I’ve had some great A1cs in my life, and some really crummy ones. And most of the time, when I’m under 6.5%, it’s because of hard work and determination. But there are other ways to get to a low A1c. We can’t ever forget that A1cs are simply an average – meaning a great A1c can easily be composed of some really high highs and some really low lows. One of my best A1c’s in recent memory was from 2009 after I ran my first half marathon – it was at 6.1%, and between all my running and my great low number, I should have been feeling amazing.
The only problem was, I knew I had gotten there from seriously wild swings in my BGs. Training for my first half was one long episode of trial and error, with an emphasis on the “error” part of that equation. While I figured out basal rates and nutrition, I regularly ended runs at over 300 mg/dL because of overdoing my carbs, only to later crash into the 50s because I hadn’t adjusted for the latent effects of my exercise. All in, it got me to a nice low A1c, but the spaghetti-string mess on my CGM download was enough to prove the way I had arrived there hadn’t been pretty.
Fast forward to 2014 and training for my third half marathon. Things are way smoother than five years ago but I still see glimpses of those wide swings. Sunday’s seven miler had me coasting between 80 – 110mg/dL until mile five, when I saw the CGM arrow tilt downwards. I downed a packet of GU and smiled when the arrow righted itself a few minutes later. But an hour later, it was double arrows up, 164 mg/dL, and didn’t quit until I was well over 200. Hours later, I almost crashed, but stopped a low at 100mg/dL thanks to my CGM and a snack of an apple and a handful of blueberries. (Side note: it always feels better when you catch a low early enough to treat it with fruit, not straight sugar from something not-so-good-for-you, right?)
Exercise is by and large great for your diabetes management, but endurance training takes things to the next level. Small doses of insulin can become tidal waves, and food planning can become more confusing than ever. Although I’m still not perfect with my training and ‘betes management, I’m grateful for the tools I have now to guide me. A temp basal rate and a CGM can be the difference between a great day and a day spent on the Glucoaster. And the difference between an A1c made out of 100s instead of one made out of 50s and 300s.