Hi! My Name Is Ken, I’m A Diabetic

[Ken Helwig]

Miguel my prayers are with you.

Yes it is the biggest, toughest coach out there. I am trying as hard as I can.

[Laurie Ann March]

Oh Miguel… I can't imagine how rough that has been. Hang in there – you'll know today. Sending you a ton of positive vibes for luck and a big hug across the ocean. Keep us posted.

[Laurie Ann March]

Ken wrote "This is no walk in the park folks. Just imagine looking at EVERY label of food that you buy and reading it to see if you can eat it…everything becomes more serious because this is your life you are dealing with."

It's a proper pain in the rear end for sure, however, the label reading is something I feel every person should do. It's good to know what you are putting into your body. I will let you know that this becomes second nature Ken and next thing you know you won't even have to look at many things…. same with the portion sizes as they relate to carbs. I find that the glycemic index bit is starting to become ingrained in my brain now too.

The eye thing was definitely a tough one for me but we've caught it early enough that I shouldn't have vision loss other than a tiny bit of peripheral (and that is even a small risk). It may affect my night vision too. No biggie. The reason mine progressed so quickly was because of the pregnancy but I would not change that for the world. The key is that I am to keep as active as I can, watch the blood sugar closely, and really pay attention to my blood pressure too.

I think that there needs to be far more education about Diabetes too especially with people who are overweight and sedentary. I can't imagine what my health would have been like if I hadn't got into hiking and had been a sofa spud for the past decade or so. Getting my act together started way before I was diagnosed – being diagnosed keeps me on the right path because I am scared to death about the alternative. I also spent a lot of time beating myself up mentally for putting myself in this position. It was a bit of a roller coaster there for awhile. It was the support of GoBlue Hiker, GrinchNH, and Four Wheel Bob (all whom some of you might know from other forums) and Miguel that got me through a lot of it. I thought I'd never be able to hike again and this group of people gave me hope. I can't thank them enough.

What Miguel is going through is very scary. There are days I am very thankful I have type 2 and not type 1 as Miguel has. I've had the good fortune of being able to get off medication and control with diet and exercise because my body actually produces some of its own insulin. Type 1's aren't so fortunate. I think that's one of the reasons I want to do this Ford Race to End Juvenile Diabetes as my first running race.

[Travis Leanna]

I just wanted to say how awesome this thread is. The honest and heartfelt help and support given so freely by "strangers" about such a serious issue is amazing and I must admit that I come to BPL for much more than the latest tent review, if you know what I mean.

My prayers and best wishes to all of you!

[Ken Helwig]

Thanks Travis, very kid of you to say.

[Richard Scruggs]

Very, very well stated, Travis.

Learning how folks face, and cope with, this disease is a very valuable education for others, and a great deal more. It is an inspiration.

I join in wishing all the very best for a full and rewarding life.

[Ken Helwig]

thank you Richard for the kind words.

[Jolly Green Giant]

Add me to the list of those who are sympathetic and fighting the same fight. There are a handful of us I've seen on BPL, and I'm guessing many more with the same challenges.

[Ryan Bressler]

Just saw this thread, I'm a type I Insulin Dependent and have been for a few years so I'm not sure how much of my experience is directly applicable but I do have some favorite foods.

Nuun is great as a no sugar electrolyte drink on the trail. Gummy bears hold up the best to both heat and cold so I use them as my low blood sugar treatment. I've found that it is essental to get a good amount of protean in the morning. Toast with peanut butter or an egg sandwich keeps me even through the day, granola makes me go high.

Also be aware that certain types of exercise (generally anaerobic or stressful stuff) can cause a spike in blood sugar due to the release of glucagon while more sustained exercise like hiking makes insulin more efficient and can make you go low.

I also always try and have a fair amount of extra food and find partners who understand that need…I climb and some climbers are willing to carry less food and fuel to go light and rely on their ability to tough out unplanned bivies and suffer without food but that just isn't an option for me.

