One Good Run

HTTP Status Cats

2011-12-15T14:23:00.001+13:00

HTTP Status Cats, a set by GirlieMac on Flickr.

Diabetes Psychology - How am I doing?!

2011-07-31T23:10:00.002+12:00

I recently downloaded from Radio NZ, and listened to Amelia Nurse interview Psychologist Bill Polonsky, who specialises in the issues faced by diabetics. It's well worth a listen.

The most striking idea that hit was that one of the biggest challenges to avoiding complications from poor control it actually know how we are doing. We don't have any feedback mechanisms in place. Yeah, we know that if we don't look after ourselves we run the risk of some nasty and debilitating complications. What we are missing is more formal feedback process to give a stronger indication on how we are doing.

Perhaps all it would take is for a monthly HBA1c to be taken with the results automatically sent to us with some statistics on our own progress and how we compare to the data they have on people that have had similar control and the complications they have had. It wouldn't take much.

Speaking of which, an action for is to get another one of those HBA1c serial test cards so that I can go in whenever I like and find out how I'm doing.

Download the interview: Diabetes Psychology - an interview of Psychologist Bill Polonsky by Amelia Nurse

Sunset - Friday, 29th July 2011

2011-07-31T00:12:00.000+12:00

Just out the back window

Free Pizza - What Hell Could Do

2011-07-30T23:56:00.004+12:00

An idea to prompt the sales of pizza's care of Adrian Slack.

The idea is to have a popular custom pizza ranking, for the pizzas that customers have chosen the toppings for. You could create your own pizza, give it a name, and then others could choose it too. Or if they were choosing their own toppings and it happened to match that of a custom pizza that has already been named it would let them know. Anyhow each time a particular pizza is sold it would add to it's popularity rating and be displaced as a ranking. For every 10, 20 specific pizzas the person who created and named the original pizza could receive a free pizza. Thus creating an incentive to; create new customer pizzas and promote the pizza you created.

How I Roll – Part 2: Getting Organised

2011-06-27T10:59:00.000+12:00

My thinking for this 4 part series was prompted by Scott Hanselman’s podcast (268) Personal Systems of Organisation. Part 1 was “The Capture”, the methods you have to capture stuff with so you don’t miss out. This one, Part 2 covers some of the basics of how I get organised.

Organising is vital; remember how frustrated you were last time you had to look for your keys because you didn’t have a regular spot for them? How much less time would it take to do everything if all of what we needed was at our finger tips? You’d most likely have time do some of those things you really have been meaning and wanting to but haven’t had the time for. It would make things a whole lot easier.

Now I realise there are a huge number of things I could cover; such as how to organise your email, but I’m just going to keep it simple and a fairly basic. I’ll put together another post on some of my systems I use later.

Organising

Daily Filing: everything gets filed, everything needs to be filed. I use an Alphabetical Vertical Filing System care of Nick Petrie. Near the end of each day all the things that have been captured need to be processed and filed. Sources include: my in tray, snail mail, notes I've made in one of my spiral bound note pads, photos now in my DropBox, and new notes I've made in EverNote. With each item I decide what to do with it

Do It (only if it's going to take less than 2 minutes)
Defer It (plan to do it later)
Delegate It (ask someone else to take it on board)
Drop It (tasks that don't need to be on your radar at the moment)

(Actions care of Scott Hanselman)

Then, regardless of what it is; it gets filed for easy access, unless I think it's never going to hold any value, or if I think I'm being too much of a hoarder.

I've made the point of making my filing system vertical so that it is not only easier to pull things out and put them back, but it's also easier to search through, as files are not stacked on top of each other. I also like the files to be easy to reach, so I placed them at the back of my desk and this means they are only an arm length away. I use clear plastic slips so I can see the contents and label them with a removable sticker in the top left hand corner, the corner that is most accessible. Surprisingly I don’t have a lot to file these days. The majority is on a hard drive with a backup either in the cloud (online somewhere) or on a portable drive.

Vertical Alphabetical Filing System

Tip - Block out a time in your calendar to get yourself sorted daily

I quite often refer to this whole process as "putting it on the shelf", so that you can access it easily later.

digital tools

DropBox: Whatever I'm working on is kept in my DropBox so that it's accessible anywhere any-time (Laptop, Phone, or on-line)
SkyDrive: Anything that I don't need immediately but is kept for reference is put in a folder that is sync with my SkyDrive. This acts as an on-line backup (in the cloud)
GoodSync: to synchronise with removable drives and Memory Sticks.
Remember The Milk: for putting the tasks in that are generated from the filing. (An app on my Android phone, a desktop link to a web-client, a gadget integrated into my Google Apps Gmail web-interface, and Synchronised with Outlook Tasks)

Next up in Part 3 - Planning

How I Roll – Part 1: The Capture

2011-06-16T20:18:00.001+12:00

Scott Hanselman prompted my thinking recently with his podcast (268) Personal Systems of Organisation. I get the impression he is known for his productivity and effectiveness within the Microsoft development world. He's a smart guy, but not a Rocket Scientist though, as that could be an insult of sorts. Are Rocket Scientists actually that intelligent? Perhaps they are more comfortable than most at taking large risks?

