Ian’s diabetes learnings from the Spine Challenger, January 2022

At registration

A quick summary:

• The Spine Challenger is a 108-mile continuous ultramarathon along the UK’s Pennine Way. The 2022 winter event kicked off at 7:30am on Saturday 8^th January
• The organisers promote the Spine events as “Britain’s Most Brutal” and the weather on the first day lived up to that. There were ice-covered flagstones, challenging river crossings, 50-mph Arctic headwinds, freezing temperatures and downpours of rain and sleet. I and the other competitors entered the event knowing that such conditions were possible – even likely. I am 54. I have been type 1 diabetic for 40 years
• 65% of the people who started the Challenger distance Did Not Finish (DNF) and I was one of them. I was going well until about 30/ 35 miles when the wheels fell off over a 4-mile section. I withdrew at a safety checkpoint after around 40 miles at 1:30am on Sunday morning
• I do not consider that my withdrawal was linked to diabetes. I felt I was approaching hypothermia, too far behind schedule to be able to complete and I was despondent after a big navigational error
• But my blood sugars were pretty good throughout, my diabetes equipment worked well and my diabetes management plan was sound

On Kinder

I will be trying again. I have entered the summer version of the event (June 2022) and plan to also enter the 2023 winter event. I am learning from the mistakes that I made this time. I have no doubt that this event (and maybe the full Spine Race) is do-able for a type 1 diabetic. Diabetes just adds extra angles that need planning for. These are what I see as those angles:

Blood sugar at the start

• I find it a challenge to find a balance between blood glucose level (BG) at the start of a long event and BGs during the first four or five hours of the event. The solution that works for me is as follows. On the morning of the event I had breakfast around 5am (the hostel laid on an early breakfast especially for competitors) but with no (or almost no) carbohydrate – only egg, bacon, tomato, sausage and black coffee. I took no insulin with it. Then at 7am (30 minutes before the start of the event) I took 8 units of Fiask (just under half my normal dose) and ate a 415g can of Heinz Baked Beans & Sausages
• From then on I was watching my BG carefully (I use a Libre 2 sensor). I was surprised to find that it was going down (maybe nerves, maybe lots of repacking activity) so I also ate a load of sugary stuff that I had brought with me for such an eventuality (a Turkish Delight, a Mars and three Special K bars). This did the trick and brought my BG up. It then did not plunge during the first section of the event, which includes a steep ascent
• My reasoning for this approach is: (1) I need to reduce insulin by a lot otherwise my BG goes low during the first few hours of a run/ walk; but (2) if I have reduced insulin and a normal amount of breakfast an hour or more before exercise starts then my BG at the start is too high (16+)
• I also brought a disposable bottle of water to the start to wash it all down. I had a few more Special K bars that I didn’t need so I gave them to other competitors

Keeping the Libre sensor within temperature range

• I have a Libre 2 sensor to monitor BG. During my training I had problems with the sensor falling below operating temperature because of either the air temperature or wind chill. Another diabetic (hi Helen) had told me that her Libre had not worked at all during the summer version of the event so it seemed unlikely that mine would work in the winter event without something to keep it warm
• I made a fleecy sleeve to go around my upper arm (see below). It’s made from a fluffy snood, sewed together to make it tighter
• It works a treat and kept the sensor warm enough for the whole event even though temperatures were fairly extreme – sub-zero with big wind-chill and periods of heavy rain and sleet
• At one point the sleeve slipped down my arm by a few inches so that it was no longer covering the sensor. I pulled it back up and it stayed in place for the rest of my time in the event. In future I plan to add a soft strap across the chest to stop it slipping down

Sensor cover in place

Sensor about to be covered by sleeve

Amount of insulin

• I talked earlier about the amount of insulin I take with meals during long exercise. What works for my is just under half my usual amount of fast-acting (Fiask) – so 8 units instead of 18, or 6 units instead of 14. Also I find that the insulin remains active longer – for around six hours instead of three to four hours in normal life
• My plan was to take 8 units with my second (carb-ey) breakfast just before the start and then 6 units with subsequent meals. That would be supplemented by two units at any time when my BG was starting to creep up (i.e. 8 or 9 and going up)
• I am pretty confident that the plan would have worked – indeed it was working. What I think I did wrong was not making time to eat a meal later on

