# Marathon training



## Bartmanblues (Nov 11, 2010)

Hi guys, i'm a type 1 (diagnosed 2009) and am running the London Marathon next year - any tips on training or nutrition?

I've been injecting for 6 months and carb counting for 1 so new to most things.

Any tips on the following specifically would be great:

Reducing insulin with excercise
Carb loading for type 1s
For what distances should I be eating whilst running? And how much?

It would just be nice to hear from any other runners/sporty types and compare notes. Would be great to hear from anyone really! 

I've take a look at runsweet and garnered some good info and personal experience but would be fab to hear others' experiences.

I'm getting on with the training quite well, my main problem is tearing the top layer off my knee whilst playing football on Tuesday - dang! Had to wear shorts to work today (in an office), a little embarrassing...but mostly just amusing!


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## Northerner (Nov 11, 2010)

Congratulations on getting a place for London! I was trained up for a marathon when I got diagnosed, and found I had to find a whole new way of looking at things. The first thing I did was get a copy of Diabetic Athlete's Handbook - it gives an excellent guide to all the factors that can affect you when taking up such a challenging sport and helped me a lot in the early days to figure out what kinds of things to watch out for. However, it can only be a guide, as we all have different reactions. I, for example, don't reduce my pre-run insulin, but have to lower my post run meal insulin and possibly even my basal/background insulin for up to 40 hours! 

I can't be as spontaneous as before, as I have to make sure my levels are appropriate for exercising (prefer to be around 8/9/10 mmol/l to start with), and to have sufficient insulin 'active' i.e. I usually inject 1.5-2 hours before the run. Whilst out running I find that my levels stay pretty...er...level for the first five miles or so, and then I need to eat around 5-10g (1 or 2 jelly babies) per mile after that. As you get fitter you should find that you can run frther without top ups, but again, that's not guaranteed.

I have read of some people taking no insulin and running marathons, and some people switch off their pumps for the duration. The best thing to do is to test before and after exercise, and possibly during every half hour until you have figured out what happens in your case. ALWAYS carry some medical ID with you and a hypo treatment (you may need more than you expect). As the effort of running can mask some hypo symptoms it's best to test every half hour until you can be reasonably sure you are OK.

Hope this helps! Do let us know how the training goes!


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## Northerner (Nov 11, 2010)

p.s. Carb loading should be fine as long as you can work out appropriate injections. Again, it's trial and error. After a long run I find that my liver and muscles naturally 'restock' their glycogen stores hence my reduced insulin doses afterwards. Exercise, especially regular aerobic exercise will make you much more insulin sensitive over time too.


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## Copepod (Nov 11, 2010)

Good to hear you've already found Runsweet. There's more info in the Exercise / Sport section, so I'll move this thread there. Good luck for your training and run. Also, as you've only been injecting insulin for 6 months, your doses will almost certainly change in the coming months, in addition to adaptions you need to make for exercise.


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## lucy123 (Nov 11, 2010)

Hi - from one fella runner to another - ha ha i really am joking,
I have just started running and managed my first 5k a few weeks ago. Couldn't walk on a treadmill in June!

I am also type 2 and diet and exercise controlled, so can't help much I am afraid. Northerner is a die hard runner though and type 1 so his informtion and advice will be invaluabe. I think there are several runners on here too, so sure they will be along soon.


Anyway, you said you wanted to hear from anyone, so thought I would just welcome you! (..and try and get myself in on the runners club on here too!! tee hee.


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## Cate (Nov 12, 2010)

I did the London marathon in 2000 for DUK.  I didn't take any basal insulin the night before, and no bolus for the whole day.  I ate 2 packs of glucose tabs, a pot of liquid glucose, some hypostop and a couple of mars bars on the way round.  I was still hypoing on and off (!).  St Johns Ambulance fed me OJ and biscuits a couple of times, I think they thought I was a pleasant chance to blisters lol.

I think the hypos were mostly caused by adreniline, the event itself is *very* different to the training you do beforehand.  And make sure that you stick to your own pace, try not to get carried along with the crowd, it's really hard at the start as everyone is so packed together.


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## Bartmanblues (Nov 15, 2010)

Thanks *Cate *- that is very useful info. Though obviously it all depends person to person, it's good to know that cramming myself full of energy (if I need to) would not be setting a precedent! 

I'm going to try and run in a shorter event sometime (maybe a 10k seeing as i'm doing that distance in training already) just so as to get used to running with other people. Obvoiusly it won't compare to London but I hope to get the feel for it, compared to the cows and sheep I run with at the moment in Yorkshire.

*Copepod*, thanks for moving the thread - I completely overlooked the info section when I visited the board, very silly of me! Thanks for the warning about doses - just to clarify - do you mean my doses will change because i'm doing all this extra running or because i've only just come onto insulin? (Or both?).