I thought I'd take on board some of his suggestions and add them to what I already have in place and do. In defining this it focuses me to find and make use of the smart methods that suit me. Hopefully it gives you an idea or two as well. Please feel free to comment with your experiences and or suggestions too. In some ways it's going to open up a can of worms too, but the worms aren't going to get away, nor am I going to let them die like in my dad's worm farm.

I see personal systems of organisation being in 4 parts:

The Capture
Organising
Planning
Application

This blog post I’ll discuss “The Capture”. This blog post is part 1 of 4.

The Capture

Things just appear, and sometimes you think to yourself; “I want a bit of that”, and later you knew you had something you were suppose to remember, to do or you had this great idea but now it’s gone. I usually feel like kicking myself when this happens. The answer is to capture it. A method to capture it for later. For me I use the following

analogue tools

A pen and two spiral bound note pads; one is A5 in size and the other is A4. I take one of these with me whenever I can. It usually depends on what bag I grab.

Soon I'm going to try!

The PocketMod - It's a neat way of folding a piece of paper so that it's like a book. You design your own layout at www.pocketmod.com

digital tools

My phone's camera: I take photos and store them either in EverNote or drop it into my DropBox. I'll take photos of forms I fill out and the forms that I fill out for my clients, it means I have a copy and can give them the original. If I go somewhere and I'm going to need to show someone else later, I'll take photos. It can be good to photograph your receipts too, basically anything you could lose. If I see something cool that gives me an idea, I'll take a photo. It's almost quicker than writing something down too, as that saying comes into play "a picture is worth a thousand words". Sometimes I'll even record a video.

EverNote for both ideas and some tasks (on Laptop and my android phone, also available on an iPhone)

Remember The Milk for tasks (web-client on Laptop and as an app on my phone, also available on an iPhone)

dFit - Mon, 11-Apr-11

2011-04-12T12:01:00.000+12:00

dFit – A blog showing you I’m improving my diabetic fitness, my ability to manage my diabetes to provide myself with a healthy life.

Last night I came across Anne’s blog Annetics – She’s a Type 1 Diabetic completive road cyclist. Her post “My Latest Strategy for Managing type 1 Diabetes During Road Cycling Races” points out that exercise doesn’t always make you go low. She actually runs an increase basal rate on her pump to cope with high intensity exercise. It’s got me thinking, what does my body need for the different types of exercise I do? And from a performance perspective what is the optimum level on insulin to have in your body for performance?

Today, instead of the early breakfast I skipped breakfast all together so I could see what’s happening with my basal profile over more of the morning.

Here is now it looked, a bigger view, 3am through to 12pm.

I managed to slip a walk in for some exercise. Although it was a bit half hearted, and not because I’d been fasting all morning but more because of the very poor condition of my muscles down the front of the shins, the Tibialis anterior, they hurt and I could hardly keep a good pace up. Lucy the miniature Foxie we look after a bit had come with me. She was literally pulling me along at times. I don’t think she thought much of the walk because when the word walk was mentioned when we got back she was keen as to go again. A bit of stretching, self massage and more use of the Tibialis anterior will be on the cards. It’s pretty shameful to feel like you can hardly walk, that’s a basic function of man.

Monday, 11 April 2011
time	mmol/L	md/dL	bolus	cf	carb	protein	fat	notes
3:31 a.m.	7.5	135
7:06 a.m.	4.6	83
8:08 a.m.	4.5	81
9:03 a.m.	6.5	117
9:55 a.m.	9.7	175
10:59 a.m.	11.8	212						Exercise - Before: Walk
12:11 p.m.	10.4	187						Exercise - Post: TS 60x4=240
12:26 p.m.			10	2.5	100			Lunch
2:08 p.m.	17.4	313	3	2.5	40
3:11 p.m.			3		30			Crunchy Bar
5:06 p.m.	5.4	97			30
4:40 p.m.					32			Feeling Low, Moro Bar
5:06 p.m.	5.4	97			30
6:51 p.m.	9.0	162	3.2	1.8
7:32 p.m.			4		70
9:35 p.m.	3.9	70

