keeps track of those attributes for you. It does analysis on your ride. It makes it easy to share on social media or connect into the other apps. Some have interesting features like off-road maps, auto-pausing, camera shots included into your ride, turn by turn navigation, competitive leader boards and so on. Many have feature-rich web sites which complement the application.
Below are examples of software you can do this with on Android.
Ride With GPS (free but requires monthly subscription for premium)
Strava (free but requires monthly subscription for premium)
Map My Ride (free but requires monthly subscription for premium)
Wahoo Fitness (free but only guaranteed compatibility with Wahoo products, which are only guaranteed with iPhones. They have some Android support).
Zombies, Run (paid + paid upgrades).
Food Tracking
An important aspect of diabetes management is watching what you eat. So when I started to track what I ate, I looked for an app that could log food easily. Like being able to scan a bar code to speed up entering in details or being able to repeat something I've logged before. Things like being able to add your own recipes and foods are a big bonus.
A good food tracker can assist you with your diet. You should be able to set goals such as weight or other parameters, for example waist size. A good food tracker will help you watch whatever you need to; watching calories is great for dieting but watching carbohydrates is important for diabetics.
One function that is really important to me is a food tracker that will talk to my activity tracker. That way your diet can be adjusted according to your exercise.
A popular free food tracker many people use is MyFitnessPal.
To be honest though I've been slacking in my food tracking. At a certain point I was riding my bicycle so frequently that I was burning calories at a crazy rate. But lately things have slowed. I need to get back on this particular wagon.
People Tracking
No, this isn't a lesson in stalking or a primer for a spy. I'm talking about a more voluntary sort of tracking. While most people would eschew others tracking them, this is a good idea for a few reasons:
In the past I've tried using the built-in "meet up" functionality that's already found in subscription-based activity trackers. But it usually requires a subscription and the other person has to use the same app. And its hard to just ride up and meet with friends when you live way out in the sticks. Lately I've been using Glympse. I like it because you can send anyone a link via email and you control how long it will track you for.
Weather Tracking
One of the most important apps I use. It tells me how to dress properly for a bicycle ride. It will tell me how much or how little clothing I need to wear. I hate riding in the rain so it also tells me when I need to dust off the trainer or stationary bike. Here are several Android favourites:
The Weather Channel
The Weather Network
Accuweather
WeatherBug
Miscellaneous
So you're out riding your bicycle and you endo (flip over your handlebars, "end over end" or endo). You discover there's no reception where you are. What do you do? Well, there's an app for that! I keep around a first aid app (I use St John's Ambulance First Aid for Cyclists). A repair app would come in handy as well but I haven't found one I like yet. Best would be any application that works offline in case the area has no cellular reception.
Below are examples of software you can do this with on Android.
Ride With GPS (free but requires monthly subscription for premium)
Strava (free but requires monthly subscription for premium)
Map My Ride (free but requires monthly subscription for premium)
Wahoo Fitness (free but only guaranteed compatibility with Wahoo products, which are only guaranteed with iPhones. They have some Android support).
Zombies, Run (paid + paid upgrades).
Food Tracking
 |
| MyFitnessPal |
A good food tracker can assist you with your diet. You should be able to set goals such as weight or other parameters, for example waist size. A good food tracker will help you watch whatever you need to; watching calories is great for dieting but watching carbohydrates is important for diabetics.
One function that is really important to me is a food tracker that will talk to my activity tracker. That way your diet can be adjusted according to your exercise.
A popular free food tracker many people use is MyFitnessPal.
To be honest though I've been slacking in my food tracking. At a certain point I was riding my bicycle so frequently that I was burning calories at a crazy rate. But lately things have slowed. I need to get back on this particular wagon.
People Tracking
 |
| Glympse |
- Riding somewhere dangerous (environmental, wildlife, maybe its just the bad end of town).
- Have health issues where you might need immediate assistance.
- Live in an area with other cyclists where you might want to meet up with each other while riding.
- Riding alone. Even if it's somewhere safe. Like winter biking around my house. If I were to slip and hit my head, I could get knocked out and freeze to death.
In the past I've tried using the built-in "meet up" functionality that's already found in subscription-based activity trackers. But it usually requires a subscription and the other person has to use the same app. And its hard to just ride up and meet with friends when you live way out in the sticks. Lately I've been using Glympse. I like it because you can send anyone a link via email and you control how long it will track you for.
Weather Tracking
 |
| The Weather Network |
The Weather Channel
The Weather Network
Accuweather
WeatherBug
Miscellaneous
 |
| St Johns Ambulance First Aid for Cyclists |
Thursday, 28 August 2014
Diabetes
"... the results of your A1C..."
