Diabetics who run Marathons!


Diabetics who run Marathons!

Diabetics who run Marathons!

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Comment by Tatiana Vassilieva on January 21, 2014 at 10:54am

Thanks, DEA and acidrock23, for your comments! Ultimately, of course, I'd like to go back on the pump (yes, I'm one of those who tried it for 4 years in high school/college, and then decided to go to MDI...). Although I do realize being on the pump doesn't solve all the running issues, it seems to make them a little easier. As for now, I'll continue to experiment and to carry my pen and sugar with me on runs. :-)

Comment by DEA on January 19, 2014 at 5:54pm

Tatiana: Honestly, NPH insulin caused me to stop running for years due to crashing hard during races. As for your plan to skip Lantus, I think the only way it will work is to inject some shorter-acting insulin to cover you through the race, as you'll need something onboard to get the energy to your cells. I imagine the highs you are seeing are due to your body accessing glycogen stores while running, but without the ability to use that sugar to fuel your muscle cells. Disclaimer: This is not a medical opinion, I'm just trying to game this situation out here. Novolog should start working relatively quickly, and give you 2-3 hours worth of action. For me, that would mean another dose in the middle of my marathon, to cover the second half of the race, but, hey, if you can knock out a marathon in a couple hours, all the better. :-)

I'm on a pump, but I know that I can't really lower my basal all day on the day of a race without having highs later. I think that would be the parallel case to you lowering your Lantus dosage before running. I'd be tempted to try with short-acting insulin shortly before and during the race to cover your body's energy needs and to keep yourself from going too high. Then a normal dose of Lantus would cover your "regular" day thereafter. Of course, I'd try this on a training run with lots of backup glucose and insulin to cover whatever this plan gets wrong. It makes logical sense to me, though, that you want/need to have insulin onboard, just not the usual dosage of Lantus, which would be too much to deal with during the long runs. Does any of this make any sense?

Comment by acidrock23 on January 18, 2014 at 5:46am

My cousin floated the idea of a "Tough Mudder" (which, thankfully, his other friends didn't want to do. I've decided I'm not a fan of mud, ice might feel good but the whole mess thing sort of turns me off.) and I figured that I usually turn my basal down to about 60% of running so I would have a snort of Levemir at about 60% of my daily dose, or maybe 60% of 2/3 of my daiy dose if I were to figure I'd split the shot (I went from R/NPH to pumping in 2008 and have only done Levemir once for a weekend when my pump blew up...) and have at it. I don't recall of the TM races have support, gatorade or whatever but I was just gonna get there when I got there.

I haven't actually tried it out but that's how I'd conceptualize an approach to MDI and then I'd try it out on training runs. It's good that you know that waiting until after the race doesn't work for you this far ahead of time so you can play around with stuff!!

Comment by Tatiana Vassilieva on January 18, 2014 at 1:41am

Really delighted to see that this group exists - what an awesome resource! I had no idea that there were so many diabetic marathoners out there!
I have a practical question... I'm on a multiple daily injection regimen (daily dose of Lantus in the morning and Novolog pen throughout the day). Are any of you runners on a similar MDI plan instead of a pump? If yes, do you alter you dosages (specifically, the daily dose of the slow-acting insulin) on race days or long training run days? Also, do you carry your short-acting insulin pen with you on your runs?
I did only one full marathon before, and am now training for my second one in May. During my previous training, especially when I started doing 15-milers and longer, I ran into the problem of being CONSTANTLY low, to the point of running out of all of my abundant GUs and other sugar supplies with miles still to go (and me being often away from civilization, where I could replenish my emergency sugar stashes...). Being weary of the lows, I decided that on the race day I would wait till after the race to inject my usual morning daily dose... After all, I usually inject it between 8-10 am, and the race would be at 6 am. Since I never had to shoot up during any of the training runs, I also chose NOT to have my quick-acting pen with me during the actual race (as the space in my running pouch would be better used for extra sugar instead...). Of course... during the ACTUAL marathon, I ended up being too high (I started at 160, then quickly climbed to 200, then 280, etc. - maybe it was the nerves, maybe the delay in my morning daily dose... who knows?). Since I didn't have my pen on me, I couldn't bring myself down. This also meant that I couldn't have any of my GUs for non-diabetic purposes (a.k.a. replenishing my energy, like normal people do), which meant that I was completely drained of any energy by mile 18 or so.
After reading how all of you pumpers somewhat lower your basal rates for the runs, I'm just wondering, do MDI-ers do anything special too? Or do you just bring a gigantic load of emergency sugar and hope for the best? ;-)

Comment by acidrock23 on January 16, 2014 at 4:29am

RE Running Strong's questions, 5.9 is kind of an interesting spot to linger. It's very good for a person with diabetes however it's indicative of some type of endocrine disorder in anyone else. I think (and, of course, I'm not a doctor...) that the standards employed by the medical industry do people in your position a disservice. You are "ok" so they don't treat you but, if you were like 6 years old, you'd probably be dx'ed as T1 and put on insulin. A little bit of insulin will go a long way. I checked your profile which reads T1 and oral? Is this based on a c-peptide test or something? The way T2 or perhaps one of the adult-onset T1 seem to develop, it seems inevitable that higher A1Cs might be down the road. It probably helps that you are running a ton as you can sort of cook your metabolism into a state where, despite whatever's going on in your endocrine system.