The high light of the day has to be that I didn’t eat as much given that my basal bolus is quite a bit smaller today.

date	total pump	total calc	basal	bolus	correction	basal %	bolus %	correction %
7-Apr-11	68.9	69.2	23	35	11.2	33.2%	50.6%	16.2%
8-Apr-11	62.8	65.4	27.4	28.8	9.2	41.9%	44.0%	14.1%
9-Apr-11	68.9	69.2	27.4	37.5	4.3	39.6%	54.2%	6.2%
10-Apr-11	82.9	84.6	28.2	45.6	10.8	33.3%	53.9%	12.8%
11-Apr-11	57.7	58	28.2	23	6.8	48.6%	39.7%	11.7%

Reflections

It was great to have another look at my morning basal profile as it was a repeat of yesterday and I found out that I’ve obviously got a bit too much insulin on board between 3am and 7am. I’ll lower the basal profile to compensate for this, and I’ll increase my profile to compensate for the rise between 8am and 11am. But I’ll also keep the insulin on board for 7am to 8am as the blood glucose level remained stable during this hour. My profile now looks a little more complicated.

Yesterday’s Basal Profile – 1.3 u/h 11pm to 8am, 1.1 u/h 8am to 11pm

New Basal Profile – 1.4 u’h 5am to 6am, 1.5 u/h 6am to 7am, 1.6 u/h7am to 10am, then 1.1 u/h for 10am to 5am.

I’ve whipped up a spread sheet to calculate the insulin on board for each hour of the day to help me with figure out how to change my profile, to keep the same amount of insulin on board for that hour that was stable yet low insulin on board before hand and increase it afterwards. Now to retest it on Wednesday.

dFit - Sun, 10-Apr-11 - An Empty Cartridge

2011-04-11T10:03:00.003+12:00

dFit – A blog showing you I’m improving my diabetic fitness, my ability to manage my diabetes to provide myself with a healthy life.

Another post on how I managed my blood glucose control for the day.

Today I discovered that my basal profile for part of the morning isn’t enough, and that you should really change your cartridge when alert tells you too. Oh and don’t expect to ride you could 2 weeks ago if you haven’t been for a bike ride since then.

Here is now it looked, I was able to check my basal from 10am through to 1pm, only a small window but enough time to see it wasn’t right.

I so needed some exercise today, I hadn’t been all that proactive to get out there and do much in the last week or so. I headed out for a mountain bike ride on my single speed at Makara Peak, my favourite local spot. I suffered a lot, my heart wanted to jump out of my ribcage, I had no power and I really struggled to get any flow happening. To top it off at the beginning of the long climb my pump decided to tell me that it had run out of insulin and it wouldn’t shut up to matter what button I pushed. In the end I took the battery out. Having this happen just added to the tension I could feel in my body, more underlying stress. Luckily part way through the climb a guy had broken his chain and didn’t have a tool so I was able to help. This gave me a little time for a break too. I’d been looking for that excuse to stop. Surprisingly when I tested after the ride it was only 7.5 mmol/L I was expecting it to be a lot higher, fluky is all I can say. The lack of insulin may have been the reason for my elevated blood glucose at dinner.

Sunday, 10 April 2011
time	diff (hrs)	bgl	bolus	cf	carb	protein	fat	notes
12:16 a.m.			1.8		18
12:35 a.m.			2.5		25
1:06 a.m.		8.5			15
3:16 a.m.		8.2
5:16 a.m.	0.00	10.4	10	2.4	100
9:44 a.m.	4.47	8.4
12:01 p.m.	6.75	11.2
12:59 p.m.	7.72	13.8		4.1				Exercise - Basal Reduction to 60%
2:15 p.m.		11.3						Exercise - Before
					80			Training Stress 125x7=875, Carteridge Empty about 30mins into ride
4:26 p.m.		7.5		2				Exercise - After
4:31 p.m.			1.8		18
5:45 p.m.			3		30			Mars Bar
7:19 p.m.		12.4
7:34 p.m.			7.5	2.3	75
9:55 p.m.			5					Snack
10:50 p.m.			2					Snack
11:15 p.m.			12					Snack
11:38 p.m.		14.3

And the not so cool of it all is that I’m just eating way to much late in the day. I really need to get this under control otherwise I can see myself turning into a fat boy really soon. I used 45.6 units for boluses, that’s 456 grams of Carbohydrate, which is 1824 Kcals. Plus the amount of insulin I used for corrections was high too.

date	total pump	total calc	basal	bolus	correction	basal %	bolus %	correction %
7-Apr-11	68.9	69.2	23	35	11.2	33.2%	50.6%	16.2%
8-Apr-11	62.8	65.4	27.4	28.8	9.2	41.9%	44.0%	14.1%
9-Apr-11	68.9	69.2	27.4	37.5	4.3	39.6%	54.2%	6.2%
10-Apr-11	82.9	83	45.6	26.6	10.8	54.9%	32.0%	13.0%

Reflections

I’ve gone ahead and increased my basal prior to the time block of 10am to 1pm. I just extended the time that I have the overnight basal rate at 1.3 u/h.