Actual BGs from the Libre

• Below is a screenshot of my BGs during the event. It kicked off at 7:30am on the Saturday and my participation ended at around 1:30am on the Sunday
• I’ve written above about what happened leading up to the start. I think I took two units of Fiask at 12pm on Saturday as it looked like I had overdone it a bit with the pre-start carbs
• After that it was pretty good until I dropped out. After I dropped out it rocketed up. This was a combination of stopping the exertion and eating/ drinking to try to warm up (cheeseburger/ sweet tea/ hot chocolate). I was seriously cold and a high BG was not a big concern. But it did take 12 hours to get it down to a reasonable level again

Eating

• In my two years of training for this event I had developed a routine of eating a small amount of protein every couple of hours (either a boiled egg or a cube of cheese), supplemented by a source of fast-acting carbohydrate as required – Jelly Babies, a Mars bar or a Snickers bar. In extreme situations (BG low and going down fast) I would have half a slab of Kendall Mint Cake. I had also learned that I can only go about 12 hours without something more substantial – even if my BGs are in the right range I just run out of energy
• In truth I failed to follow this plan in the event. Protein-wise, in the 17 or 18 hours that I was out there I probably only ate three or four cubes of cheese. My BGs were generally OK so there wasn’t a need to eat anything like a Mars bar. There was one time when my BG was on the low side (around 4.0 and reducing) so I ate half a bag of Jelly Babies and it came back up
• But even though my BGs were about right, my energy levels lowered towards the end of my time in the event. I think this was partly because I had no active insulin in my system.
• With hindsight I should probably have been taking small amount of Fiasp (say, 2 units) every six hours and then eating carbohydrates regularly.
• I think there were probably two reasons why I didn’t take the time to do this. (1) the weather was pretty horrific and stopping to unpack insulin and food from the rucksack was not a enticing prospect – not only does your stuff get wet but you get cold. (2) I entered the event on my own and started off on my own, but in the conditions (crossing remote locations through the night in cold temperatures, strong winds, heavy rain and sleet, treacherous river crossings and ice underfoot) forming into small teams was a safety necessity. With time becoming an issue I think I was trying to minimise the number of times I asked the team to stop for five minutes to allow me to get food/ get insulin/ fix my Libre insulation. They were lovely people and didn’t mind when I did but I think I held back anyway. If I had been on my own (which would have been madness) I probably would have stopped to rehydrate a proper meal at some point

What I’ll do different in future (diabetes)

• I will eat something worthwhile (e.g. Super Noodles – not sweets or chocolate) every four hours or so. Although I was able to keep my BGs in a good range throughout the event, I was probably not taking in enough calories for amount of activity I was doing and the weather/ temperature. This will mean also taking small amounts of insulin (probably 1 or 2 units) every six hours or so as I see BGs start to rise
• I will add a soft chest strap to my Libre sleeve to stop it slipping down my arm

The other things I will do different do not relate to diabetes :– putting on extra layers early when I start to get cold; changing the batteries on my GPS as soon as they run out rather than relying on others’ navigation; and putting on Yaktrax when travelling on iced-over flagstones.

I am disappointed but not crushed. I will be back in June and January to finish what I started.

Infusions

My first week of Bactober 2018 was anything but enjoyable and I thought that a chunk of this was caused by caffeine withdrawal symptoms. When the month ended I was much better at limiting my consumption (maximum two coffees a day) and this year I switched entirely to decaf from August onward. So far (I’m writing this on the 6th October 2019) there has been no repeat of last year’s pain, so it appears that it has worked out.

This year’s hot drink preparations have focused on growing plants whose leaves are added to hot water – lemon verbena, lemon balm, peppermint, three further mints and lavender. They all lack the body and hit of a nice coffee, but they’re a lot better than nothing and having a choice of plant gives variety.

