Long Distance Running

Healthy Living Physical Activity
21

Well, I was 2 miles from home. I have a straight job that pretty much kills weekdays for long runs so the weekends are "it". At that time, I'd signed up for two 1/2s and felt like I was ready to go farther. But I screwed around that AM, ate some cereal right before I left to "cover" the IOB (with FOB...) and hit the road. The insulin hit first and I ran low but, in addition to the Smarties and sprinting, I figured the food would come on at some point which turned out to be the case.

I've found 120 is a good spot to run at. Not high enough to be damaging but a 40-50 point margin before you're dangerously low, once you get to the point where you know how many carbs to take how often to balance it. I'd guess from the parts of your post where you are having a salad and fries at 195 or the sandwich at 343 that you don't run down to 120 that much but maybe that was just on freakyworkoutday or something. I want my no exercise BG to be flat and then just add enough sugar to fuel the exercise, as if I were a "straight" athlete, not dealing with this garbage but fueling to perform or after lifting w/ protein or whatever other things people like to do.

I have good runs and bad runs but the good runs feel really awesome, like drugs or something. I've run a 23:17 5K, 49 minute (training run but times w/ my Garmin...) 10K and a couple of sub 2 hour 1/2 marathons, all of which paces, I feel like I'm "running" rather than jogging, which I'm doing in a 4:38 marathon. All at 40+ years old, really all in the last couple of years, 44/45. That running buzz is what I'm after and I feel better trying to hit it with decent BG and all of that. Small hits of carbs to keep it flat. For a 5K, I don't worry about it but the longer distances, I bring stuff along. The running group I run with is very adamant that "everyone must bring hydration" and they recommend that you bring some sort of fuel as it pushes out to 14-16-18-20 milers. I don't think there's anybody who doesn't bring anything but there's people who run with interesting fuel solutions in the crowd, one girl had bacon, another guy ran his leg of the Ragnar Race with peanut butter sandwiches in his pockets.

22

I'm not seeing any lows at all, in fact only highs...every time I'm high a feel like i'm burning up, sweat and feel awful. it's one of my triggers, symptoms of my blood sugars rising high. I'm sometimes more uncomfortable high then low. Yes, if you're used to being high all the time then normal is going to feel low but please work on your numbers so you body can and will adjust to healthy blood sugars. It sounds like you were just downing gatorade w/out testing and pushing your blood sugars up?

23

also, many diabetics get cramping, it's the fluctuation in our blood sugars, i get them when i go from high to low or stay high too long (also we can get neuropathy symptoms that will subside once BG's are normalized). also happens when our blood sugars are adjusting, especially when newly diagnosed. it's the muscles, responding to the high glucose levels.

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25

AcidRock:

So, you feel comfortable at 120, maybe I should try 140 and see how that goes. I just feel I would pass out if I don't run with a higher BG, but that's probably, because I run and do not use any of the Gatorade, unless I feel I "need" it. If you can run that many miles, keeping your BG at 120, that's what I want to do. The only thing is, I take the Lantus and do not have a pump, so I think that can cause some issues. Even still, I know there's people that run with T1, take injections, and still manage to be alright after long runs. Like I said, this was my first "episode" when running, and to associate it with a low BG could be wrong, since I was at 180-212 every time I tested. Unless, my meter was incorrect.

You sound like, what I want to be. Having that control and still be active is great! I'll need to look into those books and hopefully my Diabetes Coach can help as well. I appreciate all your input, sir!

26

Sarah:

I feel the same sometimes. If I'm at 170 or higher, I feel "Great!" Anything over 220, might make me feel sick.

So, are you blood sugars under control? I know mine are not, and I need to improve them. My A1c's have improved from my last doctors visit though.

Actually no, I was testing during this "episode." I tested 177 once, 180 another time, and 212 a third time. When I got home after all that and showered, my BG was, 343.

27

It may also just be the mileage and all that. It's always fun to run with people when it's time for the 14 mile run, which is farther than all of the people who've run a 1/2 before have run and we all get jazzed up about it. And then run the last mile.

I agree the lantus would make it considerably harder. I don't think I've ever started running a long run and not had my basal cut although on some of them, if my BG gets up for one reason or another, I'll kill the cut and go back to 100% until it comes around again. Chicago 2012, I did a lot of extra insulin as I was trending down at the start, ate a couple of Luna bars I got somewhere, was still trending down at 3 miles so I had some Gatorade and then it blew up for the next couple of hours so no more food. Not according to plan but it went ok, I ran with a group, saw a bunch of people watching, etc. Training can be a bit grimmer, without the spectacle of a large race but BGwise, I think that in general, having a goal of normal BG is a good plan that people should try.

