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Half Marathon weekly updates

Week no.	Distance	Elapsed time	Avg HR	TIR (3.9 – 7.8) (%)	Average Blood Glucose (mmol/l)	Coefficient of variation (%)	Strava Fitness Metric
Week 10	32	257	132	69	7.0	12.0	37
Week 9	36.29	242.65	133.95	87	5.0	17.0	42 (+5)
Week 8	34.1	240.94	152.9	79.87	6.0	3.1	45 (+3)
Week 7	67.5	295.01	136.46	96.0	6.2	9.0	54 (+9)
Week 6	46.36	340.12	133.0	73.56	7.3	16.2	53 (-1)
Week 5	40.57	224.91	142.6	89.43	6.4	12.2	55 (+2)
Week 4	29.46	208.03	140.2	90.0	6.2	9	54 (-1)
Week 3	8.75	73.37	142.9	100.0	6.0	8.7	49 (-5)
Week 2	23.14	146.82	153.63	50.0	6.8	18.6	48 (-1)
Week 1	25.4	169	148	60	8.4	22	51 (+3)

Week 10 (24th – 30th)

Week 10 is done and dusted. During my long run on Friday I decided to use the New Balance Fresh Foam More V3 running shoes to see if that improved my experience. This is because they are the most padded shoes I own, and the small 3 mm drop is supposed to reduce the risk of injury. Unfortunately this only reduced the pins and needles, but I must have laced them poorly as I got a few blisters. I also started my run way to quickly, and if I cant maintain a few zone 2 runs I am not going to work my slow twitch muscle fibers and improve my fitness fast enough to enjoy this race. These were shoes I had used before so I think it was down to the lacing and running technique. The last run of the week was a 8 km zone 2 run on the treadmill. This was actually the first of run week 9, but I decided to mountain bike ride on the Monday as it was raining on the Sunday so I switched them. For this run I used the New Balance 1080v12 shoes, and this was a great run. Not sure if it was due to treadmill suspension but every second felt good, despise a hypo half way though.

Exercise stats

Blood glucose stats

My experience with AIMI AI has not been a good one, for some reason I keep going on the blood sugar roller coaster and the system either gives too much or too little insulin. I am eating way less at the moment so I would expect more control. I’m back to Boost once this Pod expires to try and improve my glucose values. Probably not a great time to be trying a new system while increasing my training.

Measurements

Weight 75.6 kg

Week 9 (01st – 07th)

In an attempt to reduce the pins and needles I was experiencing I got some 2XU vector compression socks. This seemed like it may have improved the experience somewhat, until I started wearing my Brooks Ghost shoes. During the 8km run with the Ghosts I experienced no issues whatsoever. Blood sugars with AIMI seemed to be much better this week, except for a few isolated incidences where AIMI provided too much insulin. Since AI (or in this instance machine learning) requires data to build its model accurately, its seems likely that I needed more data in order for the system to perform better.

Exercise stats

Blood glucose stats

Measurements

Week 8 (08th – 14th)

This week was was a big training week with the start of the extended distance (15-20 km) runs in the training plan. I have bee using the Ghosts more and although I no pain during my runs, I had quite a few blisters afterward the 15 km run. No vector socks this week. The long run was a little difficult to manage with my sugars requiring (22g+25g+28g) 75 g of carbs to stabilize for the run. I wasn’t expecting that. Quite a few more hypers that lasted longer than I had hoped. I think this is my last week of testing AIMI-AI before heading back to good old Boost. I like the fact I can very accurate with IOB with Boost, although my difficulty is due to AIMI adapting so well with all the changes. I also found myself on my Strava groups leader board twice 🙂

Its been interesting to see the difference between how Garmin and Strava track fitness, with Garmin using Vo2 max as its measurement and providing a stamina metric.

Exercise stats

Fitness

Below is a post highlighting the difference between the two systems in relation to fitness metrics.

Fitness metrics, Garmin vs. Strava

Strava fitness metrics

The Strava fitness metric seems to build with every run, providing some motivation to keep hitting those zone 2 runs. I am still 10 fitness points lower than I was in December. I am currently averaging 6 points every two weeks. If keep at this pace I should reclaim my fitness in about 23 days, or by the 6th of June. So that leaves almost the whole of June to work on improving fitness.

Garmin fitness metrics

The Garmin fitness metric is Vo2 max, or maximal oxygen consumption. This refers to the maximum amount of oxygen that an individual can utilize during intense or maximal exercise. This measurement is generally considered the best indicator of cardiovascular fitness and aerobic endurance.

Blood glucose stats

Measurements

Week 7

This week I decided to shake things up, do a little mountain biking in New South Wales and also travel to new beach locations for my runs. It was amazing and I had an incredible time. I have also been asked to be a front runner for the Gold Coast Marathon team training sessions at HOTA.