2019 preparations

I learned last year that I had not prepared as well as I thought. This year I’ve prepared a lot more. I have a full cupboard, freezer, fridge and wine rack plus plans for making more stuff to reduce the repetition that was a downside of Bactober 2018.

Wine: Last year I was lucky enough to be given a few bottles of wine (thanks John and Jason) but this time I’m much better prepared. I have 20 bottles ready-to-go (rice & sultana and blackberry & apple) plus a gifted elderflower champagne (thanks George). I plan to use some of them to trade for produce from others. I also have a bottle of slivovitz (plum brandy) as a special treat.

Beer: I made two barrels of beer from kits in 2018. This year I have upgraded to making it from the raw ingredients – malt and hops.

Meat: I had an amazing piece of good fortune when a deer was knocked down outside my house just before last October. I have had no such luck this year and so am looking at much less meat. This is probably no bad thing (particularly for the deer of the neighbourhood). But I am not totally bereft – in the freezer I have cuts from a rabbit (scraped off the road) and two pheasants (from beating at a local shoot at the start of the year). I hope to get another pheasant or two at the end of the month when I help out with beating again.

Produce: I have grown and harvested garlic, potatoes, mushrooms (which I have dried) and tomatoes (frozen as passata).

Jam: Last year I sorely missed spreads to go on bread (thanks to Jason for donating a pot of mature jam). I have been determined to not repeat this am have been in major jam-production mode (assisted by the “jam” setting on my bread machine). I may even have overdone it. In the fridge I have pots of strawberry, raspberry, yellow cherry (thanks Madeleine), bramble jelly, blackcurrant (thanks mum) and plum jam. It’s more than I’ll need for bread so I’ll be able to use it also in baking and yoghurt.

Also in the freezer: Wild garlic, broad beans, French beans, and leak & potato soup

Also in the cupboard: Raspberry cordial, wine vinegar, malt vinegar, pickled eggs

Anticipated harvest: Apples, nettles, a selection of mint tea’s

Plus I’m allowing myself to buy basic ingredients. Below is my initial shop – rice, flour, milk, sugar, butter, oil, yoghurt (as an activator for homemade yoghurt), yeast, salt and pepper.

Nettle soup

This evening I knocked up some nettle soup for the freezer in preparation for my second year of Bactober which starts in a couple of weeks.

The recipes I’ve followed before all recommend using young nettles but there are some juicy-looking big nettles in the garden with nice clean leaves so I thought I’d try them out, using just the leaves and not the stalks (which give the stringiness bits that you are trying to avoid). I snipped a mixing bowl-full with scissors and gave them a quick wash to get rid of extraneous flora and fauna.

I fried up carrots, onions and potato (all home-grown) in butter until soft then added hot water, salt and pepper (all permitted as basic ingredients) and boiled until I was sure it was soft sand mushy. Then I added the nettle leaves and enough hot water to cover them. The online recipes say that you don’t need to boil for long at this stage as you’re just wilting the leaves. I gave them five minutes and then whizzed it all up in a food processor for a minute.

I returned it to a clean pan and am am now simmering for an hour to thicken it up a bit. I’ve added a glug of (homemade) rice and sultana wine as some recipes recommend adding sherry and this wine has a definite sherry twang to it. I’ll pour into two or three takeaway tubs, leave to cool overnight and freeze in the morning. This will provide two or three easy meals for occasions when I can’t be bothered to cook next month.

I’ve just had a sneaky sample and it tastes good, if a little bitty. I probably won’t make any more of this despite the huge volume of raw materials in the garden as nettlw soup is the sort of thing you can tire of quickly.

Lock up your pets. It’s that man again

Welcome back to blog subscribers from last year. I am pleased to announce the return of Bactober for 2019. (Where “BAC” = harking “back” to ingredients from a simpler/ tastier/ healthier/ cheaper/ less processed time, and “TOBER” =  it will happen across the month of October.)

Ignoring irritations like malnutrition and disease, I am shamelessly remembering a time when processed food was not an option and people consumed what they (or their friends) had grown, foraged, scraped off the road or made from basic ingredients.

