Okay, I'll try my best to make this short and sweet. I'm going to be a senior in high school, I've had diabetes for a little bit less than 2 years, I'm on an insulin pump, and I run cross country. I've been having a lot of issues in which my doctors can't really seem to help me out, so I was hoping you guys could give me some suggestions...my first race is in 2.5 weeks and I'd like to get it fixed by then. I do everything my doctors tell me to do...suspend the pump, eat fast and slow acting carbs...regardless of what I do I still end up going low into my run and end up having to stop. First and foremost, do you guys have any suggestions? Also, is there a specialist I can see that can assist me with this. I'd appreciate a response ASAP thanks for all of your help in advance!
Great post by the way. The best specialist in my mind would be someone that has the experience of this race and who has diabetes (might be hard to find). Otherwise, I feel like you're going to get the same suggestion that your doctors give if you go to a "specialist". At the end of the day, no one knows your body better than you and trial and error is part of the training. How long is your race? It's kind of hard to gauge if the length is unknown. My suggestion would be to try and read up on it from people who have been in your shoes before. If not, definitely look for at least someone in the field (even if they don't have T1D). Are you suspending your pump early enough? Are you checking yourself often enough during the race to make sure your blood sugar doesn't go low? Sometimes you need to check more in training than you will during the race to get used to your body. I'm no specialist so take my advice with a grain of salt.
I would love to hear what other people have to say. I'm running a relay race in about a month and a bit which for me is 2 legs for a total of 17 kms. 10 kms then 7 kms. I don't usually have issues with going low and I check every 2.5-3 kms (I believe around every 1.5 miles if you use that measurement).
Hi JSeltz – Congrats on running cross country! I ran cross country and track in college, so I know how hard running is…even without diabetes. Since you have 2.5 weeks before you’re first race, you still have time to experiment during practice runs and workouts to see what works best for you. Since I assume your high school races are 5Ks, here’s what works best for me at this distance. Obviously, test your blood sugar often, starting a few hours before the race (if you have a Continuous Glucose Monitor that’s even more helpful…especially for runners so you can see which way your blood sugar is trending–either up or down). Like you said, it’s the low blood sugars (100 or less) that make running incredibly difficult. Running with high blood sugars (150-250), however, make running much more tolerable–and less dangerous. So, if I eat a “normal” meal containing 30-70 carbs about 3 hours before a race, I lessen the amount of insulin I bolus by half and suspend my pump about an hour before the race, (and leave it suspended during the race) but keep testing my blood sugar about every 15 minutes to ensure I toe the starting line around 200. If I’m too high, I may give myself a 1 unit bolus. If I’m too low, I eat 16 grams of glucose tablets (which I carry with me during the race in case I start to feel low). Your sensitivity to insulin and glucose probably differ from mine, so start experimenting to see what works best for you. Good luck and hang in there, even during the tough run days. All of us Type 1 runners are cheering for you! Post again so we can see how you improve during the season!
Hey Adam, thanks for the quick response! It's just been really annoying since my season started last week, and each time I've had to stop due to a low blood sugar. My race is a 5k. One hour prior to exercise, I suspend my pump and keep it suspended throughout the practice. I've just been getting really annoyed lately because it's a bad feeling when you have stop an exercise especially due to diabetes. During the races, I don't check my blood sugar because I don't have a place where I can keep my meter, but I always carry the gu chomps with me. Once my blood sugar gets to a certain level though (under 80) I just feel like I can't go any further an I have to stop.
Hi Scott, I try to use the CGM as often as I can, but I always have difficulty keeping the sensor in, so I haven't really been wearing it, but the next time I change my site I'll try it again. I try to get my sugars in the 200s prior to my exercise, but I still drop regardless...I always carry sugar with me, but like you said, when I get under 80, I start to feel terrible like I'm going to pass out and I have to stop, so I really don't know what to do since no matter how high I start I still end up dropping. Your post really helped a lot, I'm glad I'm not the only one who is experiencing this, but I just want to get this fixed already so I don't have any issues my first race! My problem isn't getting high enough, it's maintaining it that's hard for me, and it seems like nothing is working, but thanks again!
I'm considering running in college, but I am not good enough to get recruiting...were you recruited?
Hmmm. It seems like you got a pretty good plan in place. Suspending it an hour before and during is usually a good idea. What about eating? As Scott mentioned above, eating a meal 2-3 hours before is a great idea too as you'll fill up a little on carbs that will peak over time and keep the blood sugar up during races. Do you eat anything right before the race? For example, something light like a granola bar of some sort? I do that before my runs and I usually either don't bolus at all if my blood sugar isn't where I want it to be or I bolus just a little if it's a little high.
If I could make a suggestion, it would be to master checking yourself on the run. It's an art, but there are many ways to do it and you can even look at videos on youtube of people checking while they run. You will slow down a little no doubt, but at least this way you'll see a low coming before you start to feel it.
Also, a very cool tip I read up on for running entailed the idea of sprinting for 10-30 seconds if you ever start to feel weak/low. When you sprint, your body naturally releases glycogen into your bloodstream which will actually raise your blood sugar and you'll start to feel a little better (although it's not a long-term solution during your race, it will do enough to keep your mind focused and to correct any issues). I got it from a great book which has helped me greatly during my training:
Prior to a run, I try to balance between fast and slow acting carbs, so normally I'd have some GU and an Extend Bar which is made specifically for diabetics. From what everyone is saying it seems like the only thing that can be done is trial and error...As for the checking during a run, while I practice, I wear a fanny pack, but I don't normally check midway into the run, but I think I might start doing that...or begin wearing my CGM again. As for races, my uniform is very basic...really short shorts and a tang top, so I have no place to carry my meter and the fanny pack would go all over the place...I don't have any place to put my meter, so I just carry carbs with me during the race. Do you have any suggestions for something that I can use to hold the GU/chomps? It's basically gummies made for runners. I think it would be hard to hold during a run since I'm gonna get really sweaty.