Exercise stats

Blood glucose stats

Measurements

Week 6

This weeks long run was a little harder than usual, but it did have a beautiful view. I wanted to do a 15km but unfortunately was cut short to 14km. My feet felt good and good issues with blistering with the Ghosts. I also did a park run which almost ruined everything as my tendon issue faired up with the lack of a proper warm up. I was a little slower than I thought as I only managed 5min/km for 2,5km before burning out.

Exercise stats

Blood glucose stats

Measurements

74kgs

Week 5

This week’s long run was fantastic! I completed the full 16 km without experiencing any pain or discomfort. As an experiment, I decided to try a Cliff Bar for the first time during my run, and I think I may have found my new go-to snack for long-distance running. I started my run with a blood glucose level of 4.1 mmol/l and waited approximately 20 minutes after consuming the bar before getting started. This slight delay caused a small spike in my glucose levels at the beginning of the run. To mitigate this, I plan to wait only 15 minutes before starting my next run.

Analyzing the graph below, we can observe when the Automated Insulin Delivery Systems (AAPS) kicked in to provide a temporary basal rate adjustment to lower my blood sugar levels. Since I set a slightly higher temporary target of 8.3 mmol/l, AAPS registered my insulin sensitivity to be around 55% less than my standard needs. AAPS responded perfectly, gradually bringing my glucose levels down to a comfortable 5.2 mmol/l by the end of the run.

Overall, this run was a success, and the combination of the Cliff Bar and the effective response of AAPS made it even better. I’m excited to continue fine-tuning my routine and exploring the benefits of different strategies to optimize my long-distance running experiences.

Exercise stats

Blood glucose stats

Measurements

74 kgs

Week 4

This week was a bit of a mixed bag for me as far as my diabetes management goes. On the one hand, I had a great park run, where I managed to run a respectable 5:10 min/km for the 5km duration. This landed me in second position overall for this particular park run.

My long run started off very strong, but towards the end I developed some pain in the glute which resulted in me needing to stop the run at 17km, rather than the planned 18km. I managed to stay in range 100% (3.9-7.8 mmol/l) for the duration of the run with an average of 5.8 mmol/l, and my standard deviation was 1.024. I attribute to this to the cliff bar I ate 15min prior to starting the run.

I had a high percentage of low blood glucose readings on my CGM this week, which was mainly due to CGM sensor issues. This, in conjunction with poor rest has resulted in my HRV being quite for low for the week.

I went one full work week without sugar free soda. This change was due to recent research released indicating the significant detriment to health sugar free soda can have.

Exercise stats

Blood glucose stats

Measurements

Week 3 (12-18th)

Exercise stats

Blood glucose stats

Measurements

Week 2

During my last long run, I had to make the difficult decision to bail out early. Unfortunately, I was dealing with an ankle and tendon injury, which limited my capacity to cover the desired distance. Additionally, my blood sugar levels dropped significantly, adding another layer of challenge. Upon reflection, I realized that this low blood sugar episode was a consequence of inadequate planning. I had not set a high enough temporary target of 8.3 for a sufficient duration, leading to the drop in blood sugar levels.

To alleviate some stiffness in my legs, I sought a massage on Sunday. However, this revealed another issue – lower back pain on the left side. It became evident that this discomfort was likely a consequence of my existing tendon problem on the left side, as my body attempted to compensate for the imbalance. While I have been diligent in incorporating stretching exercises into my routine, it is unfortunate that I began doing so too late to make a significant impact on my current situation.

Despite the challenges I have faced, I consider these setbacks as valuable learning opportunities. Moving forward, I intend to implement the following lessons to prevent similar situations:

Prioritize Injury Prevention: Understanding the importance of injury prevention, I will be more cautious with my training and listen to my body’s signals. This means recognizing the need for adequate rest, seeking professional advice when necessary, and gradually increasing intensity and distance.
Establish Effective Blood Sugar Management: To avoid experiencing low blood sugar levels during physical activities, I will proactively set higher temporary targets and ensure their duration aligns with the demands of my workouts. This way, I can maintain stable energy levels and perform optimally.
Address Imbalances and Compensatory Patterns: By acknowledging the connection between my tendon issue and the resulting lower back pain, I will incorporate exercises and therapies that specifically target these areas. By addressing imbalances early on, I can prevent further complications and improve overall performance.

While my fitness has undeniably declined due to the limitations imposed by my injuries, I have gained valuable insights from these experiences. By emphasizing injury prevention, refining blood sugar management, and addressing compensatory patterns, I am confident in my ability to overcome these setbacks and continue progressing on my fitness journey. Remember, setbacks are not roadblocks but opportunities for growth and resilience.