Basal Profile – 1.3 u/h 11pm to 8am, 1.1 u/h 8am to 11pm

I struck in lucky with my bike ride that my blood glucose level didn’t rise a whole lot more. I’m making a promise to myself to change my insulin pumps cartridge soon after the alarm from not on. But on the whole I think I manage the situation okay. I gave a little extra after the ride than what I would normally correct with because I knew I didn’t have the insulin in my system for the coming hours as a result of the pump not being on.

And lastly to avoid the fat boy syndrome I’m going to make a conscious effect to not eat when I don’t really need too. Last night it all happened in front of the TV while I was feeling bored and I would have been better off just going to bed.

dFit - Sat, 9-Apr-11 - Starvation

2011-04-10T00:12:00.001+12:00

Once again another post of just how my diabetes control has gone. In some ways the post is more for me than anyone else, to show myself that I can apply myself and get results. Hopefully my ramblings might help someone a little bit in some way.

Today I managed to get my blood glucose down over night and breakfast planned out as well giving me a chance to check my basal profile for the afternoon. I struck it pretty lucky given that yesterday I’d taken a bit of a stab in the dark and increase my basal profile by 4.4 units and simplified it to just 2 blocks (11pm – 4am at 1.3u/h & 4am – 11pm at 1.1 u/h) and that I’d also chosen a ball park insulin to carbohydrate ratio (1u for 10g) and had done the same with my correction factor (1u for 2mmol/L). Well not quite a stab in the dark, I’d used the calculations from “Insulin Pumping” by Walsh & Roberts. It was good to know I’d stuck it lucky, but they do say to check it more than once. But good so far I reckon.

Here is now it looked, I was able to check my basal from 1pm through to 8pm.

All I can really say is that I got very hungry. I felt just like the very hungry caterpillar from that kid’s book. Actually it wasn’t too bad, I knew I was hungry and I just put that feeling aside. I also knew I was fasting for a reason, a very good reason, to can better control of my diabetes, to be healthier and to live longer. Kinda important really, I think.

Here is the data from the day. I discovered, well realised that Mega Milk is pretty cool, 200mL gives you 10g Carb, 10g Protein, and 2g Fat – giving it a low-ish Glycemic Index and the protein helps you to feel full for longer, plus the other benefits like calcium, and some fat soluble vitamins. You can’t really go wrong with is as a snack.

Saturday, 9 April 2011
time	diff (hrs)	bgl	bolus	cf	carb	protein	fat	notes
2:19 a.m.		14		4.3
4:16 a.m.		12
6:57 a.m.		9.3
8:33 a.m.	0.00	8.3	10		100	10		Breakfast - then fasting
10:46 a.m.	1.32	5.7			10	10	2	Going to go low - Milk
11:13 a.m.	1.77	6.2
12:00 p.m.	2.55	9.2
1:07 p.m.	3.67	6.9
1:32 p.m.	4.08	7.8
2:15 p.m.	4.80	6
2:27 p.m.	5.00	5.4			10	10	2	Start of Basal Check
3:13 p.m.	5.77	7
3:44 p.m.	6.28	7.6
4:37 p.m.	7.17	7
6:03 p.m.	8.60	7
7:28 p.m.	10.02	7			80			Dinner - Forgot to dialup
8:08 p.m.			4
8:36 p.m.			6		128	13	48.4	Whole Cake of Chocolate
8:49 p.m.			6
10:42 p.m.		9.5
11:12 p.m.			1.5
11:38 p.m.			10		100	10

And check this out – I’ve managed to drop my percentage of insulin used for correcting high blood glucose values down to under the magic 8%, and it just happens to be exactly the same amount of insulin I used on Thursday (7^th April). I’m stoked!

date	total pump	total calc	basal	bolus	correction	basal %	bolus %	correction %
7-Apr-11	68.9	69.2	23	35	11.2	33.2%	50.6%	16.2%
8-Apr-11	62.8	65.4	27.4	28.8	9.2	41.9%	44.0%	14.1%
9-Apr-11	68.9	69.2	27.4	37.5	4.3	39.6%	54.2%	6.2%

From here I obviously need to check out my basal profile for the rest of the day, and that’s a bit of planning and a bit of luck. All you can do is be ready to check it when the right conditions come up. The luck is coming across the right conditions. Hopefully I can check my over night profile to night if I get in an early dinner.

dFit - Fri 8-Apr-11 - Perspective

2011-04-08T17:00:00.003+12:00

Last night I got reading again and came across ‘The Diabetic Welfare Queen’ and her blog post on New Year’s Resolutions, and it provoked some thoughts and resonated with some of my own principles. We don’t need to shout it out, what we are going to aim for, but we do need to quietly work away at it and ask for help.