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So basically, I need to start at a BG within the hundreds. Bring plenty of carbs and actually use them while I'm on my runs, since being in the two-hundreds is not helping anything. I'm still thinking the Lantus is at a good dose, since the readings were still pretty high, when I was testing on my run. It had to be a lack of water, the heat, and my high blood sugar. I just associated the feeling to a low BG, when it reality, my mind was just playing tricks on me.

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Super Sally:

I guess, I really don't know. My doctor told me to use the 1 unite for every 50 mg/dl over 120. A New doctor, who is diabetic himself, told me to use 1 unit for every 100 mg/dl at bed time. I feel that both have work, but really the 50 mg/dl has given me better results.

I definitely need to target a better BG, becuase I don't want to live like this. God willing, I will have a longer life to live, and I don't want to complicate it.

I'm a coffee drinker, I've read coffee doesn't really impact BG levels, but in T2 Diabetics it can, do you think that can throw off my levels as well?

I use to have A1c's of 6.2, now they're at 7.4, which is better than the 7.8 they were at. I definitely have to put in work. I just hope to get over this hump, again, to so I can start running.

I appreciate your help!

Lorenzo

30

Super Sally:

I guess I need to control my BG first, before I work out with BG levels of, 90-120. I'm used to being high, normally < 200, that I feel shakey when I'm normal.

You're not on the pump, correct? I doubt that my Lantus (long lasting insulin) could bring me down that much, especially if I'm taking the carbs, while I exercise.

I guess I had a "system" that worked, but really it didn't, because I was exercising with BG's greater than 220.

The mental part is a difficult factor, and one I need to get over quickly.

Thanks again! Your advice is great!

Lorenzo

31

Lorenzo,

Did you actually go really low at all during all of this because all the bg you mentioned are high...? It seems your bg is way too high? Not good. I don't run at all, I stopped years ago due to knee pain. I really don't do any exercise that is too strenuous due to chronic pain, just walking, gardening, and various other things.. I am active though, as much as possible. I just think you should get back to normal ranges before exercise and then eat what you need to keep you going... going to the 300's is bad I think. I know what you mean about being afraid of lows, I have been so careful about lows lately to the point of over treating and ending up way too high after, but it's better than passing out imo. Maybe if you have a severe low running when you're in normal range then you just shouldn't run, but walk instead?

32

Sally:

Yes, the coffee a drink is only "sweetened" with Splenda.

I did start with 30 units of Lantus, but as left the hospital and became more active, I had that reduced to 25 unts; the dosage has been working. The correction factor was given to me by my doctor. It's worked for me, so I haven't really tested it on my own...I should now though. So, would mid-day be more of a problem, because we are more active?

I followed you all the up to 7.4. What is this number and how did you come up with it, and the rest of: 185 = 7.4 x 35.5 - 77.3?

You know, I've been hearing that a lot, splitting up the dosage two times a day. I usually take it around 1, after lunch. Sometimes, by 4 o'clock I will experience a low. Not all the time, but at times. I wonder if splitting this up would be of any help.

33

Meee:

Yes, I don't think I ever experienced a low. Every time I tested, I was within range. It could of been anxiety and my mind playing tricks on me, along with the heat and lack of hydration. It's never been an issue in the past. I play soccer for the last 4 years, indoor and outdoor, since diagnosed, I run and never had an issue. I don't think I had an issue of low blood sugar, but whatever it was, it caused me to think I did. I love running and being active, Diabetes should not be the reason to stop running, you know. I figure I'm capable, physically, to run, so I will run until I cannot anymore. I've told myself, "If life took running away from me, it would kill me." The peace I get from running is great. When I experience an episode like this...not so great. Slow and steady, I'm sure I'll get back out there.

Thank You,

Lorenzo

34

Super Sally:

I did start off with 30 unints of Lantus. As I became more active, I felt that was too much. I lowered the dosage to, 25 units and that has seemed to work for me.

The thing that gets me is, I've never had an episode until this one, and I still don't believe this episode was from a low blood sugar. Reading everything people are telling me though, is making me feel like I've been doing everything wrong. I never thought being at 240 and eating a banana was a "bad" thing, since I would need the energy on my run. I've been on a run after testing at 220 and eating a serving of oatmeal, no insulin taken. Gone on my run, 6 miles, and returned home, testing at 90 mg/dl.

To put things into perspective, I've been that high, ran what I've have (6 miles), and made it home fine. I can't imagine being at 120 mg/dl and drinking a Gatorade along the way, will prevent me from crashing. I run with a backpack, packed lightly: Two water bottles (17oz) and two Gatorade (20oz) bottles.