Exercise stats

Blood glucose stats

Measurements

Week 1

The lead up to race week has been less than ideal. Unfortunately my injury is preventing me from training and is causing pain and discomfort when I run, especially at incline. This was a reminder that injury prevention is key, and if I ever attempt this again I will ensure I follow a program that prioritises injury prevention through intelligent training, gradually increasing mileage and strength training. Please read my retailed post about the race below.

Gold Coast Half Marathon

Exercise stats

Blood glucose stats

Measurements

Featured

Half marathon (2023) update 1

It’s been three weeks since my last post on the half marathon goal for 2023. I had set myself a target of being able to run 10 km by the 28th of April in order to commit to the 21 km run. So far its undecided as I seem to keep getting a numb right foot during runs, although my fitness seems like its returning slowly.

Blood glucose Analysis for the last three weeks:

During this time I was using a dev branch of AAPS with automations to scale the insulin requirements.

Exercise analysis for the three weeks:

The last week was the start of my running ramp-up increasing distance more substantially from 3-4 km to 6-7 km.

Unfortunately I have been plagued by a numb right foot as I exceed the four (4) km distance. This prompted me to do a little research and the most common problem found seemed to be shoes that did not fit well, or that were laced too tightly.

This could of course be glucose related (neuropathy), as when my A1C was in the sevens (7) I experienced something similar, but It seemed to start as I laced up.

Today’s run I changed shoes to see if that helped, unfortunately I still experience the numbness quite early on in the run, but I kept going. At around the seven (7) km mark I decided to increase pace and this seemed to remedy the issue strangely. Below is a graph of the 9 km run from AAPS / Nightscout data using my custom Python scripts.

The next steps are to purchase some Omega 3 and Alpha lipoic acid and ascertain if that can assist with the foot pain.

Featured

2023 Half Marathon

3rd Apr 2023

It’s been a long-standing goal of mine to run a half marathon. It’s long enough to be a challenge, and short enough that I don’t need to be training all year round and can focus on my other sports.

Pre-requisites

Basal review – I will be doing an incremental basal review in the next few days (hopefully). Skipping meals where required.

Full profile review – Once the basal profile has been updated, I will check my CR (carb ratio) and CRR (carb rise ratio). No need to check ISF (insulin sensitivity factor) as its calculated in Android APS. I will need to be on the look out for blood sugar dips two or more hours after meals as I may need to reduce the Dynamic ISF Adjustment factor.

Injuries

At the moment I have an Achilles tendon issue I am in rehabilitating. It’s the first time I am experiencing this issue, so I am working with a Physio to remedy it.

Training Program

I plan on using the Garmin training program to do most of my training. My longest run prior to this was 16 km and I mountain bike so I think I may be ok with fitness if I can get back into training fairly quickly, but this is dependent on how well my current rehab program works.

This will be updated as and when I can, but the next 3 three (3) weeks are as follows:

Tendon Rehab Program:

Week	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
1	Calf raise holds 5 x 45 seconds, Gym	3km run, double leg calf raise x 3 12-15, body weight single leg calf raise 3 x 10-15	Calf raise holds 5 x 45 seconds, Gym	Calf raise holds 5 x 45 seconds, Gym	3km run in AM, double leg calf raise x 3 12-15, body weight single leg calf raise 3 x 10-15	Calf raise holds 5 x 45 seconds, Gym	Bike in AM
2	Calf raise holds 5 x 45 seconds, Gym	4-5 km	Calf raise holds 5 x 45 seconds, Gym	Calf raise holds 5 x 45 seconds, Gym	4-5 km	Calf raise holds 5 x 45 seconds, Gym	Bike in AM
3	Calf raise holds 5 x 45 seconds, Gym	5-7km	Calf raise holds 5 x 45 seconds, Gym	Calf raise holds 5 x 45 seconds, Gym	5-7km	Calf raise holds 5 x 45 seconds, Gym	Bike in AM

NOTES: If pain/stiffness gets progressively worse, then reduce load and re-assess. If not monitor and keep working.

Strava Running Program:

I had really wanted to use the Garmin program, but I was too late to start it. The Strava program doesn’t seem to have the ability to select the days I plan on running or feedback on training progress at a granular level. My desired routine is 3 days per week.

Garmin Running:

Global Triathlon Network (GTN) half marathon training program

I really liked the plan from GTN, I have modified it a little to fit within my availability.

Click to access GTN-HALF-PLAN.pdf

Training Progress

I will add a table to the weekly updates with progress on my training plans.

Diet / Food

I plan on sticking to my diet as much as possible. I will however cut back on alcohol and focus on drinking more water.