Last night I ate and I dialled, and then I ate and then I dialled. Yip and as sure as the wind is in Wellington I’d ‘stacked’ my insulin up and I can crashing down. Classic, and kinda funny when you’ve just read about it in a book too. So there went my plans of checking my night time basal.

To top it off I then ate and ate to deal with the low. I really hate lows. And there goes a good blood glucose level in the morning to start my day with. I’d shot myself in my foot. Luckily days past and there will be further opportunities.

Also on reflection of yesterday I notices that my totals were more than a bit outside the ranges that are typical.

Total Daily Dose – 69.2 units

Basal – 23 units at 33.2% of TDD (outside the typical 40%-60%)

Bolus Total – 35 units at 50.6% of TDD

Correction Bolus Total – 11.2 units at 16.2% (typically under 8%)

Having seen this I decided to up my basal by 4.7 units to bring it up to 40%. I also used it to simplify my basal profile to just 2 values.

11pm to 4am its 1.3 u/h

4am to 11pm it’s 1.1 u/h

Fingers crossed I can go to bed with a reasonable bgl to check my night time basal profile.

My basic approach

Having already set myself some figures to work from (basal rate, carb ratio, and correction factor) I’m going to work through these steps:

1. Tune my night time basal

2. Tune my morning basal

3. Tune my afternoon basal

4. Tune my Carb Ratio

5. Tune my Correction Factor

I’d like to think I can roll through this and then just keep doing it, starting again and rolling through it, so that it become a continual process of improvement and adapting to my bodies changes.

The Second Experiment

I still haven’t obviously checked and tuned my basal rates (overnight, morning or afternoon) so I’ll admit this is a bit hit and miss. But I still feel one can learn from doing what I’m doing. If anything I’ll develop a habit of analysing what is actually going on with my bgl.

I’ve lowered my target blood glucose level is the golden 5.5 mmol/L (99 mg/dL)

Carbohydrate Ratio – 1 unit to cover 10g CHO

Correction Factor – 1 unit to cover 2.0 mmol/L

Once again a 100g of Carbohydrate with 10.0 units of insulin to cover it and the breakfast was again about 20mins after I dialled up

A correction of 6.0 units to low the blood glucose level by 12 mmol/L

In Reflection

Well you can see it, just too much insulin on the whole. Now which one was too much? I’ve just been looking at how yesterday seemed to go okay, but you couldn’t tell from it if all the basal, carb ratio or correction factor were right, or if I just struck it lucky. I’m now look at today’s graph and going how can I tell what went wrong? To mush insulin and I just can’t tell what is wrong and what is right. Hense there is a need to follow that structured approach I outlined above, starting with checking my overnight basal. Now if I can win a good bgl to go to bed on I’ll be set.

dFit - Thu, 7-Apr-11 - What an Effort!

2011-04-07T20:12:00.002+12:00

Last night I read a post titled ‘The Psychology of Diabetes’ on The Diabetic Duo. It really got me thinking about my diabetes and the life I’ve had with it. It actually swelled up some pretty sad thoughts too and that all almighty question “why me?”. However you can’t change the past it’s one of those things you don’t have control over, so you might as well focus on what you can change, which is the right now, right here stuff. So that’s what I’m going to do. It’s only by application that you find success.

The scary part of all of this is I feel really stink to have poor control. I know there’ll be a more than a few of you out there thinking I’m just a Muppet.

My HBA1c has never been flash, my last one was the most hideous it’s been for a while too. But that matches up with the how the year went for me. 2010 was the darkest year so far. Miles off a balanced life that’s for sure, most aspects were at all time low. Things have improved a bit, but they are still below par. I’ve been working a bit on ‘me’ things to make myself a stronger person, but I hadn’t been working on the one thing that will probably make a big difference to my outlook on life and that’s how I look after my blood glucose levels, how I control my diabetes rather than let it control me.

I hadn’t realised and probably still don’t realise how much it is controlling me. I know I’ll feel loads better if I have a good looking HBA1c and that my body will cope a whole lot better as well without all of the physiological stress I put it under from elevated blood glucose levels. Basically I’m sure I’ll end up a happy person if I deal with it.

So...here goes...