[Laurie Ann March]

thanks everyone.

the aerobic vs anaerobic is something I'm still trying to wrap my head around (and I'm not sure where the running fits into that)… backpacking is pretty straight forward with the blood sugar control for me now. Where I am having difficulties is with this training to run bit. Generally my blood glucose is about 5.5 to 6 mmoL pre-training session and post is about 3.8 mmoL (sometimes 4.2 ish). However, today it was 3.8 mmoL. I had a very small lunch (25 grams of carb) and 4 hours later I was at 8.9 mmoL (and that's really high for me as I don't usually let postprandial go above 7.2 mmoL). I'm going to keep an eye on it but it has me a little bit confuzzled. I'm only doing about 3 km a session right now but within a few weeks I'll be running a full 5 km. Anyone have experience with a weird rise like that later on in the day? I've had that from eating something fatty like egg or pizza but never that high.

[Ken Helwig]

Laurie Ann, what is mmol and the numbers next to it??? Is that a different way to gauge glucose?

[Laurie Ann March]

Yes… I forgot you all are in the US and the American system is different. Converting mmoL to mg/dL is done by multiplying by 18.

Here are the equivalents from my post in mg/dL (so it will make more sense now).

Generally my blood glucose is about 96 to 108 pre-training session and post is about 68.4 (sometimes 75.6 ish). However, today it was 68.4. I had a very small lunch (25 grams of carb) and 4 hours later I was at 160 (and that's really high for me as I don't usually let postprandial go above 129.6).

[Ken Helwig]

That is a HUGE swing upwards. I thought it might have been the Canadian way of doing this. Your blood glucose is low. I wake up and it is 140-150. Post workout 115-125 and it usually goes down as the day progresses. I wonder if dehydration during the evening makes my numbers spike

[Ryan Bressler]

That would still be considered good control for a T1 but 68 is pretty low and it is possible you got so low soon after that it triggered a glucagon release form your liver causing a "bounce."

In my experience, running makes insulin more effective and the effect lasts for a bit so you may find that the day after a run is more similar to a day you are hiking then a purely sedentary day at least until your body adapts to it a bit.

[Laurie Ann March]

Waking is usually between 80 and 90. My first A1C (at diagnosis) was 17.1. A1C since then have been consistently between 4.2 and 5.4. The doctor had me on insulin and then glucophage and I was basically having to eat to keep from going low which meant weight gain. Finally, I made an appointment and told him I wasn't needing medication anymore. He's a fabulous Doc but a little puzzled by my need for understanding of diabetes and my unrelenting control. I probably would have lost my mind if I was T1 because I've heard it is so much more difficult.

My lowest low was on a wilderness canoe trip with about 12 km of portaging on the first day. My numbers dropped to about 2.4 mmoL or 43 mg/dL. I think that is the worst I've felt. There was quite an emotional bit that went with it. Crying. Disoriented. From a physical standpoint I was acting like a drunk person and had extreme shakes with nausea. Bryan, darling spouse that he is, caught on right away and got me some jelly beans. It was a pain because we (he) also had to un-hang the food. That was the day I learned that I had to watch the numbers more closely.

Did I mention before that the lightest/smallest accurate meter I've found is the One Touch Ultra Mini? If it is really cold though – put the battery inside your coat. I find it flattens quickly in 20°F weather.

One person mentioned granola. I've found that using amaranth or quinoa flakes will up the protein a bit and slow down the spike that most granola will give. Hope that helps.

I also adore roasted chickpeas as a diabetic friendly trail snack that's a little lower carb than trail mix. I usually add a few nuts in too. I can post a recipe if anyone wants it.

[David Ure]

Any one hear from Miguel? Hope the tests came out negative.

[Ken Helwig]

David, I have not. I sent him a pm a few days ago and have not heard from him. I have not seen him on Facebook either. Concerned

[Laurie Ann March]

I'm concerned too (scratch that – I'm really worried). Hopefully he's just busy. I think the last post I saw on FB was Tuesday-ish.

