In talking to non diabetic athletes, I found they all eat every 30 minutes during exercise and refuel with protein at the end of training and events. If they didn’t eat during training etc, they would have ‘low patches of no energy where they couldn’t function’ – very similar to lows like we have.

By adjusting my exercise patterns to include eating every 20-30 minutes and drinking via a camel pack, I hardly had any lows during exercise and eventually built up to 4-5 hours at a time. I ran the Coast to Coast main devide run over the Southern Alps in 5 hours and 5 minutes, without a low.

It did take a while to find out what food worked for me etc, but now I’m pretty sorted. I also found if you are doing 2+ hours training a day over the weekends and 1-2 hours a couple of times during the week, you can eat as much as you like, look gret, feel good, refind muscle balance and lose weight. Hypo’s actually became less common the fitter I became.

These multisport events have given me a lot of confidence that as an older T1, I can still be fit, competitive and athletic. We just need to prepare ourselves properly.

None of my hospital long stay diabetes visits have been for ketoacidosis, at least in the coma stage. How close to that I was, I wouldn’t like to know now.

I didn’t know that Acetone and the kidneys had such a destructive relationship. I did noticed looking back at some early hospital records I have that there was always a trace of Acetone with a brown urine test, not sure where in the range this was now. I’ll chance somewhere in the middle, but there was never any showing at the orange, upper limit (err! 15mm/l or there abouts), of the range, which could mean the brown was one off the top colour of red and ketoacidosis territory.
I have been more concerned with protean loss from the kidneys, this tends to occur with long service and I have no doubt, one’s control over that service period. Know some that had it showing after fifty or more years and some that have it showing a long way short of fifty or more years, but I will continue do an Aaron Acetone runner and stay away for as long as possible.

Comments are welcome whenever you like – no worries there!

I’ve been very lucky to have never been admitted to hospital for ketoacidosis and so far as I know, haven’t ever had a really bad bout of it but there were periods that I didn’t test for quite some time so that may not be true at all! I start get feel pretty crook around 13mmol/L now but hopefully won’t ever have too many issues in the future – the acetone absolutely destroys your kidneys so I’m planning to stay well clear!

Ali, if you would care to comment, I am interested in what your GP or medical team say about your 6.5 Ac1 level, 7 is recommend?

I understand that the female of the species will using insulin, gain on average, 5 kg (11 lbs), due to a hormone thing, how much the fact you have to eat as well adds to this I don’t know.

Struggled to understand the ketoacidosis thing for ever Aaron, still get muddled up with it, been there a few times along the journey. I don’t know about about the Acetone, other than that is what shows on the breath, but if there is no insulin in blood stream to unlock the body cells to let the glucose in, then the body as you say uses fat for energy and it does not take long to reach this fat burning zone.
Ketones can start to appear in the urine from 13mm/l but by 17mm/l will be gathering for a coma party, especially if it stays up there too long and more so if the the BG is increasing. Familiar territory in some ways, aye? Never seems like death’s door step even with the high end hangover, or does it?

I’ve also heard bad things about diets where you lose lots of fat because when body fat breaks down (I don’t know if this is actually true) acetone is created and if too much fat goes too fast then the body can’t cope with it. Acetone is the primary ingredient in nail polish remover and is what causes ketoacidosis from my understanding. When the glucose can’t get into the cells to be used your body breaks down your body fat to use instead – same process right? Not good news for your kidneys and as a consequence, I don’t diet.

Go us.