And that’s what I’m going to do for the whole of October. I will post updates, recipes and photos on this blog. Today’s photo (as I launch into a month of final preparations) are some parasol mushrooms that I found in a field this evening. As I type they are drying in my new dehydrating machine (2 – 3 hours at 35 degrees and stinking the house out.

And to be clear, this is not intended to be a month of self-deprivation. While there is a down-side (no McDonalds, coffee, curry, tea, peanut butter) there is a lot of upside in that everything I eat will be fresh, home-made and prepared with effort and love. If I asked you to choose between a can of supermarket soup and an earthenware bowl of freshly made soup with ingredients from your own veg patch, which would you go for? It’s a lot more effort to prepare and that’s one of the reasons for doing this – to force myself to make that effort for a month.

Welcome back to Bactober.

 

Festive Flapjack

I’m not planning on making a habit of this, but I have just cooked my best thing ever and I need to share.

To go with the Xmas food this year I’m cooking a couple of things to share memories of my month of semi-self-sufficiency in October. There will be a side dish of chestnut stuffing with the main meal (made with foraged chestnuts) and a special Festive Flapjack in memory of the numerous batches I made in October to keep my carbs up. The Xmas theme for the flapjack was daughter Eve’s idea and it’s fabulous (though we say so ourselves) – so good that I’ve made an extra batch to hand round at work on Xmas Eve. The mincemeat and cinnamon give a Xmas-ey taste that is unmistakable. As with all flapjack it’s easy, cheap and quick to make:

1. Preheat over to 200C
2. Mix together 250g of porridge oats (not jumbo oats), 125g light brown sugar, 125g butter (easier to mix if you microwave it for 30 seconds), 3 tablespoons of golden syrup and 3 dessertspoons of mincemeat. Mix together by hand or with spoons (not in a food processor or it will become too dense)
3. Line a baking dish with baking paper (so it doesn’t stick and to make washing up easy later)
4. Spread the mixture into the dish. Firm down with the back of a spoon, including around the edges. Sprinkle cinnamon powder over the top
5. Bake in the middle of the oven for around 10 to 15 minutes but don’t just go by the time. It’s important that you leave it baking until it is just about to start burning. Look at the flapjack every minute from 10 minutes onwards and leave it in for as long as you dare. Get it out and have a proper look in the light if you need to (but close the oven while you’re doing so to minimise the heat escaping). Only take it out when the edges are starting to go seriously dark brown. Be brave. The more brown it is, the tastier and crunchier it will be
6. Cut into squares with a sharp knife while still in the baking dish and put the hot dish somewhere where it will cool down quickly (so it doesn’t carry on cooking). A good place is on the mesh of the grill pan on top of the cooker. When it has mostly cooled down, take it out of the dish (still on the paper and still together) and put it straight onto the mesh of the grill pan so it can finish cooling down. Only break it into squares once it has reached room temperature

The photo is of a fresh batch straight out the oven, and the remains of the last batch next to it. Happy Xmas.

Back to normal? No, not really

I won’t pretend otherwise. It is wonderful to be re-united with coffee, curry, McDonald’s and tomato juice with Lea & Perrins. But I am some way from reverting to my pre-October food life.

I am making bread and yogurt. I am using fewer processed ingredients. For today’s lunch I nipped to Tesco Metro and bought a can of chopped tomatoes, some spices, some Chorizo and heated them up in the microwave. It tasted nice and felt creative (although it would have benefited from liquidising).

I am limiting the caffeine. After the surprise of caffeine withdrawal this time last month I am now allowing myself no more than two caffeinated coffees a day. I’ve bought decaf Nespresso capsules (they taste no different) and am having more tea. I will not be slipping back to the seven or eight a day that I must have been downing pre-October.

I think I am “achieving” more. Having spent an hour or more preparing food every October evening, I am finding time to tick a few things off the to-do list each evening before crashing out in front of the telly.

