# Marathon training and carrying insulin



## counsellorneil (Nov 28, 2022)

I've been fortunate to get a ballot place for the London marathon next April and have set up a page to fundraise for Diabetes UK. My question is about carbs and insulin whilst running long distances. Most of the training reading I've been doing mentions eating 20 - 40g of carbs every hour!! So far I've run 13 miles over 3 hours, without eating anything during the run. I recognise the need to eat as the length of my runs increases. But if I eat even 20g of carbs every hour, I will need some bolus insulin. I'm curious how other type 1 diabetic long-distance runners manage. Do you carry insulin with you? If I had a pump that would work, but with insulin pens, which I'm not that keen on carrying with me whilst running, stopping to inject mid-run, doesn't seem much fun. But if there's no other way, I guess I'll need to . Any help or suggestions much appreciated. Thanks.


----------



## AndBreathe (Nov 28, 2022)

counsellorneil said:


> I've been fortunate to get a ballot place for the London marathon next April and have set up a page to fundraise for Diabetes UK. My question is about carbs and insulin whilst running long distances. Most of the training reading I've been doing mentions eating 20 - 40g of carbs every hour!! So far I've run 13 miles over 3 hours, without eating anything during the run. I recognise the need to eat as the length of my runs increases. But if I eat even 20g of carbs every hour, I will need some bolus insulin. I'm curious how other type 1 diabetic long-distance runners manage. Do you carry insulin with you? If I had a pump that would work, but with insulin pens, which I'm not that keen on carrying with me whilst running, stopping to inject mid-run, doesn't seem much fun. But if there's no other way, I guess I'll need to . Any help or suggestions much appreciated. Thanks.



Neil, I wouldn't comment on your regime or training programmes, except to mention Dr Ian lake who is an endurance runner who follows a low carb/keto diet.  He also took part in an endurance event - fasted.  Might be interesting to have a look at some of his stuff.

Ian is an extremely personable individual.  I am sure he'd be happy of you reached out to him.






						About - Type 1 Keto
					

Rethinking Type 1 Diabetes with a Ketogenic Diet.



					type1keto.com
				









						Zero Five 100 - Type 1 Keto
					

Eight people covered a distance of 100 miles, over five days, with zero calories, to gather information to re-think diabetes management.



					type1keto.com
				




Good luck on your adventure.


----------



## rebrascora (Nov 28, 2022)

I am just a little curious to know why you think you would need to bolus for the carbs. I thought the whole purpose of taking carbs was because your muscles will be sucking glucose out of your blood stream and you need to replace it or risk a hypo. 
I am not however a long distance runner, just curious as to the need to inject insulin for the carbs during long distance endurance exercise.


----------



## counsellorneil (Nov 28, 2022)

AndBreathe said:


> Neil, I wouldn't comment on your regime or training programmes, except to mention Dr Ian lake who is an endurance runner who follows a low carb/keto diet.  He also took part in an endurance event - fasted.  Might be interesting to have a look at some of his stuff.
> 
> Ian is an extremely personable individual.  I am sure he'd be happy of you reached out to him.
> 
> ...


Thanks. I’ve found some articles on Dr Ian Lake. Sounds fascinating. Will continue researching him.


----------



## counsellorneil (Nov 28, 2022)

rebrascora said:


> I am just a little curious to know why you think you would need to bolus for the carbs. I thought the whole purpose of taking carbs was because your muscles will be sucking glucose out of your blood stream and you need to replace it or risk a hypo.
> I am not however a long distance runner, just curious as to the need to inject insulin for the carbs during long distance endurance exercise.


I probably need to run further and see what my glucose does. At the moment I can run 13 miles keeping my glucose fairly steady around 7/8 without eating anything. This seems to go against recommended training plans which say to eat at least 20g of carbs every hour. So if I followed that guidance for running, with running 13 miles (furtherest so far) I’m sure my glucose level would have spiked. My concern is running the same distance again without eating anything. Maybe it’s possible. I’m curious what others experience is. Do I need to stop at 13 miles, bolus and eat something? Don’t want to hit the 20 mile wall many first time marathon runners mention when they didn’t eat anything. Maybe it’s connected to low heart beat running burns more body fat than carbs ‍♀️. Thanks for your reply.


----------



## Benny G (Nov 28, 2022)

As an older competitor I would not expect you to achieve a high speed while running. Running 13 miles in 3 hours is about the pace of a brisk walk for younger folk: 4.5 miles per hour, or the speed of a fat burning jog.
If you want to run at a faster rate, over distance, then you would require some extra fuel and water.
My best advice is to measure your glucose levels during your exercise and through the following 24 hours, if they go too low top up with a little fast glucose.
Be very wary of adding bolus during your exercise, hypos can come on swiftly and take you by surprise. While running you should be able to eat free snacks that don't require extra insulin.

If you have access to Libre this will help you see the full impact of your exercise on your glucose levels.


----------



## Inka (Nov 29, 2022)

counsellorneil said:


> Thanks. I’ve found some articles on Dr Ian Lake. Sounds fascinating. Will continue researching him.



Be very wary. I’d never go keto and especially not before a marathon. It’s potentially dangerous. I assume the person recommending this above has commercial links with keto sites….:

https://www.dailymail.co.uk/health/...run-five-days-no-food-daftest-stunt-ever.html

“_Cracknell's health claims about the benefits of fasted exercise – especially for type 1 diabetics – is 'scarily incorrect', says McGregor.”

