I ran another half marathon last weekend, and it was tough. My blood sugar was about 150 mg/dl when I woke up. I had coffee and a graham cracker like I do every morning, gave myself a small injection of rapid-acting insulin and 8 units of basal insulin, and got ready for the run. I tested my blood sugar about 30 minutes later and was frustrated to see that it had crept up to 225. I knew it was partly because I was nervous about the run (the same thing had happened to me the month before when I ran the Kiawah Island Half Marathon), but I didn’t want to give an extra injection because I didn’t want to be low during the run. (I should add that, after 32 years, I mostly manage diabetes by myself. But even if I wanted to talk with an endo, they are tough to make appointments with, and my next appointment isn’t until April.)
The run started off strong and I felt good until about mile 10. It was a warm day for January, and I prefer to run in cool temps. I tested my blood sugar at mile 6 (175 mg/dl) and again at mile 10 (220 mg/dl). Running with high blood sugar can be OK, for me anyway, unless it’s on its way up. When my blood sugar is slowly increasing, I feel sluggish, as if I’m running through water. So I had to dig really deep for those last few miles. All the while I couldn’t stop the negative thoughts circling in my head that if I couldn’t do a half, I wouldn’t be able to run a full marathon.
It’s been 20 years since I ran 26.2 miles, and I’ve been fantasizing about running a marathon again. I tried last year but stopped training after 16 miles. My heart wasn’t in it. But I kept thinking about the marathon even after I quit training. That day, as I gritted my teeth and pushed myself toward the finish line, I thought, forget it, this is too hard. Over the line, I stopped, leaned my head between my legs, and guzzled two bottles of water. I found my family and we walked together away from the crowd. When I tested my blood sugar a few minutes later it was 250 mg/dl. I remained high for the rest of the morning and needed 4 more units of rapid-acting insulin before my blood sugar leveled out. Frustrated, I knew it wasn’t the weather that made the run difficult.
Later that week I ran into a friend who has Type 1 diabetes. While we were talking, she mentioned that she’d recently had an appointment with her endocrinologist who suggested she divide her basal insulin shot into two times a day. She said it was working for her, and I got that excited feeling in my chest when the clouds part and you see a glimmer of light. Of course! I thought. When basal insulin was first prescribed to me years before, I remember my doctor and diabetes educator being very excited about it because it was a 24-hour insulin, which meant fewer injections. Instead of a morning and evening injection of long-acting insulin, now I would only have to do it once in the morning. It seemed too good to be true, and I remember in the beginning that it was. My basal insulin never seemed to last the full 24 hours, and I ended up giving extra injections of short-acting insulin to cover the highs, but when I complained to my educator, she just told me to increase the amount of basal insulin. But then, of course, I ended up having more lows during the day.
I think I’d forgotten all that when I talked to my friend. I’d gotten used to trying to do everything by myself. When Terry told me that she didn’t think basal insulin lasted for 24 hours, I was relieved because the answer to my problem was obvious, but I was also frustrated that I hadn’t figured it out on my own sooner. I’ve been following Terry’s suggestion for the last few days, and it’s worked out beautifully. My blood sugar isn’t spiking in the morning, and my runs feel stronger. All of this reminds me that it’s the people living with diabetes who are the best resources. And sometimes, even when we’ve lived with this for decades, we need new ideas, suggestions, and advice from friends with diabetes.
People whose blood sugar has been running high can start to feel hypoglycemic at target numbers, but it’s worth toughing out this period to gain better control, says nurse David Spero. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.