Diabetics who run Marathons!

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Diabetics who run Marathons!

Diabetics who run Marathons!

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Comment by Mike M on September 18, 2014 at 6:03pm

Hi Brian, I wonder if the insulin you are using peaks for you later than the medical folks predict. If so, you might have more insulin on board than would be typical even three hours after a bolus. Also, I experience similar drops with running. It helps me to reduce the basal rate to 15% or less at least one hour before running. If I forget to do this, one Power Gel about 30 minutes into the run helps stabilize the sudden drop. Hope this helps you. Keep experimenting -- something will work!

Comment by Brian on September 18, 2014 at 5:21pm

Today I was hoping to go for 6 miles. I ate a late lunch and bolused 3units at around 2:20pm. At 5pm I went for a run with my blood sugar around 250. 30min later I was 99 with double arrows down. I'm starting to feel like I need to be 400 in order to go for a run. Apparently, I'm extremely sensitive to insulin when I run.

Those are my chickens in the background in case you were wondering :)

Comment by acidrock23 on September 16, 2014 at 4:31pm

I agree that ups and downs are rough! I generally try to "run" (ha ha!) as flat as possible, rather than running up, burning it down and then boosting it back up. I think that ideally, you can sort of feel out how many carbs you burn off in say 3 miles and sort of aim for that during training. If it works, that usually works out very well for races, as there will be fuel stands every few miles and you can just use their goodies. To me, it's easier to keep nudging it to stay flat than to run up and down. It doesn't always work but it's fun to keep at it.

A lot of times, I sort of use the basal rate as a BG Gas Pedal and sort of nudge it up and down with that. If I kill the basal to 7%, even if I'm running, I'll usually see it start to ooze up. Then I turn it down. And up and down and so on until the race is done. Sometimes, I can space out 5 or 6 miles playing with my BG and trying to get it to behave...

Comment by Brian on September 16, 2014 at 8:37am

Exercise is indeed very important. I think for now I'll keep refining my strategy as best I can to until my BG is more steady on my runs. The ups and downs can be brutal (I did eat a gel when I was at 160). I am glad to have gotten the mileage in. It's helpful to have a CGM on runs although when I had a Dexcom it never worked for me when I ran. The enlite sensor has been much better when it comes to exercise.

Comment by Jerry Nairn on September 15, 2014 at 1:19pm

Hi, Brian,

Yes, sometimes it's not possible to do all of the things we talk about doing to get our blood sugars right during a run. Your run yesterday is an example.

I had an afternoon run yesterday with similar issues. Maybe I was just luckier, or maybe I handled it a little differently, but my blood sugar wasn't perfect either, starting at 157 and ending at 240.

The important thing, I think for both of us, is that we got the mileage in and we're here to discuss it.

I knew I had too much insulin on board before starting, my run, so I had a glass of juice, and took lots of carbs with me.

My Dexcom sensor had just timed out, so I wasn't getting readings there. I carried a meter with me, and I was still around 170 at the turnaround, and still worrying about my meal bolus, so I ate a gel.

So I was at 240 when I finished 7 miles. Not great, but I think it was better than erring in the other direction and going low.

When people say it's hard to manage exercise with diabetes, I almost always point out it's hard to manage eating, but we still do it. Exercise is that important. We do what we can to keep our blood sugars in line during our runs, but as long as we don't hurt ourselves, we should consider it successful.

In your case, I might have tried to take in some carbs when my bg was at 150 with two down arrows. Maybe you did. Whatever. It worked out.

Looks like it's time to change your battery.

Comment by Brian on September 15, 2014 at 6:31am

Jerry thanks for your feedback. These were some suggested training tips I received from someone local here in Denver. He's not on this website. I think the idea to minimize insulin on board before exercise is a good idea but not always easy to put into practice. Yesterday, I went for an 8 mile run. I wanted to do a morning run after breakfast so I didn't wait the recommended 2+hrs after taking a meal bolus to begin my run. Instead I reduced my mealtime bolus then went for a run. The attached photo is the typical problem that I run into since being on a pump.

I think maybe should I should have eaten a little closer to the start of my run and taken a little less insulin. Timing these things just right can be tricky. And maintaining steady BG on a long run is even harder... I'll keep tweaking my strategy.

Comment by Becky on September 13, 2014 at 1:52pm

Thanks everyone. That is a great idea for the sensor to be on my arm. I find that sometimes it is good to put my infusion sites on my arm. They tend to stick better and since the weather is getting cooler, it doesn't stand out as much. I think that I have been super dehydrated hence the nausea. Still a little nauseous today but since I am forcing myself to drink more, I am starting to feel more like myself. I will try wearing the pump next week for my long run. I feel like it is adding more bulk. I don't have enough pockets for all my supplies. :( Do you all wear packs or the belt? Where do you fit everything?

Comment by Jerry Nairn on September 12, 2014 at 2:25pm

Hi, Becky,

I wear my Dexcom sensor on the back of my arm, up near the shoulder. That works OK for me. If the sensor is on for a while and feels like it might come loose, I have a few cut off sections of tube socks, and I can pull one of these up over my arm covering the sensor and holding it on.

For a marathon, I will usually put in a second infusion site in case the one I'm using comes out, which has happened a couple of times.

I have also ended up carrying a CGM sensor that has come out during a race.

Things happen. It's always best to carry a meter.

DEA is probably right about your nausea, especially if it was a hot day, or if you know you didn't get enough fluids and electrolytes.

Comment by Carlos Candela on September 12, 2014 at 1:46pm

I do agree with DEA. I do keep my pump and the CGM while running. I was having issues with the sensor at early stage of training but was able to find an area little bit higher and closer to the belly button (But not too close) that the sensor has been staying put for the duration of the longer runs.
I do adjust depending of my sugars readings. Also I do not carry a meter during the training runs but I do during the events. I do not really know why, but more often than not the variation between what the sensor reads and how I feel is higher during events and races. Be aware of the location of the medical stations/tents. They are happy to help and they normally have a glucose readers in hand. Do not be afraid to ask them and use them. It might take 30 to 40 seconds but at least you will have a reading that you can use to make decisions.
So far I have only had a scary situation in one race that forced me to actually stop (not even able to walk) due to a low while the sensor was reading normal. Take fuel, put the pump on suspend and waited and waited. But was able to finish the race.
So prepare plan A, B and C with the additional if everything fails use plan D. Wish you good luck with your training and your goals.

Comment by DEA on September 12, 2014 at 9:36am

Hi Becky,

BG might rise during endurance exercise because your body is tapping your glycogen stores. My sense is that this causes BG rises after stopping because the BG from the glycogen release is still extant in the bloodstream but the muscular activity to burn the sugar has stopped. Once you hit 15-20 miles, your glycogen stores deplete (varies by person), and so you are not getting the BG boost from that source any longer. I'd also suggest that the nausea might be from dehydration/electrolyte depletion. I get that around 18 miles or so unless I really replenish my fluids with a good, electrolyte-containing beverage or two. Particularly during the warmer months, keeping as hydrated as possible and keeping your electrolytes replenished is a tough, but necessary job.

As for tips: I use a run/walk interval method that helps keep my BG in a more level state over the course of races of 10+ miles. I started a marathon with a BG of 55 in January and was able to get through it without keeling over my loading up with fuel at the beginning and using a conservative interval. I've never used Lantus, but I was wondering if the pump might be better because you can suspend insulin delivery if you need to during the race?

 

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