Supplements

Vitamin B – https://www.healthline.com/health/food-nutrition/vitamin-b-complex#benefits

Alpha lipoic acid – https://www.healthline.com/nutrition/alpha-lipoic-acid

Omega 3 – https://www.healthline.com/nutrition/17-health-benefits-of-omega-3

Vitamin D – https://www.healthline.com/health/food-nutrition/benefits-vitamin-d

Gear

Shoes: New Balance 1080, Fresh Foam More v3, Brooks Ghost

Watch: Garmin Fenix 7

Hydration vest: Osprey Duro 6 hydration vest

APS Hardware: Cubot King Kong Mini 2 Pro

Artificial Pancreas System: Android APS / Branch: Dev (Dynamic ISF)

Pump: Mixture of Omnipod and Accu-Check Combo

Insulin: Fiasp

Insulin Peak: 55 minutes

DIA: 9 hours

Glucose statistics

Measurements

Weight: 75km (afternoon)

Waist: 88cm

Body fat (estimate):

Updates (Weekly)

I will try and update the blog weekly with progress.

Android APS – AIMI, Boost & EN

The efficacy of any AID (Automated Insulin Delivery) device is directly proportional to the amount of insulin it provides in relation to your needs, and everybody’s needs are slightly different. To ensure safety the native AAPS loop only administers 50% of the calculated insulin requirement per loop cycle. This limitation can be overcome by using one of the branches I mention below, or by profile switching, using temp targets and automations.

AIMI

Pros:

A ton of unique features seen nowhere else (dynamic SMBRatio, DIA change for every SMB or Bolus, if TIR above 180 during the last two hours and up of 30 % the profile during the next hour if it’s still the case,if the TIR below 75 one hour before and reduce the profile during the next hour,calculation to propose one basal value for the day,A new function is working, after the manual bolus > iTime_starting_bolus, AIMI will force the basal 500% during the next 20 minutes.)
Frequent updates
A lot of collaboration with the diabetic community.

Cons

The DEV branch takes much longer to calculate cob using my KK mini 2. This can result in periods where I think insulin may be delivered later than preferred.
The battery life of your loop device is significantly impacted due to multiple calculations.
Watch seems to be less stable with more periods of stale data
More frequent pump disconnects.

Thoughts: I don’t think I gave this a fair go. I should have adjusted to use less insulin. I think this is more suitable to people using UAM.

BOOST

Pros:

Best control I have ever had
Adjustable and scalable insulin required percent (SMBRatio). example. You can set Boost to provide 75% of the required insulin %, but if the glucose deltas are greater that percentage can increase to a maximum of 150%.
The setup process is straight forward.

Cons:

Less frequent updates

Thoughts: Suitable for people who enter carbs or who use UAM. Works well with Dash pods.

Eating Now

Pro:

Frequent updates
A lot of unique features seen nowhere else (too many to mention here, read the docs)
Excellent documentation
The reasons (device status) behind why the system is adjusted are well documented and clear in the loop status and the documentation.
Lots of safety functions in the code.

Con:

You can adjust insulin required percentage but its (as far as I am aware) a static value.

Thoughts: Works extremely well when entering carbs and pre-bolusing.

Android APS – Adjusting Boost after testing AIMI

25th May 2022

An interesting set of results from my time with Boost. I cant wait to return to AIMI with what I have learned.

I was eating slightly less carbs (118g vs. 136g) than when I was using AIMI, but I would expect that if your profile is setup correctly that the amount of carbs shouldn’t have much of an impact on performance metrics. I was running into a few hypos so I lowered the algorithms insulin required percentage (70% vs. 100%) which resulted in a whopping 1.6% decrease (57 minutes vs. (288 minutes / 4.8 hours)) of time spent in a hypoglycaemic state while using Boost.

My standard deviation was slightly lower (1.3 vs. 1.4) signifying less fluctuations between readings while my time in a hyperglycaemic state went up 0.6% (25.2 hours vs. 26.6 hours)).

I did have to turn off “enable boost percentage scale” as this was providing too much insulin, but more experimenting could remedy this.

Another interesting observation was that my ratio between total daily dose (TDD) and total carbs eaten went down from 4.2 to 4.01 (grams of carbs per unit of insulin) as my average blood sugar lowered.

My exercise seems to have stayed pretty consistent during testing (as per the table below) which leads me to believe the reduced insulin need may be related to requiring less insulin when blood sugar is euglycemic. Its going to be a little more difficult to track that for the next few weeks as I am preparing to ramp up training for the Southern Cross 10km in July. The training has however provided an opportunity to fine tune my running routine as outlined here in my post about predicting blood sugars while running.

I cant wait to do some further testing with AIMI, Boost and Eating now.