Thanks for the link to that book *Northerner *- looks essential for someone like me! I'll be buying that very soon. By the way, I live in Yorkshire (so, kind of Northern, but I a London lad so distinctly _not _Northern!). Thanks for the anecdotal info though, it's very interesting to see how other runners combat Type 1, probably more for reassurance that not knowing exactly what i'm doing isn't such a bad thing for the moment. 

I do carry ID though (a velcro ID strap) and take around both my mobile phone and a pack of glucose tablets in my bum pocket (very uncomfortable to sit on!). With regards to the carb loading, is it the case that because the body is placing the energy into long term storage (glycagon), that you don't need as much insulin? I bet i'm completely wrong because I am new to this! 

*lucy123 *- hi! 

Thanks guys, great to hear from you all.


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## Copepod (Nov 15, 2010)

Your insulin doses are likely to rise as your pancreas produces gradually less insulin - most people have a "honeymoon phase" of at least a few months after diagnosis. Your doses are likely to be lower with exercise than without. A bit confusing, but just use the doses and food you need, and you'll be fine.


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## Bartmanblues (Nov 15, 2010)

Yes I may well be on that "honeymoon" period. 

When I was first diagnosed with diabetes, my surgery thought it was type 2...though they never explicitly told me that, because I was still producing insulin. On further investigation into it myself (I knew I was not a typical type 2 patient!) I thought it may be this type 1.5 or LADA. Only on referral to the hospital did they conclude I am type 1. It may be that my body still produces insulin, but I don't know if there's a way to tell whilst I am injecting it.

Thanks.


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## Northerner (Nov 15, 2010)

Bartmanblues said:


> Yes I may well be on that "honeymoon" period.
> 
> When I was first diagnosed with diabetes, my surgery thought it was type 2...though they never explicitly told me that, because I was still producing insulin. On further investigation into it myself (I knew I was not a typical type 2 patient!) I thought it may be this type 1.5 or LADA. Only on referral to the hospital did they conclude I am type 1. It may be that my body still produces insulin, but I don't know if there's a way to tell whilst I am injecting it.
> 
> Thanks.



There is a way to test how much of your own insulin you are producing called the C-peptide test. C-peptide is produced in equal amounts to the insulin your pancreas produces, but injected insulin doesn't contain it.


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## Bartmanblues (Nov 15, 2010)

Thanks! I'll ask about that one at the surgery next time.


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## Pigeon (Nov 15, 2010)

JUst popping in to say high from another runner - I've done the Great North Run twice since getting T1. I found I had to reduce my basal insulin loads towards the event as I was training every other day and so had loads of hypos if I didn't reduce it. Not sure I can add much else to what's been said at the moment, but will try to help if you have any further questions - or maybe you'll be able to pass on some tips in time!


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## Johnnyroyale (Jan 12, 2011)

Hello, I have run a couple of marathons and am still alive - and still running. I have type 1 and take my basal (lantus) at night. If I run in the morning, around five miles or less - assuming my blood sugar is normal - I have a normal breakfast but only take about 30 to 50 per cent of my normal bolus dose. If the run is over 5 miles but less than 10, I have breakfast and my basal insulin keeps my sugar low. Afterwards I eat something and again, adjust my insulin to about half.

If the run is over 10 miles, I have a normal breakfast, no insulin and along the way have one jelly baby for every mile (as well as water of course). I find this usually works out well. I have had spikes in my blood sugar occasionally and if I don't take extra insulin for it then I get dehydrated - as my kidneys are trying to flush out the extra sugar - and this eads to extra stiff legs. So I take a shot of bous to level me out and don't do anything like drive for a couple of hours, as a hypo sometimes comes on. I find a hypo is preferable to haveing locked-up stiff legs through dehydration.

If my blood sugar is a little high (10 or above) then I add an extra unit before the run.

That night I lower by basal dose by around 1 unit for every two miles I have run that day. In my case, on a day of 'normal' activity - walking 10 mins to the station and back - I take 23 units. If I have run a four or five-miler, I would take 20 or 21. I can't remember what I took the days I did the marathons, but it must have been around 15. I tried omitting the basal altogether after a long run, but it led to hyperglycaemia, dehydration, cramp and sore muscles. So however little insulin you end up taking, at least take some.

For the marathons themselves, I took 8 units of Humulin I with an extra big bowl of muesli a couple of hours before the race, ate a jelly baby every mile and drank the lucozade at every station. I finished each race in around 4 and a half hours, but the more pleasing aspect for me was that both times my blood sugar was around 6mmol/l at the finish line.

Hope this helps a bit!


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