“Shall I just stick your needle in you if you go a bit funny”, friends often ask. As a Type 1 diabetic, the needle would have insulin in it and the answer to the question is an emphatic NO!
I would be amazed by the lack of public knowledge about diabetes had I known anything about it before I was diagnosed in 1999. Sadly, I didn’t.
I know a bit more now though. Insulin is used to regulate blood sugar. Type 1 diabetics don’t produce insulin for themselves and thus their blood sugar is abnormally high. This is dangerous, with long-term life threatening dangers if it is not balanced. Hence the use of needles to inject insulin.
However, in the short-term, the real threat to a diabetic is a hypo; when blood glucose levels drop abnormally low. When this happens you do tend to “go a bit funny”. Mild hypos will see diabetics feeling shaky or faint – a bit like the morning of a bad hangover. Serious hypos can lead to drunken like nonsensical muttering, poor coordination and even comas. Hence, if you are having a hypo the worst possible thing you can do is be given more insulin; as you already have too much in your system.
As a runner, this balancing act takes a little getting used to. You need to tread a fine line between ensuring your body can run at the desired pace for a certain distance without your blood glucose dropping low, or going high. Neither are optimal for your performance, and dropping low if running on your own could be dangerous.
If I run within a few hours of injecting insulin to eat, my blood glucose will drop as the exercise exacerbates the insulin’s impact. As a result, I need to load up with ‘sugary’ food in advance of leaving the door. During the last four years my body has become used to eating just before I leave the house on a run, with dry fruit bars, or even chocolate providing the counterbalance to the insulin I had earlier injected.
If, however, I run first thing in the morning, having not injected fast acting insulin (taken ahead of meals) for up to 10hours, and only having injected slow acting insulin (taken at bedtime), I know that I can run at least 6miles at a decent pace without going low in sugar and without eating anything.
I have learnt this from just getting out the door. Sometimes carrying food, sometimes not. No one can tell you exactly how your body will react, you have to try it for yourself – though ideally in a safe environment with someone else (or on a loop close to home).
When I run half marathons I know I can load up on something in advance, such as a Bounce protein ball, or a tasty Chia Charge Flapjack, and some dried fruit, and I won’t need to take anything else on for the rest of the run. No gels (that I hate), nothing.
In a marathon, I again will load up before the start. Usually I will have some boiled egg sandwiches (just because I fancied them before a marathon last year) and a flapjack. The issue I have is the need to eat within 1hour of the race starting to ensure my blood glucose doesn’t get too high before I start depleting it by running. It’s all a balancing act.
I know that from ten miles in during a marathon, I need to keep topping up my sugar levels for the rest of the race. In the last few marathons I have been using ‘old school’ Kendal mint cake to do this, taking a large square of it every 5k. The key thing is to remember to do it. So I try to check my last split time and eat as I push on into the next segment.
This approach allows me to get on with my race without worrying about gels or energy drinks out on the course. I just hydrate with sips of water as and when appropriate.
Remarkably, it works. In every marathon I have run, my blood glucose level has been perfect (between 5 and 8 for those diabetics out there) when I finished. That doesn’t mean I don’t feel ill or nauseous post marathon like other runners, I do. It doesn’t mean that I won’t hit the ‘wall’, I sadly do. But my diabetes isn’t the cause, running a marathon is.
Diabetes shouldn’t prevent people running marathons. Anyone can run one, you just can’t do it on the fly, unprepared. Everyone needs to train for a marathon with endurance, pace and nutrition in mind. The one difference for diabetics is the need to make sure their nutrition properly regulates their blood glucose levels throughout the whole 26.2miles. Go on then, sign up to a marathon, or at the very least a local parkrun, and run down diabetes.