I managed to pick up a loan copy of ‘Pumping Insulin’ 4^th ed by Walsh and Roberts from the Wellington Diabetes Society’s little library. I figured I’ve been ignorant for long enough and that I don’t really have any idea where to start. I needed some sort of system to follow. So...how about I start at the beginning?

Ball Park Calculations To Get Me Going

To start with I needed to know what my Total Daily Dosage (TDD) of insulin is. That’s easy my pump records the last 5 days; 68.6, 61.8, 59.1, 54.4, 57.2, 46.1. Walsh and Roberts also suggest you can estimate it based on your body weight.

Walsh and Roberts also 2 other calculations to get you started; a carbohydrate factor and a correction factor.

Total Daily Doage of Insulin
Estimated TDD by Body Weight (for Adults)
Body Weight	93
0.5 unit/Kg/day	46.5
0.7 unit/Kg/day	65.1

Carb Factor (the 500 rule)
New TDD	50
Carb Factor = 500 / New TDD	10.0
1 unit of insulin will cover ... grams of carbohydrate
Can use a range from 450 to 550
Carb boluses usually make up 35% to 55% of your TDD

Correction Factor (the 110 rule)
New TDD	50
Correction Factor = 110 / New TDD	2.2
1 unit of insulin will reduce my blood glucose by ... mmol/L
Can use a rage from 100 to 120
Correction boluses usually make up no more than 8% to 10% of your TDD

I choose to go with 50 units a day, it’s a nice round number. It might be a bit under but I should be able to sort that out later, right? I also know I need to eat a bit less and I’m a little worries that if I go with a higher number that I’ll just pack more of the glucose away for storage as body fat.

I’m pretty sure I currently use a lot more than 8% of my daily insulin on corrections.

I’ve recently taken a bit of a random stab in the dark to increase the insulin in my basal profile to bring my blood glucose values down. I made some changes based on fasting blood glucose values. Basically if my blood glucose level rose from 3 hours after a meal to the 4 hours after it needed to be increased. I made the changes on just seeing it once, so it wasn’t that well founded but I figured that if blood glucose values were high enough all the time that even if I was quite right it wasn’t going to hurt things too much.

I’m now armed and ready, as I have:

· A basal profile

· I know what 1 unit of insulin will cover in the way of carbohydrates

· And I know how much to give to correct an elevated blood glucose level

The First Experiment

My target blood glucose level is <8 mmol/L

· 9:27 am – 13.5 mmol/L, correction 2.7u & bolus 10u for 100g Carb, total dose 12.7u

· 9:46 am – 12.3 mmol/L, Breakfast (100g Carb)

· 10:18 am – 14.4 mmol/L

· 10:49 am – 18.9 mmol/L

· 11:20 am – 18.4 mmol/L

· 11:48 am – 18.1 mmol/L

· 12:21 pm – 17.2 mmol/L

· 12:54 pm – 14.4 mmol/L

· 1:27 pm – 12.4 mmol/L

· 1:57 pm – 11.1 mmol/L

· 2:21 pm – 10.1 mmol/L

Retrospectively – My target blood glucose level should be the bulls eye of 5.5, otherwise I’m going to be high all the time and what’s the point in that. Well I honestly thought I was going to go low with the amount of insulin I dialled up. But no it panned out okay. At 5 hours I ended up with a bgl that was 3.4 mmol/L lower than what I started with and only 2.1 mmol/L above my target. So about right. However I can’t tell if I was lucky or if the carb ratio and or correction factors are right. Hopefully I’ll land it lucky tomorrow with a bgl at breakfast that won’t need correcting.

Big Fat Fiasco - Is Our Fear Of Fat That Well Founded?

2011-04-05T23:10:00.001+12:00

Tom Naughton producer of "Fat Head" presents on how we have been misguided by bad science into fearing fat, and how this has lead to the so called obesity epidemic.

I spotted this post on Facebook by Studio 41

I found this to be a good watch, in that it got me thinking even more and his story (perspective) isn't bad, I think it's quite good. What do you think?

My standard disclaimer applies: Everything should be taking with a grain of salt as it always comes with a marketing spin as they try to get their perspective across and make their story more convincing.

The next question we need to answer is how do we make use of it.

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Blood Glucose Meter Test Results Comparision - Optium Xceed vs Accu-Chek Performa

2011-04-03T23:49:00.000+12:00

I can remember the first time I tired the Accu-Check Performa out, after using an Optium Xceed for quite sometime. The Performa gave high results, but what really turned me off about it was that it was so big compared with the Optium and the strips came in a bottle that you couldn't easily slip into anything. I know round things are easy to manufacture, but they're big and don't pack well. So that was the end of that. I stuck with the Optium.

