I ran five miles a couple times a week, went mountain biking about once a week, and periodically lifted weights.Like most Americans , much of my day was spent in front of a computer.I was 35 years old, 5’9″ tall, and 150 pounds, with a BMI of 22.2 and body fat composition of about 13 percent.
My cortisol level was at the high end of the normal range before the trip and dropped by 40 percent during the hike—a testament to the stress-reducing benefits of being in nature , even when you’re pushing your body.
Before the trip, I was burning 66 percent fat and 34 percent carbs during low-intensity exercise or any activity during which I had a heart rate of 112 bpm. At a slow long-run pace, with a heart rate of 145 bpm, I was burning 52 percent fat and 48 percent carbohydrates. My crossover point—the heart rate at which I was burning carbs and fat equally—was 153 bpm, or a moderate-to-slow running pace.
After the trip, I was, as my test administrator at Real Rehab in Seattle put it, “a fat-burning machine.” At 110 bpm, I was burning 91 percent fat and 9 percent carbohydrates. At 145 bpm, I was burning 70 percent fat and 30 percent carbohydrates. My crossover point had moved to 168 bpm, which I reached at a fairly fast running pace. And even at my maximum heart rate (184 bpm), I was still getting a quarter of my energy from fat.
HbA1c levels were tested at enrollment, six months and 12 months after the launch of the game. Overall, diabetes game participants had significant reductions in HbA1c levels (a drop of 0.74% compared to 0.44% for the control group). Patients who had the highest HbA1c levels before the game began (9% or more – an indication of high blood glucose and greater risk of diabetes complications) saw the most dramatic drops in HbA1c over the 12 month period.
The diabetes self-management education (DSME) game presents a player with a multiple-choice question related to glucose management, exercise, long-term diabetes complications, medication adherence and nutrition.