Diabetes Self-Management Blog

In college I ran cross-country and track. In my mid- to late twenties I ran because I enjoyed it. In my thirties I haven’t really done much running. Oh, I’ve done and will probably again do the gym thing, spinning classes, all of that, but lately — and in no small part because of lovely weather and a beautiful hilly, forested cemetery two blocks from our house that has beautiful trails on which we take our dog on long walks — I’ve had the urge to start running.

So what’s stopping me?

First I need to get decent running shoes. That’s an OK excuse for not getting out on the trails as soon as possible. I mean, the support in the years-old tennis shoes I have is pretty much gone, and they’re torn up from gardening, so I need to make a trip to a shoe outlet soon and pick up a discount pair. Simple enough.

Second is knowing that I’m not in the kind of cardiovascular shape I was when last I ran. I’m older, and heavier, than in those college days and years in my twenties. That means that I’m slower. Oh, and that I’m slower. Did I mention I’m probably not as fast as I used to be? This means I need to call upon the wisdom of my years to deal with the internal monologue, because it will do its damndest to try to shame me out of even trying to get back out there because I’m not what I once was. I know this about me. I know the self-defeating inner voices will conspire to keep me inside. I need to override them, remind them that I’m a much happier, more well-adjusted person now than I ever was during the cross-country days of yore. Winning doesn’t matter. Pushing it to the extreme doesn’t matter. There don’t have to be any races; there is no clock.

The third thing? Hmm. Well, it may just be the fact that two years ago I was diagnosed with Type 1 diabetes.

Now I know, I know… yes, I know, that there are all sorts and kinds of folks with Type 1 diabetes who run, who even do marathons. And it’s not as if I haven’t exercised since my diagnosis (for nearly a year I was pushing myself intensely in those spinning classes). The thing about running, though, about heading off on my own through city streets and cemetery trails, is that I’ll more than likely not be around anyone who’ll know what’s going on if, for some reason, I were to have an episode of low blood glucose.

During spinning classes the instructor knew I had diabetes and that I was on insulin. As well, I had a bottle of Gatorade or other carbohydrate-intensive drink with me on the stationary bike as I pedaled. I also had my kit and could monitor my blood glucose as I continued to pedal.

But here’s where I get stymied with running streets and trails: all of that diabetic junk — carrying extra carbs, a kit, probably my cell phone just in case, and thinking about the preparation to have my blood glucose in line before running, and so on — it really does weigh on me, both literally and emotionally.

It doesn’t seem fair. I want to pout about it (I just did). I so wish it wasn’t necessary.

Unfortunately, all of the diabetes accoutrement is necessary. And I know that I’m making something out to be way more problematic than it actually is. I know about carbohydrate gel packets. I know I can stop to check my blood glucose if I need to. I know about starting out slowly, not trying to run five miles the first time out, that I should stay close to home, only go out for 15–20 minutes the first time, watch my blood glucose patterns. All of that stuff.

So why does it still loom large? Seem overwhelming to contemplate it? Because I’ve yet to start, and the shadow looms so much larger than the actual object. And there’s that internal monologue. It’s there. Probably always will be. It’s very adept at talking me out of things I ought not be talked out of.

However, doing something like this, writing down the supposed impediments to returning to running: that helps. It’s sort of like setting up each perceived roadblock and then pushing it down as I write through it.

I’ll get out on those trails soon.

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Comments
  1. This is the perfect article. This is one of the situations that I think most of us with any kind of diabetes faces, it is good that you are vocalizing it. I know that I worry and stress over all the “little things” that go along with diabetes and the people around me sometimes don’t get that.

    Thank you for giving it a voice. I am going to show them this article and hope that they “Get It”.

    Shelly

    Posted by Shelly |
  2. Hey Eric, I totally get you that not being as fast/in shape/lean/etc. is hard to deal with sometimes. I’m dealing with that a bit now. Did my first 1/2 marathon in Feb, and had a slump after than. Now I’m rebuilding…am slower than ever and have a tendency to bet myself up about it. When I’m feeling that way, I tell myself “I’m faster than my couch”. Silly, I know, but it helps.

    As for all the stuff, I know you can figure out the details, but purchasing an amphipod belt really helped me. I got an extra large pouch for mine that holds meter, test strips, lancing device, and gels or shot blocks. Also nice to be able to carry my own water in the heat here in TX.

    And when I let those little things that can be overcome keep me out of the game, there is usually some larger issue I’m grappling with underneath. Running is a great “therapy” for working out those things though, so I hope you will get out there…today. Don’t let your couch catch you!

