# Running with diabetes what do you do ?



## Deano (Mar 16, 2009)

Hi all,

I know the answer to this thread can be found on various threads scattered about but i thought it might be nice and helpful to have them in one place.

I have just been given the go ahead to start running again after being diagnosed with type 1 in January, I have done a couple of short runs so far and am still getting used to what to do so many questions, How much to lower my insulin by ? what BGL to start with ? How far to run before i need to top up with carbs.
It really is a mind field but one i am determined to conquer and my goal to run the London marathon 2010 for diabetes uk after having to pull out of this years race due to the diabetes.

So what do you all do, please post your routines on here no mater if you run 1 mile or ultra marathons, it would really help me and hopefully many others looking to run with diabetes.
Good luck and thanks to you all for your support on this board.
Best wishes
Dean


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## aymes (Mar 16, 2009)

The exact numbers will be so different for everyone but for me I find I need about 10g of 'free carbs' per mile I'm running. By 'free' I mean taking on extra carbs without insulin before or during the run (obviously making sure I have some insulin 'floating around') or reducing my insulin dose of the meal before running if going out no more than 2 hours after eating. I'll usually push my bg up to 10-12 before I go out and then take on carbs during the run in the form of glucose tabs or juice. It's often necesary to reduce my insulin dose for the meal after the run also.

As it's so different for everyone my advice would be to build up slowly and test so you can work out what amounts work for you, and of course bear in mind that as your running improves chances are you will become more efficient and so need less carbs for the same distances.

Doing the London Marathon is my ultimate goal, I've given myself a target of having done it by the time I'm 35 so I've got a little way to go. I did my first half marathon back in November, certainly not the fastest person there but it was a good achievement for me. My next race is a 10k in just under 4 weeks time so currently training for that by doing at least 10k every weekend and doing 3 or 4 mile runs 3 or 4 times during the week.


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## Northerner (Mar 17, 2009)

Hi Dean, I know how it feels having to pull out of a race because of diabetes. I missed last year's Stockholm Marathon mainly due to the fact that I was in hospital being diagnosed! You don't say whether you've done any long races before diagnosis, so I'm assuming not in the following.

I had to take a break from the running for a couple of months due to a problem with my heart (some very wacky ECGs!), which was particularly hard for me as I've been running for over 25 years, and had just trained up to 'marathon' levels before falling ill.

The main thing is to take things slowly, measure and record. Prior to diagnosis I just used to go out and run, usually before breakfast as the sun was coming up. Now, I don't really have that option as I have to eat breakfast and allow it to digest before I can leave the house. I usually wait about 1-2 hours after eating. I measure my BG and record it. If it's below 6'ish I'll have some orange juice. If above 6.5 I don't normally have anything extra. I can't say what I'd do if my level was high, because it hasn't happened, but the general advice is that if it is above 13 or so, then to wait until it comes down a little.

I then go out for my run! I've found that I can run about 5-6 miles without needing any extra top-up - I measure my levels when I get back and they are usually almost unchanged, or maybe a bit higher or lower. It's possible your levels will increase rather than drop due to the release of cortisol and adrenalin, depending on intensity - this is more likely on race day, when you are excited/apprehensive.

Beyond 5 miles I have a couple of jelly babies a mile. For a longer run, it's also important to drink, and I suppose you could take an energy/isotonic drink instead of the JBs, but I prefer to drink water. You'll probably find that, as your fitness improves, you'll be able to run further and further without it affecting your BG too much. Also, you'll become familiar with your routes and ability to cope over time, so it will become less of a chore!

I always take some jelly babies or glucose tablets out with me, plus diabetes ID, just to be on the safe side. I'm thinking of getting a 'Cram Alert' ( http://www.cramalert.co.uk/ ) to be extra prepared.

