Take Me Through Your Marathon..Please

Ok, Here’s the deal. I’m running my first and maybe only marathon in 14 weeks. I’ve done the beginning marathon runner’s plan from runners world…oh I think 4 times…each time I had a different excuse for why I didn’t do the actual run.
About 8 months ago I ran my first half marathon and it went something like this:
Woke up felt great. Ate a little.
Opted not to take the lantus (long acting insulin) because I didn’t want to get too low.
Started the race around 230 mg/dl.
Expected it to go down some throughout the race, but it never did. Therefore, drank just water at the water stations and skipped gatorade.
Race was hot and hilly.
Finished the race at snails pace in 2:45mins. Half Marathon.
Threw up, probably 4 times, in the trash can.
Cooled off, blood sugar was still 230’s but ate a banana anyway and snapped out of it.

I’ve been running for a while now, and have been doing well on the training program. I was just wondering if any other T1’s have trouble with feeling nausious when doing the distance. I usually feel that way after about 10 miles but have been feeling much better with better training…

If you have a marathon story can you tell me about it?
If you get nausious like me what do you do about it?

My simplest advice is take more insulin. You were starting with your blood sugar way too high, but insulin isn’t just to keep your blood sugar in range. Insulin gets nourishment into your cells.
Do you always keep your blood sugar over 200 when you run? You’re not helping yourself if you do.
Concerning marathon stories, I’ve run lots of races and fun runs from 5K to 50 miles, and there are some accounts of them on my blog:
Probably better than that, on the right side of my blog you’ll see a section title Infusion Sites. This lists the blogs of dozens of other diabetics, mostly endurance athletes.
One of the best blogs for advice belongs to a type 1 diabetic marathoner and ultra-marathoner, Missy Foy:

I usually start the day before, eat a larger than usual lunch and skip dinner. Before the 1/2s I’ve run, I had some social stuff and drank a couple of beers but that’s about it the night before. Breakfast= toast. I avoid eating a lot. Jeff Galloway’s running books suggest this, as it takes the port-a-potties out of the equation. It also seems to be a decent way to get my BG stable, although I have a pump?

1/2 marathon#1 was in a forest preserve, about 300 people, really nice day for a race, mid-30s when we started but bright, clear skies. I had about an hour trip to get there and was all set to go when I got out of the car. The crowd was pretty fast as the organizer (my aunt…) runs ultramarathons. This one was about a week after I got the CGM. I got the hang of it but the tape, the IV3000 stuff MM gives you with it, fell off, followed shortly thereafter by the sensor which I was fortunate enough to get before it fell off. No data but I just kept running. It was very peaceful to just run through the woods. It was an out and back but the crowd coming back were running pretty fast. There were quite a few hills towards the end but, at the top of the last one, you could smell the burgers they had going on the grill!! It was in the 50s by then and a nice downhill jog. I don’t recall any BG issues. Unfortunately, I don’t recall any diabetes stuff at all from that race.

1/2 #2 was two weeks later and was about 14000 people in Champaign, IL, where we’d moved from the previous year. I’d been there about 30 years to the route was really a walk down memory lane. I did the same ‘no dinner’ plan which worked ok, woke up 90 or so, ate a piece of toast w/ a partial bolus and then noted BG of like 100 about an hour before showtime so I drank a small glass of OJ. I’d acquired some stickier tape so CGM was working and, about 2 miles into the race, of course, it was showing 160 so I was getting nervous so I just did a CB to the 160# (although it may have been higher, as the CGM typically lags behind?) and cut it to maybe 1/2 or 2/3 the dose (sorry I don’t remember). It drifted down to 120ish a couple miles later and pretty much stayed there the rest of the race.

Except for the fast/ forest preserve race, I’ve run a few 5K too and there are always people puking. I have not checked to see if they have diabetes but I’d think not? I suspect that it may be eating the night before, the whole “pasta feed” tradition and people getting carried away with that and eating more than they need? I’m not quite sure how I’d approach MDI and a race though. I switched from R/N to a pump and find that pretty handy for running.

Did you check your BG in the race? I did that in 1/2 #1, since the CGM failed and it wasn’t that big of a deal. One lady who was about 60 (but wearing an Ironman shirt…) ran by and yelled ‘keep going’ when I slowed to a walk to test once but I SMOKED her at the end, when I smelled the burgers! LOL. And thanked her for keeping me going, of course! I would think that it would be useful to have some lantus on board so you could hit some or even all of the gatorade stops? Even people w/o diabetes need carbs and the puking might be from not being able to have any if your BG is high? It might be useful to do like a 50% dose and see how that goes? What do you do on your training runs?