    Posted by Carol |
  3. Thanks for the comments thus far, guys. Last night after dinner my wife wanted to go out with me and get running shoes because she knows how badly I actually do want to run and doesn’t want the shoes thing to be any part of the excuse. So I found a comfy pair of Reeboks (I’ve always been partial to Reebok and Saucony for runnin).

    Around 8:30 I went online and mapped a 2.5-mile loop from our house and told myself it didn’t matter if I walked parts of it. I ran the first 2 miles and then realized how much I want to do this again (maybe this evening) and again, so not wanting to overdo it, I walked the last half-mile for a cooldown.

    I carried a small Nalgene bottle filled with Powerade during the run, and I checked before running and was at 168 mg/dl (after loading up a bit on carbs). After the run I did drop to the 70s for a bit, but I was able to correct and got it back up to 120 pretty easily. Relearning running now that blood glucose is a factor.

    Just now, after lunch, I stopped by a store and picked up some Clif Shots gel packs: 25 grams of carb in each, and very unobtrusive. I’ll carry one or two of those, as well, depending on the length of the run.

    Anyway, maybe a loop through the cemetary after work. Slowly but surely.

    Eric

    Posted by Eric L. |
  4. Woohoo!!!!! Way to go. You left your couch in the dust! Your wife is awesome too for supporting and encouraging you.

    Posted by Carol |
  5. Eric,

    I am partial to swimming laps and am not as good as I used to be. Some days are better than others. I just say to myself, when I am a bit down on those not so better days, “some is better than none” then do what I can at that given point in time, knowing that the next day will be better. So keep on running……

    Posted by Diane |
  6. Way to go! You are very inspiring! I too am a runner, (who hasn’t been running for two years), and am currently taking the steps to get back to full on running again. I am in love with the sport. I was diagnosed type 1 in January and have been re-learning how to exercise with diabetes since then. I went hypo the very first time I used Humalog with breakfast and then went for a brisk walk not knowing that the dose was too high for me…oops. What a way to find out one is insulin sensitive. I was lucky I made it back to my office that morning. I agree that the idea of running in areas where people might not know what is going on if you do hypo is a bit daunting, but I plan on being prepared with all necessary tools. I have a pretty good network of friends, co-workers, gym-buddies and family to help along the way. Each step at a time…So, yay! to you!

    Posted by Lisa |
  7. Eric,

    They make Road ID bracelets (in a variety of colors). They differ slightly from medical ID bracelets which I hope you have. They are velcro and can either go around your laces or your wrist and are very clearly marked. When you take it off, it has a little card that slides out with all of your information on it. Amazingly useful! As a paramedic I wish every patient I came upon had such a bracelet. It holds Meds, Allergies, Dr. numbers, emergency contacts, medical history. EVERYONE should have one, but it is definatly a huge comfort for me to have it when I go running alone in case my sugar drops.

    Posted by Nicole |
  8. The worst for me is timing the run. The best time if I didn’t have diabetes is right after work, or right before bed. The worst time with Type 1 is right after work, or right before bed.

    Given you bolus after you eat, when do other Type 1s run?

    Posted by Dan |
  9. I enjoyed reading this thread. I have type 1 and used to run quite a lot and have turned into the very occassional runner. Now for the last month I’ve been running 5-6 times a week. the thing I love about running is seeing progress. When I started I had trouble making it 2 miles. Now I still have trouble making it 2 miles (but not as bad as at first) and also manage to then survive the trouble of the next couple/few miles after that (but I make it!) And I am seeing progress, as I’m able to run farther, feel better, losing a few pounds.

    Just like running 2 miles at first was really hard, it was also very difficult figuring out tweaks to carb rations, temporary basal rates, and trying to find the right time to fit in the run that won’t negatively impact work, my family time, or that won’t lead to hypo/hyperglycemia. The good thing is I’m also starting to see progress with my diabetes management of all of this. Far from perfect, but I’m staying safe, getting healthier, and having fun.

    Anyway, just like I’m not yet ready to run a 1/2 marathon (but come September or October I’ll be there), there’s a lot of progress I can still make with the diabetes management issues.

    Here’s the struggles I’m trying to work through personally right now:
    1) I like to run early in the AM prior to breakfast because my glucose level is pretty stable and I don’t have carbs being digested and extra insulin working. Problem with this is I need fuel to run farther than 4-5 miles.
    2) When I run in the morning– my gluscose spikes post-workout. I’m getting close to knowing how much extra to bolus. I can have a breakfst of 35 g carb and take 7-10 U insulin when I might eat 3 times that for dinner and use a unit or 2 less of insulin.
    3) If I run at night I need to reduce my bolus at dinner and then still wait preferrably 3 hours before I run. When I do this I still better be prepared to check my blood sugar a couple times during a 40 minute run and make sure to have ample available carbs.(even with a glucose sensor because the sensor will still show stable when my glucose level has already dropped 50 points!). I’ve also learned that it’s OK to turn a good run into a nice slow walk while munching fruit snacks because of a low bloos sugar.