Regarding insulin - you will become much more insulin sensitive with the exercise, and this effect can last (in my case) up to 40 hours. So, after a run I will reduce my insulin by around 25% for the next three meals, and might also drop my basal by 10% that night. If I've done a particularly long run I might have to reduce my insulin by 35% - I found this out recently after stepping up my training!

Race days need different considerations. If your aim is London 2010, then I'd suggest you plan at least a couple of shorter races - 10k, 10m or half-marathons before then, so you can get used to the different things you have to do on an event. Usually, you have to be there long before the start - especially with a huge mass-participation event like London - so the food you have for breakfast will probably have been fully digested by then. Depending on how many hours prior to the event you have to be there, you might need to have a snack earlier, but then something more substantial when you arrive. 

You also need to consider insulin - you need some 'circulating' insulin for the food to do its work. I'm just thinking aloud here, as I've only done the Great South Run since diagnosis, and that was a shorter race within the 'lifespan' of my breakfast and novorapid. But, I've run a lot of marathons and half marathons over the years and you can be kept waiting for ages. Before, it didn't affect me too much, but now I need to consider these things.

It's a little more complicated for me now, but the benefits are huge. I might have diabetes, but I'm in far better shape than most people I know of my age!

A good book to read is 'The Diabetic Athlete' by Sheri Colberg for information about how everything works when you're exercising

Good luck with the training - keep us informed of how it's going, and please ask any questions you might have - they might be very helpful to me and others!


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## Deano (Mar 18, 2009)

Hi Northerner,

Many thanks thats great, Prior to diagnosis in January i had done 6 marathons ( 4 Londons,New York and good old Blackpool !!) and various other races since i started running in 2002. Last year though i didnt do too much i found myself losing a little motivation and everything started to be an effort i thought it was me just being lazy but now wonder if it was the start of the diabetes. I have just started back running last week taking it slowly i did two 4 mile runs and this week i will have done 3, 5 mile runs and i must say i have been plesently suprised how good i am feeling while running cosidering i had 3 months off.
Like you i used to get up at 5 scoff down a bannana and go out and run 15 - 20 miles when training for a marathon I know i cant do that now so its all a new learning curve, Knowing what to eat and when and how much to lower my insulin by so thanks for your reply it was just the sort of thing i was looking for. so far on my runs i have found my bg drops quite a bit and i need to top up on anything over 3 miles.
I will keep you posted with my progress, good luck with your training.
Best wishes 
Dean


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## Northerner (Mar 18, 2009)

Ah! You're a bit of a London veteran then, so you'll know what to expect on the day. When I was diagnosed one of the doctors said that my pancreas may have started spluttering some time before I ended up in hospital, but that the fact I was a regular runner would have made me very sensitive to the decreasing amounts of insulin I was producing. Eventually, I got a virus which killed off the last of my beta cells and turned into DKA. Looking back, I'd had symptoms for some time - losing weight, very thirsty all the time etc. and also feeling lethargic and lacking motivation. I actually ran the Hague half marathon 10 weeks before diagnosis in my slowest ever time - I was practically last! Now I have a possible explanation for the slow time.


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## matts (Mar 21, 2009)

Thanks for the information Northerner.  I have just registered for the Great South Run.  I have run it twice before (once pre diagnosis and once the week before diagnosis - I was already feeling rough when I ran it).

I am planning to start running again this week - short distances at first and then gradually build up.

Do you take your normal bolus insulin withyour pre run meal or do you reduce it?


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## Northerner (Mar 21, 2009)

matts said:


> Thanks for the information Northerner.  I have just registered for the Great South Run.  I have run it twice before (once pre diagnosis and once the week before diagnosis - I was already feeling rough when I ran it).
> 
> I am planning to start running again this week - short distances at first and then gradually build up.
> 
> Do you take your normal bolus insulin withyour pre run meal or do you reduce it?



Hi matts,

I don't reduce my pre-run bolus specifically for the run, but may take less than I have previously because of my increased sensitivity from previous runs - if that makes any kind of sense! What I mean is, I have to reduce all my bolus insulin for about 40 hours after I've increased my activity levels, so I'm not reducing it because of the run I'm about to do but because of the run I already did! 

