Running longer distances and type 1

hi, ive got a questions for people who run long distances.

the last year or so i have had the same niggling injury and so after seeing this racing techniques course by my park i decided to join, thinking that having a running coach with education in physiology and who knows all about training would be able to help me focus on staying uninjured.

i have learned so much from my coach, different ways of training, doing intervals and fartlek and all these things id never done before. i used to just run a nice long slow pace every other day. i got injured every other month, more or less.

anyway, im considering running a 10k and would like to aim for a half if i can. today i ran a 7k race in 33 minutes and felt awesome. i started at about 160 bg and finished at 112, which i thought was pretty good. i had an egg and sausage and a slice of toast for brekkie about 2 hours before the start of the race.

my questions are:
if you run longer, like 10 or 15 k, do you pull off to the side and test in the middle of the race or do you just eat/drink a bit without testing?
do you have a certain amount of carbs that you ingest per km or 5km?
do you lower your basal that morning or do you do it that evening to avoid lows the night ofter the race? i am on mdi so id appreciate insight with regards to that.
i think i finished with pretty good bg. what bg do you aim to start and finish with?
i had a couple of gulps of the gatorade type drink afterwards and was able to walk my 3km home as a cooldown with that (i thinks about 6gr) and 2.5gr of carbs in the form of a chocolate square.


and also, if you feel low/are low, do you actually STOP running and just walk, or stop completely, which is what i was always told to do?

I run 4-8 miles 2-3 times a week, mostly on the beach, often at lower tide when the sand is firmer but also at high tide in soft sand, with a pace varying between 8 and 10/min miles (the latter in softer sand, which really slows things down).

I find that if I go in the morning, before eating anything or injecting bolus insulin, my BGs will stay level or elevate a little, and I don't have to worry about them. I just started on a pump, and while I've been leaving it at home, my BGs get a little higher than I'd like so I will probably start taking it so I can continue pumping basal insulin.

At other times in the day, I suspend my basal insulin about two hours in advance (am still tweaking this), am very careful to have as little bolus insulin still on board as possible, and use fast-acting carbs as needed. I find that if I have food still digesting and insulin on board, the run dramatically slows down the digestion process and dramatically speeds up the insulin absorption process, so that's a recipe for getting low. I've had endos and others recommend that I eat a small amount and bolus at 50 percent before a run, but that's still a recipe for going low for me. But I should note that I still make a little endogenous basal insulin, if I'm trekking or alpine climbing or the like I can actually go off insulin almost entirely. I generally test at certain intervals, like after 45 minutes, or if I feel low, and try to keep my BGs a little elevated, e.g. ~130 mg/dl, as a buffer. I had an older Dexcom Seven+, and I found it was too inaccurate and prone to "???" loss of readings during exercise, though I'm hoping the new G4 I should get soon will be better.

Is it safe to assume, based on the workout regimen you just described, that your profile picture is not actually you?

Ha, that does seem like a safe assumption! My profile pic is Leonid Brezhnev, the former General Secretary of the Soviet Union from the mid-60s to early 80s. I've always liked the idea that when the President in Washington picked up the red phone, Brezhnev might be chilling on the other end like that. :)

Eventually I'll probably post an actual photo, but for now I'm happy to stay more anonymous, not so much with regard to this community, but with regard to others who might come across the stuff I post. I'm not shy about being diabetic, but also not eager to be defined by it.

Relatedly, it's been interesting switching to a pump recently, because while lots of people saw me test or inject before, and would have lots of questions, now it feels like a much higher percentage of people notice the pump, and have questions, or at least make facial expressions that suggest interest/confusion. So these days I do feel a little more defined by the diabetes, and if it were up to me I wouldn't have quite so many diabetes 101 conversations, though I do also enjoy those to a point, and it's a good opportunity for public education.

Wow, I can relate to that sentiment so much. I started out on here with a profile that even contained my last name-- and my real picture. As I reached more and more career milestones I realized I was entering a stage of life where people I encounter in my professional life might actually consider googling my name to see what they could learn about me. The thousands of posts I’ve made on a diabetes forum weren’t what I wanted leaping to the top of the list of digital cyber content about me, so I toned it down to just my first name. Like you, not ashamed… But at this point in my life id rather the rest of the world knows me as Sam the highly regarded professional in my field than Sam the diabetic

Yep, we're on the same page. I was about to make a comment on your nautical stuff, but I see you've just edited that out. What I was going to say was that I'm an amateur sailor. It's actually been interesting to manage my BGs, because races entail a mix of relatively little activity with short bursts of incredibly intense activity, often associated with lots of adrenaline. And it's a very wet environment, so BG testing is a stretch, and even wetness aside, not really feasible during a race. And if you want me to edit out the nautical reference, just say so within the next 15 minutes. :)

Nah you do t have to and I’ve mentioned it a number of times on this forum. I’m an unlimited master mariner and ship pilot-- I just don’t care for that and D… To appear in the same paragraph for the benefits of Google users the world over.

