Diabetics who run Marathons!

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Diabetics who run Marathons!

Diabetics who run Marathons!

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Comment by Jerry Nairn on January 31, 2012 at 9:31am

I had run 12 marathons before I got my pump, and I used to leave my insulin at the same level and just consume more carbs during the race.
Justina,
You ask why fiddle (that was the f word, right?) with a good thing, then you talk about some of the reasons you might want to use a pump.
I don't want to evangelize for a pump if you really aren't going to do any better with it. It's easy to over-state the benefits. Most of the things you talk about dealing with when you're on injections are still issues when you go on a pump.
Delayed starts for example, have been a pain for me on a few occasions.
So, about going high occasionally, for an hour or two, I have an opinion. I think this relates to your concern about competition, too.
Training for and competing in these things makes diabetes management more complicated, but it's worth it. The benefits far outweigh any negatives, even if you're temporarily out of control every time.
But we should be trying not to be out of control every workout. We should be using our workouts, besides conditioning our bodies, to learn, or at least try, to keep our blood sugars even.
On race day, like everyone else, we have different priorities.
You wrote about feeling great and rolling along and having to stop. It's hard to imagine something happening when I'm feeling great and rolling along in a race, and I would have to stop.
If I felt crappy, I might stop to test my blood sugar. I had my infusion set pull out about halfway through a marathon once. I could have quit and walked back to my car, which was only a couple of miles at the time, but instead I made the race day decision that I would be fine for a couple of hours of no insulin while I was running my blood sugar down anyway.
I hope I'm not just rambling here. I guess what I'm saying is we go for even blood sugars while running, but the priorities are different on race day, and the important thing is never perfect blood sugars, but just getting out there and doing it.

Comment by Mike on January 31, 2012 at 8:56am

I ran 5 marathons on shots and I just took a few units less the night before a big run. It didn't seem to F-up the rest of the day because of the high mileage.

Comment by Justina on January 31, 2012 at 6:31am

It sounds like you guys all have pumps. I don't...by no means am I against them, I just have fantastic blood sugar control with shots...and why F' with a good thing right? So that being said, I will still have insulin working in my system at the start of the race (Lantus). Now I don't think it is very responsible for anyone to choose to have high blood sugars on a regular basis, or for any doctor to tell you to. Now what happens if it's every once in a while for an hour or two? And what if your highs aren't that high? I do have a few options....say the marathon starts at 7 a.m. I could get up and eat by 4:30 a.m. and take my bolus insulin (Humalog how I freaking love you) It would peak before the race. That is what I've done for previous races. But that makes for a really long day. And what happens if there's a delay in the start of the race? And what I meant by competitive exercise and blood sugar is you have all of the extra factors to think about....time (for all of us with out a pump), and nerves. They are both huge blood sugar factors for me personally. I'm never scared of a long run on a non race day. If I have to stop and eat, drink, check my sugar...no big deal. BUT on a race day, what a freaking bummer to have to stop. Especially when you feel great and you're just rolling along. No matter how tough we are...how tough we think we are. We are at a disadvantage because of diabetes. And I'm fine with that! Okay I have to be fine with it, I don't have anyother choice :)

Comment by Stephen Meo on January 30, 2012 at 11:43am

Great conversation going on here!

Personally, I wanted my BGL around 160-180 on MDI when starting a long run or race, but on the pump, as Jerry mentioned, I seem to have better numbers when I start a little lower and reduce my basal ahead of time. That having been said, I don't get concerned if I see a number ~200 when racing as I'm confident it'll level out.
Regarding competitive exercise - I think most runners I know that race at all are at the least competitive with their own historical times. I've been in a few local races where I'm racing head to head for a podium spot, and I don't think I am running any harder than when I'm just going for time.

Comment by acidrock23 on January 29, 2012 at 3:25pm

The martial arts school I trained at was not competitive. We read several interesting books, "No Contest" by Alfie Kohn and "Rambo and the Dalai Llama" that discussed the notion in more detail. I've tried it playing tennis but don't play that much but it changes the game in an interesting way. I'm always racing myself with my Garmin but don't really worry about other people, except maybe at the end of the race.

Part of the reason I like to shoot for flatter BG through a race is that I love to eat at the end of it!

