When on the bike, I can't tell very accurately what my blood sugars are doing. Symptoms are confused by sweat, fatigue, and the occasional mind wandering. Which in longer road rides and races, is sometimes more than just occasional.
This is complicated even more with having hypoglycaemia unawareness. Off the bike, I can carry on quite normally with a blood sugar level in the 1s (<36).
I have come to rely on two major signs that I do still feel when on the bike: muscle contractions to indicate exteme highs, particularly in the arms; and a pain in the gut for extreme lows.
So when the body fails to give me these signs, things can deteriorate. This is of course, despite the best preventative measures taken before and during each ride.
Trial and error, experience and just plain caution must be applied in cases where pulling over and testing is not an option. Like in a race. Or running late while riding to work. Or when being motorpaced by the VIS.
Yesterday showed why despite all the learnings of my life so far in racing and training on bikes, I still stuff up.
I woke with a blood sugar of 17.7 (319). Waking with a blood sugar this high is terrible. Like having a hangover, but without the memory loss from the night before. So the day was already crap, and I was already behind the diabetic 8-ball. This meant action overdrive: immediate bolus correction.
I gave myself 4 units (1 unit to bring it down by 2.5m/mol). This should have left me with a corrected blood sugar of 7.7. I then got ready and headed out the door with Ewin to ride to work via Laverton North (a 50km ride for me).
My arms were tightening from being so high, the muscles constricting as they fought to process the high viscous-y blood through the body bits. I felt lethargic and terrible. And it showed, slowing almost immediately and being unable to get over the SummerHill rise with any pace. Knowing we were running late, I told Ewin to go on ahead and that I would meet him later for coffee.
Refusing, he stayed with me for the next 6kms, but I didn't improve. Still lethargic and feeling awful. Finally, he agreed with my pleas and rode on. He was now very late for work.
I kept riding, but my pace was terrible. The next hill at Ascot Vale was crept up. I think a mountain biking commuter passed me. I rolled down the hill on the other side, and noticed the weather coming in. It was getting cold. I was thinking about cover from the weather. I was thinking about coffee. I really wasn't thinking.
I turned off the normal route and headed down some street I didn't recognise. It seemed to be heading in a Melbourne direction. I followed along, getting passed by more bike commuters. I didn't think about where I was, but assumed the direction was correct. I just assumed I was in one of my black hole areas in my mental map of Melbourne: the inner north west.
Finally things awakened for me: I recognised the roads! I was in Kensington! Gee the road's really bumpy! And hey, its hard to pass the cars on the inside with my body surging forward and back like this uncontrollably!
But it was cold, and I didn't want to stop. I didn't want to stop riding because it was too cold for me to stop and sit and wait for my seizure to pass, or to treat it in someway before I lost all control. So I kept riding.
Luckily an inkling of common sense prevailed, or was it the appearance of shops with verandahs to shelter under? I pulled over and sunk over my bike until the body quit the sporadic jerks. I ate the muesli bar from my pocket. Then I started to panic: I was running late for coffee. I needed to get back on the bike. Then common sense returned. No, I had turned off the route. No coffee, just get to work safely now. Then the panic again: but you are running late! and so it continued.
During one of the bouts of common sense, I reminded myself to test: 2.8 (50). Although the effects of the muesli bar were kicking in, meaning the blood sugar had started to rise again, I had still dropped at least 15m/mol (270) in an hour.
Drastic drops like this can happen, no worries. Looking back I should have expected this to occur. And I did. Thats why I had put the muesli bar in an easy to access spot: under my shorts leg. But what I didn't notice was any signs that I had gone from being so uncomfortably high, to so dangerously low, and so quickly.
Swing high, swing low. Ahh the sweet chariot that is the diabetic ride of life.
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