With the previous 18 months or engaged on Enhance and utilizing it, varied patterns have proven their heads. Previously I’ve written concerning the “hangover” results of weight coaching and insulin sensitivity, and this previous summer time of collaborating within the 1mn steps problem has supplied another view of how insulin sensitivity works in a comparatively sedentary working setting.
I handed the 1 million steps in roughly 75 days, which suggests a mean of 13,333 steps per day. To attain this, in the course of the week, that meant strolling to and from stations within the morning and night, and customarily becoming it in round being at work. On the weekends, it was extra a case of steady low degree motion across the locale, home and backyard. Once more, on the whole, my weekly steps have been break up up with weekdays being 11,000 to 12,000 steps and my weekends 15,000 to 16,000 steps.
What I wasn’t anticipating was the distinction in insulin sensitivity sample that this generated, which in hindsight was maybe a bit naive of me.
What follows is an evaluation of the info I’ve been observing, with some ideas on what that may do for AID techniques. But when that’s TLDR, then right here’s the important thing level. Possibly the way in which we have a tendency to have a look at step knowledge is inaccurate. It shouldn’t be about figuring out train. It needs to be about figuring out inactivity and adjusting techniques for that.
If you wish to see the place this comes from, keep on studying via.
Over the summer time, my weekly working interval sometimes resulted in a TIR that regarded just like the 2 examples under:
The place sometimes, utilizing the Enhance publish prandial dosing mannequin, greater than 15% of my time was spent greater than 10 mmol/l (180 mg/dl), with the common at a degree of round 12-12.5.
On high of this, my common TDD throughout these durations is round 50iu of u200 Lyumjev insulin, or 100iu of u100.
For many individuals, the TIR round 80% remains to be fairly rattling spectacular, particularly the place the mealtime dosing is publish prandial, and never calculated by carb counting, however the important thing factor right here is the distinction it reveals to weekends.
The weekends present a noticeably totally different set of knowledge, with a larger time in vary, a lot decrease insulin utilization and far decrease time above 10mmol/l (180mg/dl):
Insulin utilization in these two examples is between 25iu and 30iu per day, once more of u200 insulin, publish prandially utilized, ie 50-60iu of u100.
What we will additionally see from the info is that the weekend readings have round a 35% decrease customary deviation than in the course of the week.
However what will we attribute this to?
Components affecting glucose ranges
Everyone knows of the listing of at the least 42 issues that have an effect on glucose ranges from Adam at Diatribe:
Within the context of my weeks, Meals, Medicine, Surroundings, Behaviour and Organic are largely the identical. The one issue that varies within the Organic listing is that on the weekends, the stress ranges are undoubtedly decrease. On the Exercise entrance, the variety of each day steps isn’t vastly totally different, nonetheless, the fashion of them is.
As the 2 pictures under from Oura, displaying a typical weekend and weekday, present, that the dispersion (and quantity ) of exercise is sort of totally different. In the course of the daytime on weekdays, my exercise ranges are primarily background, with the peaks round begin and finish of day.
Throughout weekends, the exercise tends to be constant all through the day with an affordable degree of motion, earlier than settling down for the night
Given the variations, the extra fixed motion over the course of the weekend, related to the decrease stress appears to make a major distinction to sensitivity and skill to maintain glucose ranges in vary.
Maybe extra importantly, doing a excessive degree of steps in bunches initially and finish of day doesn’t have the identical results on sensitivity as one thing like weight coaching, which depletes glycogen storage in each the muscle tissues and liver, and requires the physique to replenish it, resulting in larger sensitivity, even with an ongoing enhance in stress throughout work durations.
So what’s your level?
My level is pretty easy. For long run elevated insulin sensitivity for many of us, train undoubtedly helps, however we have to contemplate what that train seems to be like. Simply strolling to and from work is unlikely to be sufficient to keep up that degree all through the day. Being lively for longer durations, or intentionally doing focused train that has a long run impression is probably going to assist.
It additionally comes again to the design of automated techniques. One of many discussions that has been an ongoing one in relation to open supply techniques is whether or not it’s price integrating step knowledge into the algorithms, and in that case, what you do with it?
The view above suggests that there’s a clear cause to take action, nevertheless it’s not the obtained knowledge of figuring out train and presenting greater targets.
We already know that by the point that occurs, with insulin on board it’s in all probability already too late.
If, alternatively, we use step knowledge to determine lack of exercise, after which permit that to regulate some type of modification issue that enables sensitivity to be decreased because of this, it’d present higher outcomes.
Primarily, one thing alongside the traces of:
If Steps per 15 minutes is lower than x;
Enhance sensitivity issue by 1/(x/ximply)
It’s definitely one thing to consider in algorithm design for each business and open supply AID techniques, and possibly it’s time for an extra assortment of crowdsourced knowledge to create some fashions that may handle this.