I'm still confused on why eating carbs before a run, without any Insulin would be bad. Someone told me that, working out at a starting range of 150-250 was an old methodology of exercising for Diabetics. I under a normal BG should be my goal everyday, but when it comes to working out, being around 200 doesn't seem to be a "bad" thing, since you'll be burning that off with the workout.

When I go out on my motorcycle, or if I know I'll be out for awhile, with a gap before my next meal, I try to stay less than 200 mg/dl, to avoid a low from, riding, walking and whatever minimal activity comes from the day/sun. I feel I get depleted soo quickly in the hotter days.

I love your analogy, it is soo true. I've had these tools for alomost 4 years. Everything I've been doing, now, makes me feel I need to go back to basics.

Thank You,

Lorenzo

35

Don't worry so much about "right" and "wrong" or "good" and "bad". I am a total outlier so my advice would probably not be recommended by the AMA or ADA or AADE or most people *however* I've been able to run a lot and maintain a "passing" A1C, that comes up as "normal" according to the lab for a few years now. If my BG is much over 100 and I'm not running, I'll fix it. I keep an eye on it on my CGM and if it's 120-121-122, I don't look at it as a big deal but, if I see a 120-130 and am just running, no insulin on board, got carried away on the gatorade or whatever, I'd consider a small correction bolus, like 1/3 the amt I'd usually have. I usually use .3U boluses out of the pump, figuring about 10G/ overage to make my BG rise while running. It's harder to do that on MDI, I usually have my pump rigged so I don't have to stop to mess around with it which is very handy.

In your scenario, you're running for 6 miles. If I were calculating that, I'd want about 20G of carbs to "fuel" that type of run so a bowl of oatmeal would be about 7G too many. Not a huge amount but, if you start @ 200, eat the oatmeal, you may drag a bit on the run, since oatmeal can take a couple of hours to "deploy" and then run high when it all starts pushing your BG up after you run. The 200 to 90 scenario can work, if you get it just right, but from your original scenario, the one with which you started the thread, it seems like you're running higher than you need to. If you can find your "balance point", where you know and have a good degree of confidence that you're nailing your fuel/exercise very precisely, I think that you'll be able to enjoy running a lot more.

When I started, I had 2x gatorade bottles, one w/ 45G of carbs (I used the powder to make my own, it's also quite a bit cheaper...) and one with about 12G. I noticed I'd run high and, after bunches of runs, came up with 8-10G for me being very close to flat. Your number may be different but I'd bet it is probably a bit closer to mine than oatmeal plus gatorade and no insulin sort of scenario.

"Think Like a Pancreas" by Gary Scheiner, "Your Diabetes Science Experiment" by Ginger Viera and "Using Insulin" by John Walsh and Ruth Roberts are all books that address this. I haven't read any of them for a couple of years but their solution for preworkout eating is to cut the bolus and take maybe 1/3-2/3 the amount you'd take, depending on how long you're planning to go for. They have charts that will allow you to figure it out and may shortcut a lot of the guesswork and allow you to get on target more quickly than if you have to come up with your own methodology for experimentation.

Also, if you're in Mundelein, IL, we haven't had any really hot days all summer, compared to the last couple of years! hee hee!

36

Sally:

Ahh, I follow you now.

I might have to try that because today, I took my lantus and ate at 1:00 P.M. I waited until 5:00 P.M. I tested and read at 351. I took 4 untis, 1 = 50 dg/dl, so I would be around 151, still not at "normal." I tested at 6:00 P.M., because I felt the sweats and what not. My BG came back at 132, way too low for just an hours worth. I figured I was going to keep dropping. I tested again 5 minutes later and was at 127. I tested 15 minutes later and was at 122. I ate a little bit of of a pastry, waited 15 minutes and tested at 120. I ate a little more and waited to test again. I was already an hour and 45 minutes into my correction dose, when I felt the signs of me dropping. I didn't test, panicked, and drank Gatorade and ate another piece of the pastry. Tested after and was at 145. Waited 15 minutes and went to 170. At this point I knew I over corrected. I tested again about 2 hours after my correction dose and came up with a BG of 208. I got on my motorcycle went to the mall, walked around, tested before I left; read 308. Got home and relaxed, feeling down and out, because I've been having a bad week and half with my sugars. Tested again and read 245, 260, and 271, all within minutes of each other.

Can you help on this? Is my correction factor off? I tried the experiment today, but it just dropped way too low much in an hour time.

I have no explanation for this whatsoever. I need help.

