8.5.14

Running a Marathon with Type 1 Diabetes

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June marked the 2nd marathon I’ve run in two months. I don’t feel special, nor am I dawning a 26.2 sticker on my car. I run because I find that running is good for the soul. Nevertheless, I hope through sharing a few training tips and race tricks I can inspire more people with diabetes to lace ‘em up.

Training Breakdown

Here’s how the average training week looked over the previous three months:

M – Off
T – 6 miles (Some kind of interval training)
W – Cross Training (Yoga, cycling, etc.)
Th – 6 miles (Ran at marathon race pace)
F – Off
Sa – 4 miles (10K pace)
Su – 10 to 20 miles (15-30 seconds slower than marathon pace)

Food

Fuel is everything. I’m a believer in the idea that what you put in after the workout is what you get from the workout.

Prior – Before the 4-6 mile runs, I would usually eat a banana or any other simple whole food carb source. Before the long runs, I’d eat a Clif Bar or Scott Jurek’s 5-grain pancakes with some almond butter. Blueberry chia seed smoothies worked well too.

After – When your muscles are fatigued, it’s critical to fuel up with some easily digestible carbs right after. I’d eat a banana or drink cherry juice. Maybe whip up a quick smoothie. Then within the next hour I would make a standard meal based upon the 4 to 1 carbohydrate to protein ratio for recovery.

During – Most people stick with Gu’s, Clif Shot Blocks, or Hammer products during the runs over 6 miles. I try to mix it up. I’ll eat sweet potatoes, bananas, dates food processed with coconut oil, and raisins too.

*Note: I do not have a sensitive stomach. I have yet to become nauseous while running and eating. There’s a good chance that I could run on radishes if need be.

Insulin Plan – Pump

This has evolved throughout years of exercise. If I’m running over an hour, I turn my basal rate down to 25% of normal for that time of the day. If I’m running for less than an hour, I turn down my basal to 50%. As soon as I finish a long run, I expect to get a pretty strong high blood sugar whiplash. I usually bolus 2 additional units after I finish even if my blood sugar is below 120 along with the insulin needed for the food I eat.

Blood Sugar

If you run, your blood sugar will come down substantially 99% of the time. I like to keep the levels above 140 going into a run that’s less than an hour. I like to keep the levels above 170 for runs lasting greater than an hour. This tends to give me enough of a buffer to end up around 80-100 by the time the runs end. The whole idea here is to not go low during a run. If you’ve ever gone low in the middle of a workout, it sucks the joy and motivation out of everything. Two gels and two cups of Gatorade later, your sugar still sits at 70. Not sweet.

The Marathon Gameplan

Prior – I ate an Oatmeal Raisin Walnut Clif Bar an hour before the race start. Made sure my blood sugar was above 170. At the Gov Cup race in Montana, my blood sugar at start was actually 270. I made a choice to not take insulin to bring it down because I knew that having too much insulin in my system would guarantee a low in the first half of the race. I crossed the finish line at 106. It worked out that day.

During – I go for fuel every 5 miles or every 45 minutes. I used two sources in Montana (Hammer gels and ProFuel Bites). This pattern has worked for me consistently and tends to keep my blood sugar above 100. I set my basal rate to 25% of normal. During the first half of the race, I drink only water at the aid stations. During the second half of the race, I drink a water and a Gatorade (in Montana they offered Heed) at each stop.

The Montana Experience – Gov Cup 2014

It was everything a marathon should be: inspiring, grueling, uplifting, challenging, and heart-wrenching. I felt that I had lived an entire life over 26.2 miles – extreme highs and draining lows of emotion. The first 6 miles or so of terrain consisted of steep downhill. That sounds great and all but my quads were trashed by the halfway point. An old hamstring injury lingered throughout the process but the pain became the new normal throughout the race. I disappeared and went thoughtless, immersed in the experience from miles 17-23. Those miles turned out to be my fastest splits. The last three miles were a grind but I decided to dedicate each of them to someone in my life who I am grateful for. I was reading The Alchemist by Paulo Coelho at the time and had many of that book’s ideas running through my head. It was a truly unique race put on by authentic people. I’d recommend it to anyone.

This is a video clip from the Governor’s Cup at the finish line:

Are you a runner? Drop in your own running tips in the comment box below!

Former co-founder of DiabetesDailyGrind, Ryan's mission is to motivate others with diabetes to live their own authentic life. Most days, when not in the hospital during his medical residency, you can find him on the bike, surfboard, or yoga mat. He believes in the power of clean eating, and loves his Dexcom.

7 thoughts on “Running a Marathon with Type 1 Diabetes

  1. Great post, Ryan!

    I loved the line about being able to run on raw kale if necessary, and also winced in pain when you mentioned the old hamstring injury (I’m still nursing mine back into basketball shape).

    Thanks for sharing your experiences, and congratulations on crossing that finish line – twice!

  2. Great account. I am on injections (Lantus and Novo Rapid) so my insulin approach is quite different. Very similar eating strategy. Come to South Africa and give Comrades a try 🙂

    • Alex, You have officially supplied me with my next motivation! This ultra looks so cool, albeit incredibly difficult. I’d love to hear more about your approach to marathoning on injections. Do you lower your Lantus? Eat at regular intervals? Just run low the entirety of the race?

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