I’ve been lucky enough to be allowed to split my workday twice a week and go play basketball for a couple of hours over lunchtime. It’s really great. Great exercise, a good group of guys, and just generally a good time.

I’ve been generally curious about how calories, exercise, blood sugar and the myriad of other hormones (adrenaline, etc.) all play into things. The body is such a fascinating machine with all the mechanisms that are in place to deal with intensive exercise and the bodies need for fuel. The biggest stumbling block for me is that some of those mechanisms are manual when diabetic, and me and my brain are in charge of the amount of insulin I get and the food I eat.

I had a wonderful time today. One of the difficult things about exercising and diabetes is trying to get your blood sugar to a specific point at a specific time. Yeah. I don’t know about the rest of you, but I have trouble with that. I started a little high this morning, but by the time I hit the court I was at 133, I downed a slim fast drink to start, and after an hour of playing I was (are you ready for this – better sit down!) 133. Another half hour and I was at 138. Beautiful!! I felt good, my energy was good, everything was right. I played on for another hour, but didn’t test again until I got back to work.

When I got back to work and tested, it was up to 168. Not too alarming, but I was a little confused about why it was going up. Another half hour later and it was up to 194. A half hour after that and it was up to 213. Now, I hadn’t eaten a thing since before basketball. So what the heck is going on? Did I miss a low and am seeing a rebound? Did I run my temporary rate too low for too long?

On a hunch I grabbed a ketone test strip (yes, I actually keep some around) and headed to the bathroom. To my surprise, when the sample hit the strip it almost erupted into a deep dark purple color!!! Large ketones! Holy crap!!

Large ketones with diabetes is usually something you see with very high blood sugars, and after spending a significant period of time without insulin. However, in my case I was only 213 at the highest. Now, what do we know about ketones? That they are a byproduct that is created when the body burns fat for energy. What do we know about calories? That they are the bodies energy source. What do we know about basketball (and over two hours of it)? That I burned a TON of calories.

I don’t think it’s even possible for me to eat enough calories in the morning to have enough on board for noontime basketball. So naturally, the body engages one of those fantastic mechanisms for survival and starts using the fat for energy. That’s a good thing.

However, the ketones that are created in the process cause me problems. Maybe I need to stop my temporary reduced basal rate earlier, and even kick off a temporary increased basal? I also need to drink a bunch of water to flush them out.

Is that the right thing to do? If I was able to manage my blood sugar just fine, do I still need to eat to prevent those ketones? How does a non-diabetic person’s body deal with ketones, and why is it not such a dangerous issue for them? I understand that their bodies have the ability to automatically pump out additional insulin, is that what does it, or is there more to it? What’s the mechanics behind it?

I’m going to see if I can add an exercise physiologist to the mix of people I visit to keep me in decent working order. First step? How does one find a good exercise physiologist in the area?