The new Nano is so much smaller than the standard Performa

Recently I've decided I wanted to get better control of by diabetes and that meant I needed to deal with my pet hate of some how having an easy way to store all my data in one place. My pump records what it's been doing and meters all have a memory these days. So it seemed logical to look at the software that I could download both my pump and a meters of the same brand with. Luckily I discovered that Accu-Chek (Roche NZ) had just got a shipment of Performa Nanos in. So it was time to make the leap from the faithful Optium to the Performa. And I thought it would be useful to know just how different the values were from each meter so I went through a box/bottle of strips for each and discovered the following.

On average the Accu-Chek Performa gave a value that was 1.32 mmol/L above that of the Optium Xceed.

Here's a graph showing the difference between tests and the trend over the range. The difference is over the test values of the Optium.

Only 6 values out of the 48 comparisons gave a difference of less than 0 (The Performa gave a lower result than the Optium).
The other real bonus is that I discovered that even though they state they both only need a very small blood sample size, the Performa's sample is by far a whole lot smaller than the Optiums. The capillary action, it's ability to suck the blood into the test strip is also heaps better. I know wonder why I didn't stick with the change when I first tried the Performa.

BBC's - How To Be Slim

2011-03-30T18:25:00.000+13:00

The following is a documentary by the BBC on "How to be slim".
I'm not sure when it came out but it was only recently shown on television in New Zealand.
It's all quite interesting and practical too. I hope you enjoy the watch as much as I did.

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Modified Strongman Training - For Fat-Loss

2011-03-27T12:15:00.001+13:00

The following gives you brief description with my encounter with of a Modified Strongman Training session at Studio 41 with Jeff Willoughby and the thoughts it makes me wonder about the proposed weight-loss from this method of training.

Today I took part in a Modified Strongman Training session at Studio 41. Modified Strongman Training makes use of movements used in Strongman events that are used in a format to create a metabolic resistance training session. The sessions come with a note from Jeff “Be warned as it is not for the faint hearted”. And guess what – “It’s not for the faint hearted either”. Here’s what we did...

A1 – Deadlift x10

A2 – DB Bench Press (neutral grip) x10

A3 – Prowler Push x10

A4 – Pull Up (neutral grip) x10

A5 – DB Snatch x10 each side

A6 – Tricep Dips x10

The exercises are performed as a circuit and each exercise is done for 10 reps. If you can’t get the full set of 10 you stop have a breather and then finish the set. The way to do this is to always leave a couple in the tank and pace yourself. The aim is to complete as many rounds as you can within a certain time frame. The weights you choose are to be 65-70% of your 1RM, basically then need to be heavy, but not too heavy. You’ll also notice that the exercises alternate between a full/lower body movement and an upper body movement. The full/lower body movements tax your respiratory/cardiovascular system and then you get to recover a little while doing the upper body movement.

The Prowler - Load it up and push it hard for some real fun

Apparently the lactate levels become so high that it’s very common for people to throw-up during these sessions. Technically it’s actually the high number of hydrogen ions produced from the glycolysis is the cause of this. I knew I was going to be in for a bit of a treat and I wondered if it could be any worse than riding a Kilo or doing repeated 500m effort on a track bike at a velodrome.

Here is how it went for me.

A1 – Deadlift x10 – 60Kg off pins

A2 – DB Bench Press (neutral grip) x10 – 24Kg

A3 – Prowler Push x10 – 150Kg

A4 – Pull Up (neutral grip) x10 – Assisted

A5 – DB Snatch x10 each side – 16Kg

A6 – Tricep Dips x10 – Assisted

I managed 4 rounds in 1hr 1min 40sec. We finished the round we were on after a certain amount of time. For me I’d only just started another round. I don’t think these sessions are normally an hour long, but I lucked out, and really struggled with the load I had for the upper body movements. I was down to taking short breaks after every 2 reps because I couldn’t manage 3 reps of the exercises. It was tough, very tough. I was giddy a couple times after being overzealous with the prowler, it just begs you to push it has hard as you can, and that’s what I’m use to doing on my track bike, going as hard as I can. But this was levelling; I had to pace myself so I wasn’t constantly short of breath and heaving for air. I often paced the room in a dazed way, as a break, hoping this would aid my recovery as the venous system would be pumping blood away from the muscles with movement clearing metabolites faster than if I stood still or chose to collapse on the floor.

If you’re a track cyclist you could say it was similar to doing repeated 500m efforts, a.k.a. the spew session. The difference being though much more of a demand on the upper body than I’d experienced before. As I type this my biceps feel like they have a bit of a strain on them. I can see the value of this form of training for track cyclist in there general preparation phase, as you’d become more tolerant of local muscular fatigue.

