Long Distance Running

Healthy Living Physical Activity
1

No one in my family has Diabetes, and I was diagnosed when I was 23, back in 2009. I'm hoping to get some awesome feedback from some of you.

Post Diabetes I have ran up to 9 miles, without experiencing any complications or Hypoglycemia. I know they say that ideal BG levels, prior to workouts should be, 150-250.

A few days ago I took a run. Before I went off I tested at 247. I figured that was high, but since it was humid and roughly 85 degrees (probably hotter with the humidity) I ate a banana. I took off on my run feeling great. I got to about 3 miles, stretched, drank a little bit of Gatorade, water, and embarked on my run again. I felt a little iffy, so I stopped around the 4.5 mile. I tested my sugar and read at, 180. I thought that was decent, but still had another 1.5 mile to run, so I drank some Gatorade. I went another half mile and felt a little iffy again, so I tested. The test came back and read 177. I figured I would drink some more Gatorade and just walk. I felt like I was over heating, so I drank some water and poured water over my neck, which helped "calm" me down. I know I tend to relate everything to a low blood sugar, because they scare me, so I'm sure I tax myself mentally. I reached a gas station where I tested again and the reading came back as, 180. I had one bottle left of Gatorade and about another mile to 1.5 mile to my house.

For precautionary measures I went inside the gas station to purchase two more Gatorade's. I continued to walk, because I was still feeling extremely hot. About .5 mile to my house, I felt like I was about to crash, badly, and stiffened up. I dropped to the floor and drank as much Gatorade, as I could possibly stomach (Half the 20oz bottle). I tried calming myself and checked my sugars again; they read 212. So traumatized and scared for my life, I called a buddy, who picked me up and drove me home. I got home, took a cold shower, went down stairs to prepare a sandwich, with chips, for my dinner. Before I ate that, I tested again; the meter read 343. I ate, did not take any insulin and went to bed. The next morning, I tested my blood sugar and it was at, 160.

I know running takes up a lot of sugar, but that's a very high BG reading to drop that low. To this day, I'm not sure if in fact it was a low BG, since I tested every time I felt "iffy" and had decent BG levels, or if it was heat exhaustion. Needless to say, this experience has traumatized me, I'm scared to go on a run, scared to even weight lift, and my brain feels like it has been taxed. I don't feel, "normal." I hit the gym yesterday and it felt great, but when I got home I tested at, 195. I had a salad and fries, took 5 units of Novolog and crashed two hours later. Is there any advice out there someone can give me to prevent this "traumatizing" experiences? I love to run. I would hate to restrict myself from running, because of this "fear." I appreciate your time and advice, in advance.

Sincerely,

Lorenzo

2

I'm pretty comfortable running my BG lower. I take my meter on most long runs and for races and all that. RaceReady shorts have a pocket that will hold a OneTouch UltraMini and that can be helpful. If your BG are up around 200 without a lot of insulin "on board", it may mean that you could tolerate some more basal insulin but, with MDI, that can be risky if you're running a lot.

What sort of insulin stuff is going on during these runs? I've had situations where I've run low running (there's probably some documented in the
Diabetics who run marathons" threads, I had some doozies in the summer of 2011... but mostly 1 gatorade will take care of them, and that's like 12 miles into a 17 mile run or whatever, 2 Gatorades is way more than you need for a mile or mile and a half, unless you have a ton of insulin going nutso.

I'd try to do some runs with no bolus insulin going. It may also be useful to do a sort of diabetes reboot and maybe read Ginger Vieira's "Your Diabetes Science Experiment" or "Think Like a Pancreas", take a couple weeks, get through one of them or both of them, get a perspective of "normalizing" your BG instead of running high. Lows suck and have some risks and all of that but if you get a "treatment" you can lug with you running (and the rest of the time?) you can deal with them effectively and get your BG down to a near-normal or normal level. I think that might help you run more effectively too?

3

I normally have all the insulin, Novolog (bolus), used up in my system, by the time I go on my runs. The only Insulin that remains in my system is, the long lasting, Lantus, Insulin.

I always figured if you were going to exercise and use up energy, you should "fuel" up prior to the activity. In the episode I recently had, my sugars seem to be in the hundreds, but I felt like I was going to pass out. I did feel really hot and it was 85 and humid that day.