I am thinking about what comes next. I will probably do something similar next year and it would be nice to pin down a concept that can be described in a sentence rather than a paragraph. Next time I will plan lots of menu items in advance and prepare luxuries like pasta, wine, a range of frozen soups, cordials, jams, puddings, cakes, potatoes, garlic and a wider range of fruit and vegetables. We’re going to need a bigger freezer.

Thank you to everyone who sent me messages of support, encouragement and ideas. Every one made a difference, especially in the dark days towards the end of the first week. And even greater thanks to friends who dropped in gifts of wine, vegetables, potatoes, tomatoes, nuts and fruit. These provided a variety that I had failed to prepare myself. And to Pippa and family for the loan of the bread machine.

I’m going to keep this blog open and occasionally post with thoughts and preparations for next year. Since a few people have asked, I lost three pounds over the month (from 14’13 to 14’10) although that was never an objective.

Thanks for being interested. It helped.

Ian

Celebratory pint

A reminder that I will be celebrating the successful conclusion of Bactober from 9pm this evening in the White Hart. If you can bear to listen to me going on and on about it, it would be lovely to see you.

I also said that I would be serving leftovers at home from 7:30pm. I stand by that but be warned that there’s precious little left so don’t expect much or plan on it as your evening meal – we’re talking a slurp of overproof wine, some home-baked bread and a tomato “soup” with precious little else in it (which pretty much sums up the first week of October for me).

Maybe see you later.

Day 31: My last supper

It’s the final countdown and a thought crossed my mind this afternoon. “Shall I just carry on?” The thought disappeared again one second later when I remembered that (i) my store cupboard is all but empty, and (ii) I am really looking forward to coffee, tea, curry, Tabasco, garlic, potatoes, whisky and the pub. But it’s a good sign that it even occurred – it’s more than I felt on day four.

For lunch I had the final slices of venison in a sandwich and my last pickled egg. As I type this I’m sipping the dregs of my second barrel of home brew. Dinner tonight (picture below) was mushroom soup (foraged at the weekend) with a dollop of homemade yogurt, toasted bread (first batch from the new bread machine) and a pint of home-brew. Not a life-changing meal but a decent summary of the last month.

I’ll ponder the meaning of life here once the month is complete. But when I used to run marathons, people used to say to me afterwards “Did you enjoy that?” My answer was generally something along the lines of “No, I don’t think enjoy is the word. But there is a sense of achievement and it’s nice when you stop.”

Day 29: The rise of the machines

With victory within sight my thoughts are turning to “What happens next?” I expect I’ll muse more on this in a few days’ time and it’s likely that I’ll do something similar next year, but for the moment I pondering what to carry on doing immediately after the 31st October. Home-made bread and yogurt top that list with support from these little helpers:

Yogurt machine: This (picture below) is the 1970s Yogomagic that my mum found in her attic. It makes lovely yogurt but the process has been a bit of a faff – bringing milk to the point of boiling, then cooling, then putting it in the machine with a few spoonfuls of starter yogurt. While researching whether today’s machines are able to shortcut that process (they aren’t) I found that you can cut out the time-consuming boiling-and-cooling bit if you use UHT milk. This is a revelation and I wish I’d known it a month ago. I rather like the taste of UHT milk so the marginally different yogurt taste is no hardship. So the plan is to continue to make yogurt for the foreseeable future.

Bread machine: The bread I’ve had for the last month has been so much better that its sliced supermarket cousin that yesterday I splashed out on a second-hand bread machine (a Panasonic SD-2500 from Facebook Marketplace for £50) and returned the borrowed model to Pippa and Pete (for which many thanks). The big step forward had come when I accidentally bought Allinson’s Seed & Grain White Bread Flour instead of ordinary bread flour. It’s all I’ve bought since and I will continue to make loaves with it after the month-end. Homemade pizzas with the machine’s pizza-dough function has been excellent too (I use normal bread flour for that). My new machine also has a Jam setting so I’ll have a crack at that next year.

I also discovered on Friday evening that a local friend has bought a water distilling machine that I believe can be used for other purposes (which are probably not legal) so I may be quietly investigating that too…