Following the session my brain has been pretty busy pondering why this type of training is touted as a great method for fat-loss and wondering what the possible mechanisms are.

· Is it that the sustained very high level of lactate during the session is a very strong stimulus to the development of the oxidative machinery? Lactate being one of the 3 primary fuel sources for aerobic energy production.

· Is it that insulin resistance is elevated for hours afterwards due to the release of cortisol, from the high level of stress your body is put under, which inhibits the use of glucose and thus fatty acids become the primary source of fuel? Being a diabetic I tested my blood glucose levels regular after the session, they were significantly elevated for at least 5 hours after the exercise and it didn’t seem to matter to much how much insulin I dial up with my pump but it didn’t want to come down. Will this happen next week, or was it just another unexplained diabetic bit of craziness that we sometimes get.

· Is it the Exercise Post Oxygen Consumption (EPOC) a.k.a. Afterburn? But what explains this? It’s just an observation not a mechanism?

· Or is it just a good bit of hard work that uses up a lot of energy? And this is was! A very good bit of hard work!

Now I’ve decided I don’t have the time right now to figure this all out. After reading an older article by Alwyn Cosgrove where he points out that it does even matter, we’re interested in the effect, the fat-loss. It’d be nice to know the mechanism, but the answer to our real question “Why should we do it?” That’s simple “because it works”!

The Modified Strongman Training at Studio 41 with Jeff Willoughby is free and on Saturdays at 11am. Drop him a line if you’re keen to give it ago. The sessions are suitable for anyone who has done a little bit of gym work, through to the most advanced. There is also a women’s session earlier on the Saturday mornings as well.

The following works may also be of interest to you.

The Hierarchy of Fat Loss by Alwyn Cosgrove

Functional Strongman Training By John Connor

Can Psychology Make Us Happy?

2011-03-25T14:58:00.000+13:00

Martin Seligman on positive psychology | Video on TED.com

A bit

The Effect of Smart Interval Training is Bigger than EPO or Altitude Training

2011-03-15T11:01:00.001+13:00

This post is a bit premature, a draft, rough, but I wanted to get it out with the basic information. The following I’ve gained from researching, implementing with clients and using extensively myself. A big thank you to all of those clients which have applied themselves to this form of training, as I know you’ve seen some great results.

Smart Interval Training can have a huge effect on your performance, and it’s won’t chew up your training dollars either. The primary focus of the training method detailed below is that you will be training at a work-rate (power output / speed) that is high than what you can maintain as a steady pace. By performing intervals at this work-rate you can train at this level for longer. The effect is that it will lift your maximum steady pace higher. If it’s performed consistently you’ll also be blessed with the chronic adaptations of aerobic training (greater cardiac output from an increase in the volume of hearts cambers, development of new blood vessels to improve the supply of oxygen to the working muscles) ^{(I’ll provide a citation for this soon)}.

This article will be updated soon with more comprehensive detail on how to make it work for you. Unfortunately I’m a bit short of time and I really wanted to get at least the raw details out for a couple of clients. No doubt they’ll still have more questions too, but no biggie.

The Detail

Name		SuperVO2
Mode		Typically on a Trainer with reproducible load. Can also be done on an Erg, or road or track bike with a Power Meter
Targeted Change	Energy System	Aerobic (Lifting Peak Power and Anaerobic threshold)
	Neuromuscular	Neurally Weak - if the cadence is elevated, but there becomes a point where it will negatively impact the stress on the aerobic energy system. Muscular Mild - if the cadence is reduced (60-80rpm), but once again the aerobic emphasis is compromised.
	Psychological	Mental toughness
Frequency		1-4 times per week
Type		Interval
Warm-Up		3mins Easy, 10mins Progressive, 2mins Easy Roll
Work to Rest Ratio		1:1 to 5:1
Load		Initially choose a load that is just above your anaerobic threshold
Interval Duration	Effort	180s to 300s (recomended 3-5mins)
	Rest	60s to 180s (recomended 2-3mins)
Number	Efforts	5-12 (10 seems to be optimal)
	Sets	1
Termination	Set	Exhaustion - the load (speed - gear and cadence) can not be maintian until the end of an effort
	Session	Exhaustion
Warm-Down		10mins Easy using a very light load - Until your legs feel good and then at least another 4mins
Progression		Time at work rate (load/power/speed, the combination of gear and cadence).
Notes		Cadence - 90 to 120rpm. Reduce the interval length as you increase the cadence. Typically the session is performed on a wind trainer with a road bike. You "must" be able to reproduce the loading exactly for each session.