Maybe I'm misunderstanding this disease, after 4 years. I'll have to take a look at these books and see if they can help me better understand this disease. The last few times these low blood sugars have happened, they've scared me. I'm not sure if my meter is giving me incorrect readings, if the strips are bad, or if I'm just not treating myself properly.

The funny thing is, my treatment works for long periods of time, and then all of sudden I crash hard, which traumatizes me for weeks. It's a "funk" I get in, after experiencing a very low blood sugar. Let's be honest, as much as life can be tough, I doubt anyone wants to die.

4

When it's hot out, it can take it out of you, D or no D. For really long runs, I'll bring 2x gatorade bottles, drink one Gatorade bottle and then fill it with water at a drinking fountain or wherever, keeping the second for the longer miles towards the end of the run.

I have a sort of weird background in that I passed out a bunch when I was in my 20s but hung out w/ a bunch of folks who uh, partied a lot, so people were passing out here and there all the time. I'm sure it was alarming when I did and I don't feel great about it but it just seems like a consequence rather than anything to be terrified of (*knocks on wood...*). I think that if you want to run, e.g. a marathon or a 1/2 or whatever, it will be *much* easier if you can get rid of "surprise" BG readings and run things a bit tighter.

I know that both Ginger V. and Gary Scheiner, the author of "Think Like a Pancreas" work as online consultants. I sort of figured things out, so I haven't availed myself of their services however I've met some other people who have worked w/ Ginger who are all really kicking the $#!+ out of diabetes (and working out, weight lifting and other stuff too...), like it deserves to have the $#!+ kicked out of it and it may be useful to connect with either of them to try to get an opinion that's medically based to go off of. The pump was huge for me, quite possibly because it just kept track of stuff but those kind of things can make a difference in controlling D or D controlling you. Ginger works with TeamWild, who do camps for sports and T1 (I think, maybe T2 too?) that also look interesting. It may be a stretch to get these into your schedule but sometimes a little "coaching" from experts can help. It may just help to hang around here and see what answers people come up with too.

5

Word. I came from a background of doing a bunch of things, that I probably shouldn't of been doing, because I have Diabetes. I cleaned up my act and kicked that stuff to the curb. I don't get it though. I'll put in a full workout, weight lifting. Eat a snickers bar and go play a 40 minute indoor footie match, without any issues.

I run outside for a little under an hour and I feel like I'm going to die. I kind of want to say it was "Heat Exhaustion," since my sugars were at high levels, but why did I feel like passing out?

My work is paying for a Diabetes Coach for me, so I'm eager to chop it with him or her, and find out what we can figure out. I have yet to pass out (knock on wood), but there was one instance where I took insulin was dong something else and my blood sugar dropped to 30. I'm sure the combination of both factors, added to my panic attack and made it difficult for me to stabilize the sugar.

What do you mean by, "Surprise BG?"

6

Where you think your BG is one thing and it's something else. I am pretty good at knowing what's going on and that's useful for running and, pretty much, everything else.

That's nice of your work! Take it seriously but double check what they're telling you vs. those books. They are both excellent and really offer "how-to" manuals that anybody can use, if you can follow their methodologies.

7

Most definitely! That's why finding this site, was beneficial for me.

What about your meter? I've been testing from to different test strip cans and I get BG levels that are off by 50 mg/dl?

8

Super_Sally:

That's where I want to be! Like I was telling Acidrock, there are times were I do a weight lifting workout for at least an hour to hour and 15 minutes and then go play a football (soccer) game, with just a snickers bar in between.

I usually stay no higher than 200, unless I go on a run; not the greatest I know. Sometimes if I wake up at 90, I'm still feeling a little shakey. I have been told that if you are high, once you come down to "normal" levels, it can feel like your low. I think 95 or greater, gives me a comfortable feeling; no shakes, don't feel weak, and can actually carry myself pretty confidently.

9

I guess I have never thought about a heart rate monitor. I do P90X during the week and run twice to maybe 3 times a week, excluding my 40 minute indoor soccer games, twice a week.