I've probably made it sound more complicated than it is, sorry!


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## matts (Mar 21, 2009)

I know what you mean about reducing subsequent bolus doses.  I will see how I get on over the next few weeks with the training.  It is a while since I have done any running so I am sure my fitness levels will have suffered (along with my waistline )


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## Northerner (Mar 21, 2009)

matts said:


> I know what you mean about reducing subsequent bolus doses.  I will see how I get on over the next few weeks with the training.  It is a while since I have done any running so I am sure my fitness levels will have suffered (along with my waistline )



It's always hard trying to get that fitness back! I have found that once I can run 3 miles comfortably then my training comes on in leaps and bounds. I think this is because by the time you have run 3 miles your heart/lungs are up to speed, you're running aerobically, and your muscles have got warmed up. The worse thing for me after diagnosis was the beta-blockers they put me on. As these limit the upper work-rate of your heart to less than 100 bpm, my heart simply wasn't pumping the blood round fast enough to get oxygen to my muscles. Thankfully, I was able to persuade the GP I didn't need them, and then things improved.

I'm still not back to my best - far from it - but more confident now that I'm not going to suddenly keel over during the run with low BG! In those early runs it was hard for me to distinguish between hypo symptoms and just feeling plain knackered from the exercise!

Good luck with your training and let us know how it goes, all experiences are useful. Might see you at the GSR in October!


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## Deano (Mar 24, 2009)

Hi Matts or anyone else who wants to train for any sport a great web site to look at if you havent already is www.runsweet.com its packed full of info for anyone with diabetes who wants to take part in sport and well worth a look

Cheers

Dean


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## matts (Mar 26, 2009)

Thanks Deano.  I would second that recommendation for runsweet.com.  I got some really useful information from there for snowboarding.  I will have another look at the running stuff.


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## mikep1979 (Apr 12, 2009)

runsweet.com is a great site to use. 

i use a slightly different method to most, but one which was used by steve redgrave when he was rowing. i tend to have a high carb intake for the whole day and run with normal insulin doses. this can be problematic, but if you get it right the extra boost of energy you can have is something i thought id never get again!! if your serious about running and want to get to a good standard then i would talk to your dietician as they can normally point you in the right direction also ask your dsn too.


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## Deano (Apr 14, 2009)

Hi Aymes,

Sorry to hear you had to drop out of the race. What one have you entered now ? Yes i have done the Norwich half a couple of times and hope to run it again this year for the first time as a diabetic. Dont worry abouit being left behind if you join a club, most clubs have a begginers group ours included  who just go out and have a gentle run round 9 - 10 min miles, NO ONE gets left behind.

Good luck
Maybe see you soon

Dean


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## Mattcops (Apr 16, 2009)

*high sugar levels when running?????*

Hello Everyone 

i've been type one for 9 years now i run alot of racing like 10k and half marathons and london marathon but i was asking for advice about if your about to race and your sugar is to high will this affect my race and has anyone got any ideas what to do as i'm sure it's not the best thing to start having more Insulin just before a race??????

Thanks so much

 Matt


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## Copepod (Apr 16, 2009)

Hi Matt

Depends what you mean by too high - if blood glucose level is over, say 15 mmol/l, you shouldn't exercise, as levels will continue to rise. So, the only option is to take some short acting insulin and take more glucose later if needed. 

That's one reason I like orienteering - in nearly all events, except for serious national or international races, you can choose your own start time - and your time doesn't start until you "dib" your electronic timing device (SI "card" [more like a stick attched to your finger] or EMIT brick [more like a thick credit card]). So, if I'm too high, I can have some insulin and start, say 30 mins later. I always carry a pocket full of sweets during my run, which usually lasts 30 to 60 mins.


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## Mattcops (Apr 16, 2009)

thanks a lot for the help


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