Very cool, must be amazing to be in charge of a massive vessel. The boat on which I race is 30 feet long. :)

Thanks… I know what you mean about the diabetes 101 conversations. A lot of people on this forum seem to enjoy or perhaps feel some responsibility to take advantage of them to correct people’s misconceptions— I know I certainly had plenty of misconceptions 5 years ago… But I’m not so open about the subject-- I only offer information to those who I 1) care what they think. And 2) are interested to learn about the subject. Otherwise my life is just easier and simpler to keep it to myself-- except on a forum like this where we all have some common interests and understandings

haha, yes, but she does run with me sometimes! shes way faster!

oh right, that was for niccolo!


Thanks niccolo. i also make some insulin. i eat low carbish and i normally only use levemir, saving my apidra for only some meals.

Interesting. I find my marginal insulin production impairs my phase 1 postprandial response the most (i.e. my body has trouble surging insulin for a meal), so if I had to choose I'd probably take fast-acting bolus insulin over basal insulin. But I eat a low to moderate carb diet, if I were more severely carb-restricted I could get away with less bolus insulin.

Yeah I used to think that as well… I agree with your thought process completely about impaired phase 1. But if I had to chose one or the other I think that basal would keep the vast majority of us alive a lot longer than bolus-- especially if you still have a natural tendency, albeit weakened, to return to natural levels. A year ago I’d have agreed to take bonus instead; now, I’d take basal for sure and prevent spikes as much as possible with diet if I had to choose one or other

Yep, don't necessarily disagree, and the natural progression is to start on a basal insulin and then add a bolus one. In my case, I was diagnosed with a pre-diabetic fasting BG but a solidly diabetic OGTT, but I was still first put on basal insulin before adding bolus.

If the zombie invasion started and I had to live without insulin, I still have enough endogenous production that I think I'd do okay as long as I ate low-carb and was very active. In fact, during intense outdoor adventures, I go fully off basal and bolus insulin with the exception of some basal to cover dinner. I learned that the hard way, I remember my first major climbing trip after being diagnosed, I tried just cutting my basal by 50 percent, and I had an epic day on a glacier, in a white-out snowstorm, repeatedly going seriously low and eating almost all the fast-acting carbs I'd brought for a week of climbing. In retrospect I'm pretty lucky to have made it through that. Photo of that glacier attached for fun...note that this is July :)

421-Aletsch.jpg (27.7 KB)

Different paths to the same conclusion. I was diagnosed with fasting levels at 400+. Have no idea how long it had been that way, though my a1c of 11+ at the time would seem to indicate an average level of 300 or so… So logic would dictate I likely hadn’t spent that many weeks I’m the 400++ territory. After getting my act together I went without basal, but with meal bolus by and large for about 2 years Now I tske 8-10u of lantus daily… But I think that if I ran in deep sand as much as you I could probably do without also. I’ve actually found that for me, basal seems to noticeably increase the remaining ability I have to return to normsal levels. I can eat s lot of foods without bolus-- but any significant carbs fro, grain, fruit, or legume origin requires substantial bolus for me

Sorry for all the typos-- using iPad/ iPhone and this page is unfriendly to them

Ps you will need s better glacier than thst to impress me! I can see 5 of them from my living room!:wink:

Wow, I'm surprised you initially went without basal with numbers like that! Honestly, intense exercise 2-4 times a week for an hour or two doesn't really substitute for insulin for me, it's only when I'm doing it all day long, on some outdoor trip, that I can genuinely go off most of my insulin.

You're taking pretty small doses of insulin, you may find a pump helpful, allows very fine-grained calibration. I held out for years, to be perfectly honest a big part of it was not wanting to be a single guy tethered to a medical device, so I thought I'd wait till I was settled in a really serious relationship. But I finally took the plunge, even if Mrs Right hasn't come along quite yet :), and I couldn't be happier with my new t:slim. It just gives me a level of control that's an order of magnitude different. And before this I was the guy explaining how great my MDI regimen was and how I didn't need a pump. :)

Apparently my reply went to private message. Stupid ipad.