When I go on my runs, I have no short acting in my system, it's usually gone by then. I take my long last Insulin, around 1 p.m., right after lunch. The dosage has worked for me and I haven't really experienced lows while on my runs. I'm not sure if it was because of the heat or lack of hydration, but it did feel like a low blood sugar.

What about meter accuracy? I test from two different set's of test strips and they seem to be off by 50 mg/dl, suggestions?

10

One night a couple of weeks ago, I went on a run. At the end, I'd pushed myself so far past what I was able to handle that I got off shaking, hardly able to walk or coordinate my movements. I couldn't even think straight. After I'd rested for about 20 minutes, I felt much better. Before that, I had no idea of what was going on around me--I even put a bottle of (diet) Snapple in the fridge and barely remembered it afterwards! I had symptoms equivalent to my worst low ever, but I was 124.

I think it was heat and maybe some dehydration.

11

i've had a similar situation before. i blame mine on heat exhausation though.
i worked at sonic drive in (i live in the south) so it was over 100 degrees, plus humid, and our store AC wasn't working.

I thought for sure my weakness, panic feeling, horrible just out of it feeling was from my BS, but it was normal to high, so i knew it was the heat.

it can play 'tricks' on you, and i, like you, am afraid of dropping low during exercise too, but i recently have just talked myself through the fact that being too high during exercise is actually detremential. for example, lifting weights while too high puts strain on you, and if you are high, that strain is worse for a part of your body such as your eyes.
i aim for a BS of 180 for intense workouts. sometimes i will be a bit higher than that, and i will drink more water. if i am lower than 180 i will work out and just periodically check.

i find i go lower much, much faster during cardio workouts versus strength training. P90X plyometrics drops me pretty fast, too.

just try to be calm during those times. if you get your BS to a more stable range, being 'normal' will feel normal to you and you'll eventually be okay with working out <200. good luck to ya!

12

Lorenzo,
That is why I stopped running or biking. I was traumatized by similar experiences. I suggest taking it slow. Start off walking and work your way back up to running. I would also consider that device that tells you your blood sugar in real time. I forget its name because I can no longer afford them, but I still get scared just walking my dogs after my similar experience. I know this is not what you wanted to hear, that it happened to someone else, but I would start off slow until your mind doesn't feel so traumatized.

13

Continuous Glucose Monitor is the real-time device. I use a Garmin (as if the pump and CGM are not enough gizmos...LOL...) and, after a couple of four years of running, I have a good sense of my pace and, when I can't keep the pace I want to run, it's often b/c my BG is tailing off and running low for whatever reason.

I agree with not feeling traumatized by lows but I sort of look at them as something to manage and part of the deal. I had lows a few years ago when my BG was all over the place and I've had lows since then. I can feel them (not so much when I'm running, except for the tired/ out of gas sensations...) and, while they are inconvenient, they haven't made me quit. The first time I ran 8 miles, I was still running after bolusing and found myself drifting down to 39, had a few sleeves of Smarties and sprinted a few driveways (convenient measuring marks alongside of the road...) to get some adrenaline going. I still had more Smarties if the ones I ate didn't work but by the time I ran for a bit longer and tested again, my BG was heading up where I wanted it to.

The buzz I got last year after finishing the Chicago Marathon pretty close to my goal time (4:38...) lasted at least a week at pretty high intensity and was really excellent and worth all of the storm and stress of training, not going out on Friday nights all summer, driving my wife and daughter batty trying to squeeze runs in, etc. I get a pretty nice positive buzz from a good run but the whole big race/ Chicago (where I live...)/ spectacular (and downhill, which helps...) finish line experience really made things blew up into a spectacular feeling. 3-4 pairs of running shoes (at least...) $400, 3 tubs of powdered Gatorade $12, entry fee $170 (or something like that...), finishing buzz PRICELESS!!!

I don't think that you have to stop but I don't think it's practical to run up and down and I think that reasonably flat BG are very helpful, not just for running but for life with diabetes in general. I think that a *BIG* problem with the medical industry is that we are aiming at targets (110/140?) that lead directly to results that are flying all over the place.