“the stunt has been branded 'dangerous', 'irresponsible' and, in the words of Dr Giles Yeo, a Cambridge University obesity expert, 'a really, really stupid idea'.”

“According to NHS guidance, a blood ketone level above 0.6mmol is a cause for concern. On day four of the challenge, participant Jon Furniss, an engineer who has type 1 diabetes, wrote on his Twitter feed that his ketones measured 5.8mmol – more than eight times the NHS's safe limit.”_


----------



## Rob Oldfield (Nov 29, 2022)

Where are you seeing a recommendation for a blanket 20-40 carbs per hour?

I asked my DSN about this quite recently and she pointed me at this document https://extod.org/downloads/Narendran-DTN-Exercise.pdf.  That suggests taking carbs if sugar level is looking like its headed too low (of course that depends on being able to check via a Libre or other method).


----------



## counsellorneil (Nov 29, 2022)

Benny G said:


> As an older competitor I would not expect you to achieve a high speed while running. Running 13 miles in 3 hours is about the pace of a brisk walk for younger folk: 4.5 miles per hour, or the speed of a fat burning jog.
> If you want to run at a faster rate, over distance, then you would require some extra fuel and water.
> My best advice is to measure your glucose levels during your exercise and through the following 24 hours, if they go too low top up with a little fast glucose.
> Be very wary of adding bolus during your exercise, hypos can come on swiftly and take you by surprise. While running you should be able to eat free snacks that don't require extra insulin.
> ...


Thanks. I'm definitely not out to set any records . My aim is just to finish in one piece, to be able to run another day ‍♀️.  I thankfully do have a Libre. I have a meeting with my Diabetic Teams in late December, for further discussion regarding getting approval for a pump. Though, they have said before that it is unlikely as my control is good. My Libre shows fairly good control whilst running, which is why I'm questioning the ideas I've read of taking extra carbs every hour, which currently I don't need, though I've only covered half marathon distance so far.


----------



## counsellorneil (Nov 29, 2022)

Rob Oldfield said:


> Where are you seeing a recommendation for a blanket 20-40 carbs per hour?


Reading things like this "_Most experts recommend consuming between 30-60 grams of carbohydrate an hour._" on sites such as https://www.runnersworld.com/nutrition-weight-loss/a20851687/how-to-fuel-for-your-first-marathon/ - which I'm more and more beginning to doubt the validity of. It's not the only running site saying such. 

Thanks for the link. Will read that.


----------



## Benny G (Nov 29, 2022)

counsellorneil said:


> (snip) My Libre shows fairly good control whilst running, which is why I'm questioning the ideas I've read of taking extra carbs every hour, which currently I don't need, though I've only covered half marathon distance so far.


There you go, the Libre is giving you the information you need: It says 'You don't need extra food.' Whatever you are eating to fuel your runs is working.



counsellorneil said:


> Reading things like this "_Most experts recommend consuming between 30-60 grams of carbohydrate an hour._" on sites such as https://www.runnersworld.com/nutrition-weight-loss/a20851687/how-to-fuel-for-your-first-marathon/ - which I'm more and more beginning to doubt the validity of. It's not the only running site saying such.
> 
> Thanks for the link. Will read that.


The farther and faster you run the more you will need to eat. The difference for us diabetic folk is the need to carry extra glucose because we cannot turn the insulin off.

In my thirties I used to do a lot of distance running, every Saturday morning I would do my long, slow, fat burning route: 16 to 20 miles, carrying 2 snack bars and a bottle of water in my bag, and some cash just in case. That worked for me.

The main issue for me was not the balancing of insulin, food, and exercise, it was the same things that affect all runners: doing too much to soon; injuries, and recovery. For instance, over the course of 12 weeks you can train your muscles to run 26 miles, but your ligaments and bones will take a lot longer to get used to a 26 mile slog.

You could adjust your target and maybe aim for a half marathon. You have shown you can cover that distance, now you could train to increase your fitness, pace, and endurance. 6 months is a good amount of time to train for the half marathon, your bones and joints need time to build themselves up.

If you are looking at web pages for runners, make sure you are also reading the seniors section.

To help broaden your reading list:





						Tips for Runners in Their 60s | Marathon Training Academy
					






					www.marathontrainingacademy.com
				








						The Aging Marathoner – How Getting Older Affects Your Running | Marathon Training Academy
					






					www.marathontrainingacademy.com
				








						Masters Runners:  Body Changes and Injury Prevention Strategies | Marathon Training Academy
					






					www.marathontrainingacademy.com


----------



## Rob Oldfield (Nov 29, 2022)

counsellorneil said:


> Reading things like this "_Most experts recommend consuming between 30-60 grams of carbohydrate an hour._" on sites such as https://www.runnersworld.com/nutrition-weight-loss/a20851687/how-to-fuel-for-your-first-marathon/ - which I'm more and more beginning to doubt the validity of. It's not the only running site saying such.
> 
> Thanks for the link. Will read that.


I'm up to running almost half marathon distances on my long runs and it does seem that what works one day may well be different to another - at least for me.  I take a stash of Jelly Babies and do regular swishes of the Libre and, generally speaking, will get through a few of them on the long run.  But last Sunday I did just over two hours with none needed - level stayed at a lovely static 7ish for the entire time.  I guess one of the big questions is just how much effort we're putting in and that's clearly down to individuals.


----------

