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Before the start of an Ironman race, I try to elevate my blood sugar to approximately 150 or higher just before the swim start. I know that the 2.4 mile swim should bring it down.
I check my blood sugar in the Transition Area (T1) after the swim using my Lifescan One Touch Ultra meter which requires a very small finger prick and drop of blood and provides a reading in 5 seconds. To correct a low I will immediately consume a high carbohydrate drink and/or food such as a Clif Bar (approximately 42 grams of carbohydrate, 240 calories).
During the 112 mile bike I consume sports drinks in bottles on my bike and provided at the race aid stations to hydrate and maintain a stable blood sugar. I also eat Clif Bars and Clif Shot gels (approximately 27 grams of carbohydrate, 100 calories), and bananas and other nutrition provided as I pass aid stations. Many hours of training and racing has shown me that I do not need to give myself a bolus of insulin for this race nutrition. I check my blood sugar with my One Touch Ultra meter at least once during the bike segment of the race. I immediately consume a high carbohydrate drink if it is low.
In the Transition Area (T2) after the bike and before the marathon, I check my blood sugar again. I consume more nutrition and sports drink, and perhaps a Red Bull energy drink. I also have Eli Lilly's Humalog insulin available if my blood sugar is too high. However, I rarely inject insulin during a race because the extreme physical exertion will bring my blood sugar down and I risk disastrous results from hypoglycemia.
During the marathon nutrition and hydration are difficult to consume in large doses, so I hydrate consistently and approximately every hour eat a Clif Shot gel, and if necessary, other nutrition provided at the race aid stations. I check my blood sugar at least once during the marathon.
After the race I immediately test my blood sugar with a Lifescan One Touch Ultra meter. In the first one hour after the race, I consume nutrition and hydration provided by the race and repeatedly check my blood sugar and regulate my insulin doses.
In the 24 hours after the race I closely monitor my blood sugar and consume a lot of carbohydrate, protein and hydration to refuel my body and help me recover.
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