    Anyway, thanks for the opportunity to reply as writing out these issues helps me realize that progress is being made.

    One foot in front of the other,
    Erik

    Posted by Erik |
  10. I know just what you mean. I have been a diabetic for 37 years and try to keep tight control over my blood sugars. I have lost all of my warning signs for a low blood sugar incident and i am terrified to go exercise alone. I can’t tell you how many times I lace up my sneakers to go out and end up not going.

    Posted by Lisa |
  11. (I wrote this for the running group I belong to.)

    I have been a runner for about 25 years, starting in my mid-20’s, seeing running as a good way to stay in shape for skiing. My exercise addiction has grown with each passing River Bank Run, each finishers medal and t-shirt. After about 15 years of nightmarish chaffing, I worked myself into some halfway middling shape, and developed a serious marathon obsession along the way. I actually thought I was close to a breakthrough. I was running 3 oh somethings, and was chomping at the bit to break the 3 hour barrier. Instead, I broke into the world of Unhealthy Runner’s. In a testament to my arrested development and immaturity, I developed Juvenile Onset Diabetes at age 37. Type I. The kind with needles, vials of insulin and blood monitoring gadgets you see on TV these days.
    At first I thought it was the end of the road. I wailed and moaned. How can a sick person do what I wanted to do? I pictured myself as a frail, depressed guy cooped up in a dark room with rusty needles lying around. But then I got to thinking about what diabetes entailed, and it somehow sounded like the perfect disease for me. I mean, I was already watching my diet, I knew the importance of keeping tract of carbohydrate intake, and I was sort of obsessive about all of my bodily functions, all byproducts of trying to be a better runner. How much of a difference was being a diabetic going to make?
    I didn’t stop running one day because of diabetes. I learned to adapt. I had to watch out for low blood sugar while running, as this phenomenon would wipe me out like being wasted drunk, and could kill me. But that is easily remedied just by carrying one of those little GU flasks filled with some sort of sugary stuff. I was slower, for sure, but it was better than never running again. Much better. I would show up for races and it seemed no one even noticed the difference, or they were polite enough not to let on (which is a tribute to how kind runners tend to be). I just had to recalibrate my Pros for AD, After Diabetes. It was like being in a new age group.
    After about 10 years of dealing with this, I thought I was doing pretty damn good. I was staying fit and keeping my disease under control. But then, a year and half ago, I had a heart attack. I had just registered for the Boston Marathon, and was psyched to get training… and felt a suffocating pain in my chest. It turns out that heart disease is the most common way people with diabetes die, even if their cholesterol levels are good, as mine are. I guess I would have died, except my exercise fetish saved my ass. Being a runner, I had developed collateral arteries in my heart that compensated for my blocked artery. It was a natural bypass.
    Part of my heart died. I didn’t know if I could continue to run. The doctor said I’d better take it easy for a while. So I did. I ran slowly. But I kept running. In fact I ran more. I figured if I had to go easy, I would go long. And even though I was slow as a turtle, I ran Boston anyway. No one was going to keep me from running that awesome race one more time.
    I still feel pain in my heart, but just when I’m warming up, and now I can run hard and long. I have to train my butt off to qualify for Boston, but I have done it, defective product or not.
    I think these ordeals have actually been more of a positive than negative. I have been forced to come to terms with the fragility of life; no matter how healthy and fit one is, the body can be transformed in a heartbeat. I have also become more aware of other people’s problems, especially runners with problems. It’s almost rare to find someone who doesn’t have some physical or mental ailment. To see all these fighters, with their huge obstacles, standing at the starting line adds a heroic dimension to the drama.
    I am so thankful to have a heart and body that will get me down the trail. Even if I’m lucky, there will be untold other issues to deal with down the road. Running is a blessing and it saved my life. I know that through my experiences as a runner, and from the company of others I have had over the miles, that attitude can change the whole journey. I remember one Portland Marathon, at about mile 16, the group I was running with was starting to worry about the hill up ahead, and how crappy they were going to feel at mile 22, and if they would still have energy for a finishing surge, and this woman said “I’m not worried. I say bring it on!”
    Of course that may sound cocky, tempting Fate, and it’s easy to say, harder to do. We don’t seem to have much control over what happens to us, but we do have some power over our how we look at it. With the right attitude, there is less to worry about. The hills up ahead, the Wall, whatever, I say bring it on.

    Posted by Tom Halverson |

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