I haven't run into gas issues, other than a couple "oops, I shouldn't have eaten that..." issues that had me running to the port-a-potty. I generally do "carb loading" 2 days pre-races and long runs and eat very lightly the day before and generally time things to avoid portapotties. The 5 mile portapotty on our training route was like the "Filthiest Toilet in Scotland" scene in "Trainspotting" which might motivate that bit of craziness for me but, once the clock is running, I want to run, not stand in line. The 50something mom we ran Chicago with in 2012 said "let's pee in the alley" when we pulled over for a 14 mile pee break so I know I'm not the only one who considers these things!! hee hee.

82 after a long run is cool with me. I worry a bit about hypos after those situations and have had trouble with my CGM reading low after long runs, I dunno if the interstitial fluid gets cooked off or devoured or whatever.

Re checking BG, I have a CGM that does like 220ish tests/ day and usually double check it and calibrate it with about a dozen tests/ day. If your BG is maintaining at 82 at the end of 15+ mile runs consistently, I wouldn't worry about it. I would be moderately concerned about the 5.9A1C if you are not T1 on insulin. If you are T1 I think that people are generally taking some insulin, even if only a small, basal dose is required (julez_79 I think was doing this and pancreaswanted too a bit...both are pretty active so active definitely helps). The 5.9 is sort of borderline. I'm a claims adjuster and read medical records all day. Some clinics will tag a 5.9 as diabetes and some use 6.0 in which case a 5.9 is "passing". Being precise about it is a good idea. It may be useful to get more tests. Some folks report being ok fasting but flying up when they eat carbs. If that's the case, it might further substantiate a problem.

Good luck with the running though!

Comment by DEA on January 15, 2014 at 11:04am

Hi Folks. After hanging out on this group for a while, I finally became a Diabetic Who Ran a Marathon on Sunday. I finished up the Dopey Challenge (5K, 10K, Half Marathon, Marathon on 4 consecutive days) at Walt Disney World and lived to tell the tale. It was a slow and steady series of races, but challenging nonetheless. Of course, I'm now looking around for my next marathon...

Comment by RunningStrong on January 15, 2014 at 9:37am

I am just now starting to see what my BG does during the day, and while running. My recent test show my F BG is 144. A1c is 5.9. I am curious about getting a handle on my BG's throughout the day. I think I should check it in the morn, before meals, 2hrs after meals, prior to running, after running, and then sometime further out from the run because I have read that it will spike later after the run.

I am just starting longer runs again since last week (10, 14, 13). My last marathon was in July. I started having some weird consistent thing occurring at 17 miles consistently when running at faster paces. My gut fills with gas to the point I feel like I am going to explode and I can not really run at that point. Once I release it (gas) it fills back up and I go through it again. I think I read somewhere that this has to do with the body not being able to process the carbs at this point. Any ideas?

I checked my BG following my 13.17 mile run yesterday and it was 82. I ran it in 2:07:12, 9:40 pace, with HR 138 max HR average 153 (this I consider for me a comfortable pace). Would 82 following a run be what one should expect? As usual, the rest of my day I felt drained and out of it. Prior to watching my diet following a run I would literally just sleep the rest of he day. I have had people in the past ask if I was on drugs because I would just go to sleep after a run.

Any feedback folks have on checking my BG to get a good handle on where I am and what my BG does during the day is appreciated. There must be a schedule out there for this so I do not need to reinvent the wheel. Although I have checked my BG in the mornings and following meals on occasion, I have not really taken the time to get a really good idea of the big picture.

In another post I already mentioned that I take no meds and the doc wants to give me another 6 months to see if I can brings things down with a tighter diet and exercise.

I am pretty anal and would like to really figure this stuff out. I am an attorney and in the past worked disability compensation, including as a hearing officer conducting hearings and writing decisions on medical claims. I take this stuff seriously and tend to dive into it head first so I can get an in depth understanding. any information is appreciated.

Comment by jen627 on January 15, 2014 at 8:20am

Hello all, looking for some recommendations. I have been running half marathons for years, and have (stupidly, I know) gotten by without having to carry my Omnipod PDM along with me. However, I am now training for a 20-mile race and I know for safety's sake I will need to carry it with me on these much longer runs. I have a Spiblet but that pouch is too small. Can anyone recommend a belt or pouch that fits the Omnipod PDM?

Comment by Jerry Nairn on January 2, 2014 at 1:22pm

I have been singing the praises of RaceReady Long Distance shorts for a while.


There are a lot of options these days, though. SpiBelt is a great product, and they have been a sponsor and supporter of promoting athletic activities for diabetics.

You may want to check out Diabetic Lifestyle Apparel. It is athletic wear for diabetics by diabetics. I'm a little self-conscious about skin tight shorts, though, so when I wear my diabetic lifestyle shorts, I feel like I need another pair of shorts over them, which defeats the purpose of the pockets.

What you want is something that holds a lot of stuff and doesn't let it bounce around while you're running.

For long runs and races, I carry energy gels, Power Gel, Clif Shots, Carb Boom, Accel, Hammer Gel, etc. for fuel, and glucose tablets for lows, two different kinds of carbs for two different purposes.

Hammer Gel advertises that its carbs are complex, so may be less likely to cause bg spikes, and Accel has some protein, which may help with that also. I think some of the others are adding protein now, too. It's hard to keep up with this stuff.

You may not need to start fueling during your runs until you get up to over 7 miles, but you might want to find out what tastes good and sits easy on your stomach now.

Comment by John P on January 2, 2014 at 12:04pm

http://www.spibelt.com/products/specialty-spibelt/diabetic-spibelt is made for T1D. Very much like their regular running belts except it has a hole for the Inset/Medtronics/etc tubing.


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