I’ve only done 1/2 marathons (7 so far), so I can’t really talk about doing the full distance. I usually start the 1/2 in the low 200s also, however, I take my usual dose of Lantus and a unit or two of Humalog (rather than the usual 5-6). I have water at most stops but do a couple gulps of gatorade around mile 10 (or if I feel low at any point). I usually end up in the mid- to upper 100s, but have never been nauseous. (My problem comes with all the food at the end of the race, which I obviously wouldn’t need…but it always seems like a good idea at the time.) You probably do need a bit more insulin, but carry something with you (Gu, etc.) just in case. If you’re doing better with training, the nausea might have been more related to that than blood sugar. I’m sure you’re testing before and after your training runs, so you’ll probably be able to figure out what works best for you as far as starting BS as you work on it. It’s always been a bit of a struggle for me, too. Good luck!!!

I agree with Jerry and as a proud member of Jerry’s “Infusion Sites” you can read about my experiences at http://www.runningwitht1.com Most recently I ran the Memphis Marathon and wrote a long race report about it including details about how I managed my diabetes and also a big lesson I learned after the race.

2 things. You need insulin and there is no reason to not run with your BG in the 100s.

If you have insulin in your system, you will be able to take on the necessary nutrition during longer events. Your race was hot and hilly, so water alone was probably not good enough for you. I’d guess you were dehydrated resulting in throwing up. NOT good. :wink:

Best of luck to you. You can do it!

Thanks for the blog! I am enjoying the Memphis Marathon narrative a lot, perhaps so much because the diabetes section is sort of an afterthought, or at least at the end? Sure it’s there the whole way but the stuff like ‘ducking’ into the Peabody, the short grades coming out of underpasses and having your wife give you a boost at the end all are great things to read about, basically a ‘normal’ sort of marathon experience? We ran the same w/ some friends of ours who did Chicago and were running out of gas mile 23 or thereabouts? That was a couple of years ago, before I started running as regularly, but was fun to have done. Perhaps more fun for us though?

I’m also very pleased to see your review of the Kinvaras. I just got a pair of them a week ago, took them for a 6 mile test run (also trying to transition the midfoot/ Chi Running style…) and thought they were fantastic but wore my old (250 miles…) Gel Kayonos for a planned 10 mile run and rolled my ankle cutting through a yard so I will have to give them a rest for a few days.

Whoa, I think you’re replying to Gary.
You like his blog so much you’re making me jealous.

I hope I don’t get as lost in the next race I run! Thank you both for the interesting blogs. I find your review of the Revel highly entertaining as well, particularly the comments about the Revel’s ‘advantages’ LOL.

You are both running in Carlsbad it looks like? Have fun @ the race. I am visiting my in-laws there in March so I will get in some nice hill running before my next race in April. Being in Illinois, the hills there are like mountains!

It’s easy to get Jerry and myself confused. I’ll be running my 3rd and Jerry will be on 51 (or is it 52 now?). :wink:

Thanks for the kind words.

Since you asked, it depends on whether you count an ultramarathon as a marathon. I’ve done 51 marathons and 5 ultramarathons.
So maybe it’s 56.
Of course, I’ve done some non-race runs that were over 26.2 miles. Those don’t count, do they?

I think you have to count them or your BG gets all out of whack?

I appreciate all of the time spent on responses. I need all of them. The running has been going well. Last weekend the program called for 9 miles which I ran in 96 minutes. I was trying to hit 10 minute miles, but for me, 10:34 is still pretty good. This included a couple of stops at around 6 miles, and somewhere around 7.5 miles. On the nine miles I started out at around 239, which was higher than where I wanted to start. 30 mins into the run I was about 160, and after reading some of missyfoy’s training blogs I thought I should start putting some calories in before it got too low. I ate 100 calories of wal mart fruit smiley’s. that seemed to work pretty well as I was below 100 by the time I hit 60 minutes. At the 60 minute mark I ate 200 more calories(2 packs of Smiley’s) and that got me through to the end.

I have a 12 miler this weekend. My plan is to start a little lower and take some calories with water every 30 minutes. Any thoughts? Thanks again.

Thank you so much for your post. I’ve been a runner for 15 years now and have the desire to run a half marathon. I am looking forward to looking at your blog. Knowing that you have completed races like this is such an encouragement to me with diabetes.