Comment by Jerry Nairn on January 29, 2012 at 1:51pm

I think there is a whole range of competitiveness possible, it's not something you either are or are not. I agree that we are all individuals, and even as individuals, each of us could handle our diabetes challenges in more than one way. I don't think anyone chooses to compete with super high blood sugars because they have to. I think they've found something that works, to some degree, and they are reluctant to change.
Of course, I've decided to try to keep my blood sugars closer to normal, but at the start of any race there might be some reason my blood sugar was over 300. I would be figuring out what to do about it, but it happens.
I don't want to give anyone the impression that I have my own body figured out, let alone anyone else's.
Which gets back to that side-stitch thing. It was an idea that is sometimes the solution. Sometimes running with something in your stomach can bring those on, but it's not the only thing.
Good luck!

Comment by Justina on January 29, 2012 at 1:36pm
Don't you think there's a huge difference between diabetes and exercise and diabetes and COMPETITIVE exercise?
I'm a yoga instructor and the first thing I teach everyone is that we're all individuals and you never compair yourself to anybody else. What is so cool is that we're all clearly individuals...our diabetes is different. I'm a 32 year old 100 lb chick..I can't follow the same insulin/carb/exercise routine, but I can't modify what I need to to make it work for me. I'm not competive with anyone but myself. It's great to hear what works for everyone, and learn from what doesn't work out so hot.
Jerry- I've had no changes in my diet or fluid intake, they usually start oh maybe four or five miles in. The only thing I can think that's different is my CGM. I wear my monitor on the right side.
Comment by acidrock23 on January 29, 2012 at 12:24pm

I ran into 2 people at Chicago, my aunt's friend, T1 who's done bunches of marathons, Ironman event, etc. and he was like "how's your sugar" when I was testing and I was like "I little high, 180" as I was bouncing off the walls w/ adrenaline, etc. and he said "oh, I'm like 300 or so" as he ate a banana! I think he bolused, fell over 4x (he has eye issues too, and the course still has potholes, manhole covers, etc. to trip over... but still, of course, kicked my ass at the race. I suggested he check the group out and had a bit of a chat with him but he sort of does his thing. I saw an Insulindependence guy who also asked me where my BG was in the paddock and I was right around 130 or so and his was also 300. I'm sure he blew me off the road too but I have to wonder about getting into a pattern of gonzo training to do distance running seriously while cranking your BG up all the time? MAybe it's no big deal an dI should chill out about it and I'd be able to run better but a few of the runs where sites pulled out and stuff I felt like crap as my BG ran up.

Comment by Jerry Nairn on January 29, 2012 at 12:08pm

These are some very interesting discussions going on. I can see a progression going on in exercise and diabetes management.
Years ago I was one of those runners who wanted to have a pre-race blood sugar check of 180-220, or I would worry about going low. I was on long-acting insulin at the time.
Of course, even before that, I would just eat or drink something, not knowing where my blood sugar was, because I had no way to test it, but I digress.
After getting a pump, I had more control of insulin-on-board, and I could confidently start a run with my blood sugar close to normal.
And that was my advice to others, to try to get and stay close to normal blood sugar during a run.
There were, and probably still are, people out there doing things like disconnecting their pumps, making sure their blood sugar was over 200, etc., out of fear of going low. I thought I, at least had gotten past that.
Now in this discussion, I see a couple of you talking about the "spike" after eating a gel. I've been eating gels for years, and never worried about it. Before I had a CGM, I had no way to even know that was happening. Now that I do have a CGM, I see it, but I also see the blood sugar dropping back into range.
I suppose it's time for me to move on. I need a new model of how it should work. I need to try to keep from going through ups and downs, try to smooth it out.
Justina,
Concerning side-aches, one of the most frequent causes is extra weight tugging on the diaphragm. Have you eaten more or are you drinking more fluids lately? Do you notice the aches starting after you drink?

Comment by acidrock23 on January 29, 2012 at 10:29am

Mine were like muscle cramps in my calves. I think for the rib "stitch" cramps, if you breathe in and push your abdomen out and in when you exhale it can help that? That tidbit is rattling around my head from grade school?

I totally disagree with not bolusing before a race, I agree that you don't want the IOB going on but I think that eating beforehand is important, not a ton, and having good BG can help too. I think it's a lot harder to run when my BG is high. I know a lot of people routinely do it but I don't think you have to? I try to have what Jay Cutler had mentioned, like 120-160 as where I try to be. It's about balance? Part of being safe is being able to run strongly and perceive how you are feeling physically and I think that running up really high makes me feel like garbage so I try to avoid it.

 

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