"... I know the news is a bit shocking..."
"...the good news is we identified it and now..."
Did you just say I have diabetes?
And I sat there, a little bit shocked and a little bit numb, while the doctor went over details with me. I started to think about how crappy this news was. It was another salvo of bad medical news that I seem to keep running into. I felt hopeless and full of despair. Then I started getting angry.
Then I thought about how unproductive it was to get depressed and angry, and started thinking about ways to approach this. One of the things that I remembered from the doctor's visit was that I could manage this with diet and exercise. So I came up with a plan; start moving even if its just a little, increase distances and get some diabetes education.
I got a wealth of information from a diabetes educational center. I learned that I had a lot of misconceptions about the disease and ways I could eat better. I started walking a lot and eventually got on the road with my hybrid.
I set out like a first time cyclist, with wobbly steering and not enough balance to pull out my bottle while riding. On that first ride things seemed so far! I managed to rack up a couple of kilometers and make it home, completely exhausted. But as tired as I was, I felt so great! I forgot how much I loved cycling and it was all coming back to me.
So off I went every sunny day I could, with small milestones and big dreams. I kept adding an extra kilometer every day or three. My first 5 km felt like such a big win, I felt like a champion after a big race. I felt the same way for 10 km, 20 km and every milestone I've set. When I recently did 100 km, I felt exactly that same way. I began keeping a log of my food using an app on my phone. When I wasn't on two wheels, I was constantly reading blogs and news about cycling. Reading about Team Novo Nordisk was particularly inspiring.
For the first time in a long time, I looked forward to my next doctor's appointment.
When my appointment rolled around, the doctor seemed pretty impressed. I managed to bring my A1C number lower and had dropped a significant amount of weight. The benefits of exercise and eating better were apparent. The doctor reduced my medication and indicated further reduction was possible in the future if I kept things up.
I took it as a challenge and dove right in. The next few months saw me transition over to a road bike and even longer distances. My perseverance paid off; my last medical appointment had even more weight loss and amazing a2c numbers. I feel more fit than I have in years and I'm happy and proud of myself. It feels like such a contrast to that guy who was so depressed and angry months ago.
As of today, there is no cure for diabetes. I will have to continue cycling my entire life to keep it at bay. And I might only be able to slow the disease's advance. But I'm stubborn as a mule, I enjoy challenges and I really love cycling!
"... I know the news is a bit shocking..."
"...the good news is we identified it and now..."
Did you just say I have diabetes?
And I sat there, a little bit shocked and a little bit numb, while the doctor went over details with me. I started to think about how crappy this news was. It was another salvo of bad medical news that I seem to keep running into. I felt hopeless and full of despair. Then I started getting angry.
Then I thought about how unproductive it was to get depressed and angry, and started thinking about ways to approach this. One of the things that I remembered from the doctor's visit was that I could manage this with diet and exercise. So I came up with a plan; start moving even if its just a little, increase distances and get some diabetes education.
I got a wealth of information from a diabetes educational center. I learned that I had a lot of misconceptions about the disease and ways I could eat better. I started walking a lot and eventually got on the road with my hybrid.
I set out like a first time cyclist, with wobbly steering and not enough balance to pull out my bottle while riding. On that first ride things seemed so far! I managed to rack up a couple of kilometers and make it home, completely exhausted. But as tired as I was, I felt so great! I forgot how much I loved cycling and it was all coming back to me.
So off I went every sunny day I could, with small milestones and big dreams. I kept adding an extra kilometer every day or three. My first 5 km felt like such a big win, I felt like a champion after a big race. I felt the same way for 10 km, 20 km and every milestone I've set. When I recently did 100 km, I felt exactly that same way. I began keeping a log of my food using an app on my phone. When I wasn't on two wheels, I was constantly reading blogs and news about cycling. Reading about Team Novo Nordisk was particularly inspiring.
For the first time in a long time, I looked forward to my next doctor's appointment.
When my appointment rolled around, the doctor seemed pretty impressed. I managed to bring my A1C number lower and had dropped a significant amount of weight. The benefits of exercise and eating better were apparent. The doctor reduced my medication and indicated further reduction was possible in the future if I kept things up.
I took it as a challenge and dove right in. The next few months saw me transition over to a road bike and even longer distances. My perseverance paid off; my last medical appointment had even more weight loss and amazing a2c numbers. I feel more fit than I have in years and I'm happy and proud of myself. It feels like such a contrast to that guy who was so depressed and angry months ago.
As of today, there is no cure for diabetes. I will have to continue cycling my entire life to keep it at bay. And I might only be able to slow the disease's advance. But I'm stubborn as a mule, I enjoy challenges and I really love cycling!
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