14

Super Sally:

You are really helpful! As far as my meter readings go then, I'm not sure how I should correct. I'm told to correct, with 1 unit, for every 50mg/dl over my target BG reading. I use the Freestyle Lite meter. I want to target 150 as my range for now, but I'm not sure how accurate the test strips are. I've been testing from two different sets of test strips, same brand for my meter and get different readings. For instance, this morning I tested with one and my reading was, 195. I tested with the other strips and my reading was, 219. Slightly off, but still one unit more of Novolog, can cause Hypoglycemia.

Weight lifting, never seems to be an issue for me. Neither has running, that's why I believe it had something with heat exhaustion and/or dehydration. Me associating everything to a low blood sugar, is not a good thing either.

15

When I did shots, I would often adjust with the meniscus on the syringe barrel. If I needed more insulin (using the 219, or maybe splitting the difference and using 207...), I'd pull it up, so the bottom of the plunger was on the line, putting the curved "meniscus" above the line and a bit more insulin. When I was lower (say using the 195...), I'd put the "ring" of the plunger on the line, which would put a bit less insulin.

The thing that a pump showed is is what a large difference a very small amount of insulin will make. Recently, I tried to go from .8U/ hour basal (most of the time...) to .775U/ hour, not a huge difference, .6U/ day but, instead of hanging out in the 80s, my fasting BG ran higher, slightly > 100 so I put it back. It's always a trade-off between highs and lows with some of those numbers.

16

I take my Lantus, long lasting insulin, everyday at 1 P.M. Once the insulin is in my system, I have no way of omitting it {as you meay already know :)}. I'm eager to go back out and run and try it again. I really want to say it was dehydration, from my high blood sugar, or heat exhaustion.

17

Guitarnut:

Yes! I think that's what it was. I was alost cramping up. I was testing my sugars and the reads were pretty good, I would say. I'm just paranoid of the consequences that can come from a hypoglycemic episode, that I just relate EVERYTHING to a low blood sugar. Probably not the best thing to do, mentally and physically.

18

Nicole:

Thank you soo much! You are right, I do feel the strain on my eyes when I'm very high and working out. It almost makes me look like I'm stoned or something. The heat definite depletes me and makes me feel weak. When I ride my motorcycle in the hot Summer days of Chicago, I feel like I'm about to have a hypoglycemic episode. When I checck I'm usually around 220 or lower, not good I know.

I need to get my sugars stablized better and just eat/drink during my runs. Weight lifting and Plyometrics haven't really been an issue for me. Neither has running, up until this episode, which I truly belive was heat exhaustion/dehydration. The mind definitely plays tricks on you. I also like to "push" myself and see how long I can go without depending on Carbs, because I hate being dependent. I understand that's a stupid outlook to have, and if I'm bringing the Gatorade/Carb with me, I might as well use it.

Thank you very much! It feels great to know other people have experienced a similar situation and have overcome the situation.

Regards,

Lorenzo

19

Lisa:

That is a good suggestiong. Acidrock, below, states its called, Continuous Glucose Monitor.

I am the same way. Once an episode occurs, it takes me weeks to recover and have a confident mindset. It gets to the point that, I'll carry a Gatorade EVERYWHERE I go, so I have that "Sense of security," to treat a low blood sugar.

I'll never stop running, that is just not an option, I love it too much; it should be doing me more good, than bad.

I really want to blame this episode on lack of water/dehydration, due to high blood sugars and heat exhaustion. I'm a very active person. Somedays I'll weight lift and go play a 40 minute football (soccer) match, just eating a Snickers bar. Other times I've ran 9 miles, in cooler climates, being around 300 for a BG reading, and made it home at 90, without drinking or eating any carbs.

It's crazy...

I need to get the confidence back, and get my butt running again.

I appreciate your help! Slowly, but surely, we'll get everything back on track :D

Lorenzo

20

AcidRock:

That's crazy, that you can be at 39, eat smarties and keep going. When I'm at 39, the last thing I'm thinking about is working out, LOL. I know it can be done, I just need to pay more attention to it. I need to start by drinking more water than I do, being in such high BG levels dehydrates me as is, then a run...yeah not a good look.

So, aiming for 120 is a better target you're saying?

Also, after your runs, do you feel a difference in your body/brain, kind of like you're low, but not really? Or is that the after affect from the endorphins released, due to the workout?

Lorenzo