Thanks for that book! I'm gonna definitely look into getting it.
I wonder if you could use athletic tape and just tape the Gu to your singlet and then pull it off if you needed it? Assuming you only carry one with you which might not be the case. I would think the tape would hold it even if you got sweaty?
I vary between a Spibelt and this neat magnetic pouch (http://theroosport.com/) to hold stuff when I run long distance races. The Roo pouch doesn't move one bit due to the super strong magnetic piece in it so I like it more than the Spibelt but the Spibelt can hold more.
The roo pouch seems awesome! I'm gonna consider getting that (if I can talk my mom into it). But as for the tape, I don't you the regular gu, it's gu chomps, so it's several in one
The Roo pouch is fantastic; I often fill it with the sport beans and then can just grab them when needed. It also comes in handy at night as my pump clip slides around but it stays put!
Hey guys, so I went to practice today...and to my surprise another low! Ok, does anyone understand how bloodsugar could drop all the way from 261 to 67 and then back to 286...my sugar is going crazy and i'm gettting really frustrated annoyed and depressed, can anybody think of anything that can help with this?
i combine slow acting and fast acting carbs prior to running.
Hi, I do injections but may be able to offer some general tips. Running does lower the blood sugar. However, my doctor said that running at race pace should raise because of the stress hormones being released. That being said, I’m a bit surprised you are low during a race. What’s your avg mile pace for a 5k race? Usually anything 8 and above will reduce mine and 730 or less will spike it up. One suggestion I have is try running without the pump and time yourself then test afterwards. Try both a fast and easy 5k, I’d be interested to see the results. This way you may be able to better gauge what you need to do with your pump depending on the type of run.
Don't get too down on yourself!!! You'll figure this out. Extend Bars are AMAZING, glad you use them, I personally love them. I'm a little surprised you're going low even with that in your system. I'm thinking maybe your daily Basal rate should be reduced from the beginning of the day up until your training. Or just do a temporary basal rate on training days, but do it super early and then stick with your suspending it an hour before and during. Again, the food you seem to have pat down, it's just a matter of how much insulin is in your body. Clearly you're very sensitive to insulin AND intense physical activity. Or I should say I would think, not clearly. Again, I'm no doctor...just offering up some advice.
I'm sorry you had such a high to low to high roller coaster ride...those are SO frustrating. I've had T1 for 26 years and run anything from 5ks to marathons and on any given day, what worked for me for a prior run or race doesn't always work for the next. It's very frustrating; I understand how you feel!
I agree with Adam: try lowering your basal earlier in the day so you have less insulin on board and then continue to suspend before your running. Your blood sugar might run a little higher but hopefully it will stabilize rather than dropping low. While 67 isn't awful it isn't where you want to be mid-run and I know I always worry I'll keep going lower even if I eat a gu or some sport beans.
When are you eating the slow and fast-acting carbs before your practices/races? Can you tell that a certain product (Gu versus Clif Gel Shots vs. sport beans, etc) affects your blood sugar more than another? Or do you always eat the same one?
I hope it helps to know that you aren't alone going through this.
...i'm just gonna keep on trying...today we were doing 4x1 mile interval runs, and in the middle of the third one (like 2.5 miles in total) I dropped to 66! I suspended 1.5 hours before (doctors recommendation) plus no boluses...still dropped. Getting really frustrated, hope it all workds out soon.
Hey everyone, just wanted to let you know, last night I made it a full practice without dropping...I suspended my pump 2 hours prior, and no bolusing within that time...however I was all the way up to 450, and that was pretty miserable running like that, but it was bearable...so yeah I guess trial and error is all it really is
Glad you didn't drop but woof on the 450! Maybe experiment more with how long before practice you suspend and bolusing a little for what you eat? Like you said, trial and error. And unfortunately what works one day might not work the same way the next day. It's frustrating, I know, but it'll get easier. I've found that if I'm within a certain range before I start running, then I do ok but if I'm higher than that, I tend to go higher still and if I'm lower, I tend to drop lower. I've also learned to eat shot blocks or sport beans or gu's even if I'm not low yet as that can keep me from going low; just have to balance it and not eat too many. Keep trying and getting feedback!
Hang in there, Jacob! Like distance running, you'll need to be patient as you continue to figure out what works best for you. There's lots of great advice in here from people who have experimented themselves with lots of miles under their belts. Since you said you already have a CGM, but that it doesn't always stay connected to you -- especially during exercise -- you should tape it to your body. I use Smith 7 Nephew IV3000 Adhesive Dressing (www.diabeteshealthsupplies.com/smith-nephew-iv3000-1-hand-transparent-adhesive-dressing-2-3-8in-x-2-3-4in-box-of-100), but you could probably go to your local pharmacy and buy some large, waterproof bandages, too. They can be a little pricey, but it's worth it. Whatever you do, don't use athletic tape...trust me, I tried it once and the tape fell off of me before the first mile. Good luck and keep us posted on your season. Oh, and to answer your question from last month, I was not recruited to run in college, but I made the team as a walk-on after a lot of hard work. Stay positive!
Like everyone has said, it is really trial and error. I have found that a temp rate works really well to stabilize my blood sugars during any distance race. I use a -40 % during a 5K and it increases the longer the race. I typically try to have the temp rate on for about an hour after I am done with the race to prevent lows after the adrenaline leaves. Keep trying. It will work out.