Regards,

Lorenzo

37

Acid Rock:

Yeah, I guess I feel really comfortable being around 200 eating a banana and drinking Gatorade along the way, or being around 200 eating the oatmeal and maybe taking a a swig or two of the Gatorade.

I know, we've definitely been a lot cooler than years past, and I've also ran in those hotter days, and never had an issue. I'm not sure why this episode occurred. It sucks because this one episode will mess me up for weeks. I thought I had a handle on this disease, but I guess not. I need to look into one of those books and see what I can find. I guess I didn't think it was complicated. If you're going to be active eat enough and within a half hour, so your body can burn up the energy and do not correct until afterwards, if needed. Not so easy I guess...

Regards,

Lorenzo

38

I don't think you have to stop running and I hope you figure out a way to do it. What I don't get is why eat a banana if you're 243, why not just run? And then keep drinking gatorade when you're not hypo.. have you ever gone really hypo when running, is that why you're scared? I have had some bad hypos and I certainly understand the fear of that, but I would never eat a high carb food when my bg was that high. Above 140 your body is being damaged.

39

I read through the recent SuperSally Juice21 exchange which, being a bit "backfilled" in the thread is cut off. Re the scenario that Juice posted: " I waited until 5:00 P.M. I tested and read at 351. I took 4 untis, 1 = 50 dg/dl, so I would be around 151, still not at "normal." I tested at 6:00 P.M., because I felt the sweats and what not. My BG came back at 132, way too low for just an hours worth. I figured I was going to keep dropping. I tested again 5 minutes later and was at 127. I tested 15 minutes later and was at 122. I ate a little bit of of a pastry, waited 15 minutes and tested at 120. I ate a little more and waited to test again. I was already an hour and 45 minutes into my correction dose, when I felt the signs of me dropping. I didn't test, panicked, and drank Gatorade and ate another piece of the pastry. Tested after and was at 145. Waited 15 minutes and went to 170. At this point I knew I over corrected. I tested again about 2 hours after my correction dose and came up with a BG of 208. I got on my motorcycle went to the mall, walked around, tested before I left; read 308. Got home and relaxed, feeling down and out, because I've been having a bad week and half with my sugars. Tested again and read 245, 260, and 271, all within minutes of each other."

To me, the key point is when you hit the 127-122-120 bit, perhaps 1:20 to 1:30 after bolusing. If I see a 127-122-120, the thing I'm looking at is both the BG reading and the "delta" or change in the reading and, if the change is diminishing (eg 7-5-5-2) I sort of conceive it as the altimeter of an airplane that's getting closer to the ground but might not hit it. I agree with Sally that a good place to start would be something involving some protein, perhaps earlier on in the scenario, might give you a softer "landing.". I'm not a total stickler for eating clean (ha ha) but having stuff like "pastry" lying around might not be the best idea when you are trying to get a leash on diabetes. My daughter has stopped eating crap (amazingly, at 14...) so we hardly ever have any around any more. When I run low, I often think "geez, I wish we had some cookies or something that'd stick with me a bit more" but, in the end, I'm better off to just fix the lows with something that's a bit less loaded with carbs and faster acting. If I feel the need to feel hungry, I eat some cheese or something like that. I treat a lot of lows w/ skim milk because it's pretty soft, works quickly and has protein in it.

The other thing I agree with Sally about is that reading the books that have been recommended would be ***immensely*** helpful for you Juice21! Your account seems to involve overriding the meter because of feelings and then ending up sky high. This isn't necessarily "bad" as you have a great description of the timing, numbers, lots of tests, etc. but it will help if you can get to a place where the doses are set precisely enough that you have confidence they will do what you want them to. A quick scan of Barnes and Noble shows that "Think Like a Pancreas" is in stock at the Barnes and Noble in Skokie, IL or is available for a Nook (although this is a good book to take notes on, use post-its, etc...). LINK Ginger Vieira's "Your Diabetes Science Experiment" is at Amazon for a kindle or delivery as quick as you want it. She wrote another book called "Emotional Eating With Diabetes" which may also be interesting reading for you and, of course, amazon has a "buy both" deal. It's a nice day here in Chicago, take a trip or a download and get a solution. We can do pretty well here but the sort of things in those books, e.g. the rule of 1500 or 1800 to calculate sensitivity, etc. that will help you learn what to do.

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Meee:

The reason why I eat when I'm that high is, because of past experiences. I can eat a banana being that high and make it home in the range of 70-90, without taking any carbs along the run. It's not like I eat all that, after a high BG, an make it home still in the 200's. I drop a lot. That's why I figured I was doing this exercise thing correctly.

Lorenzo