[Ken Helwig]

Yes Laurie, I checked up and Tuesday was his last post.

[David Ure]

Miguel – please post and let us know how you are doing.

(Sending PM as well)

[Miguel Arboleda]

Hi Everyone

Sorry to worry you all. I went to the doctor yesterday and got the results. When I first walked in the door my doctor had a grave expressionon her face and the very first thing she said was, "Can you be admitted right now?" I thought, "Here we go…" But the blood test results from just before meeting the doctor hasn't come in yet, so we sat and talked about what necrosis entailed and what went wrong. Half an hour later (my doctor gave up her entire morning for me! And I thought I didn't like her!) the blood test results came in. My white blood cell count was normal, as was my CPE (protein test to determine level of infection). That ruled at necrosis. After consulting with an infection specialist and a rheumatologist it was determined that I have osteo arthritis.

You can imagine my relief! I spent the rest of the day zombied-out due to the draining of adrenaline…

Thanks everyone for your concern and support. I'm just glad it turned out well.

Laurie, your blood sugar spikes could be because of the amount if exercise you are doing, especially anything anaerobic. When you go over your aerobic threshold your body produces cortisol, which causes blood sugars to spike because it inhibits the absorption of fats. I strongly recommend that you read Philip Maffeton's "The Big Book of Endurance Training". He explains everything, in great detail, there. His most important and adamant advice is that you never train beyond your personal aerobic health zone (everyone is different and improves with proper training). He also strongly recommends not doing any kind of anaerobic exercise (this includes running to hard and fast) until your aerobic base is healthy. Many of the elite athletes he trained scoffed at the ridiculously slow training he recommended they do, very often being reduced to walking (that's what I've had to slow down to). He explains that being fit is not the same as being healthy and that many elite athletes have a very unhealthy aerobic system. By training slowly, with a heart rate monitor, he managed to get his clients amazing results. Try it!

[Laurie Ann March]

That's a sigh of relief. While osteo is a fairly big thing too, it is so much more manageable than the necrosis. Being as active as you are should help with the arthritis, no? I'm so glad to hear you are okay.

Thanks for the info. I'm still not entirely sure if I am going out of my aerobic zone (that's the part I can't wrap my head around). Right now I am interval training but by the end of next week the program has me running straight through. I might break that week into two if I am finding it a little too much. We will see.

I also monitor my heart rate very closely and check both my heart rate and blood pressure every morning before I get out of bed. I read in the Diabetic Athletes Handbook and another book called Running that this latter bit could indicate over-training and if it was out of whack to rest. At the moment I am only training for 2 to 2.5 hours per week and half of that time is walking. My running pace is a slow one – more of a jog. I figure I'll get good (stable, etc) first and then worry about pace later. Funny, that's the way I backpack too… like a tortoise. I can hike 20 km in a day;it just takes me the entire day (lol) mostly because I like to take my time and not miss a thing.

Over the early part of 2012 I'm going to be writing a few articles on special diets as they relate to the trail. I've done the vegan-gluten-free in the second book and now I am wondering if one of these articles should be about diabetic friendly food on the trail. I have a professor of nutrition and a couple other experts at my disposal. I know that it is a very small segment of the population but still a very relevant subject. I'd love to hear your thoughts on that everyone.

[Arapiles .]

"After consulting with an infection specialist and a rheumatologist it was determined that I have osteo arthritis"

Hi Miguel

Glad to hear that it wasn't necrosis.

Where's the osteo? I've found that the arthritis in my hip is not that big an issue, I even seem to get the nausea less than a year or so ago – but I do miss running.

[Ken Helwig]

Miguel that is so much better news than what was anticipated. Thanks for letting us know

[David Ure]

Good news. Whew.

Is there anything that you can do to prevent the potential for necrosis in the future? Or is this just a matter of 'staying of course' with your current diet and training plan?

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