Keeping Control of Blood Glucose Levels in Long Distance Running

I’ve taken on quite an extreme week of endurance running. Possibly in the region of 100 miles covered. Well, with the prospects of running 30 miles a day for 30 days across the UK, I bloody well need to step it up a gear! Along with preparing my levels of fitness and endurance in going out and running long distances from half marathons to 20 miles each day for a week, the aim has also been to keep a check of my Blood Glucose (BG) levels throughout to master the control of my diabetes.

In many ways I’ve been a bit of a Diabetic Test-Dummy this week!

The first run was a kind of ‘run-where-I -feel route’ as I set off from my home in Erith towards Wilmington and then I decided to head towards Swanley before taking a change in route into Dartford Heath and then Dartford Town Centre and back again. This saw me run by one of my old football club Dartford FC, where I decided to have a stop and stretch and it brought back some old memories. Likewise, North West Kent college was on the route where I spent 2 years of my life! A run down memory lane… The important part of this challenge was that I got everything right healthwise.

I lowered my intake of morning Levemir insulin (my long lasting insulin I take twice each day) from the normal 14 units to 9 units, with the plan that with such exercise I’d need less long lasting insulin. I was definitely right, but it comes down to how much.

I found within the opening half hour I was dramatically decreasing in my BG levels. I carried my blood testing kit in a running belt strapped around me to enable me to keep a close check. The starting level was 15, which is on the higher side of things. Although runs burn energy, for full concentration and control as a type 1 diabetic the aim when in sports is to be between levels 7-14.

I was dropping very rapidly. Within 30 minutes I had gone from 15.1 to 10.1, dropping 5 levels. My mate Ryan tweeted to say ‘that’s going down quicker than a Mexican prostitute!’ Indeed it was. I was not going out with speed, I was taking it very slow a maximum pace of 6mph and more towards the 5mph side of things – as when running 30/30 I want to go as slow as possible to save as much energy as I can. I did begin to think maybe the slowed down pace was actually playing a part in decreasing my levels, just gradually wearing it away. Over an Hour in I was at the levels of 7 and then I decided to take a boost running low on supplies. I had a break and consumed 16gs of an energy drink, which I carefully picked out in a shop. After a walk and then a light run, I had a check after the energy boost and found I was heading upwards with a BG level of 8.8.

I finished the run on day 1 for the week with a BG level of 6.2, but this was after I tested a 5.2 on the last mile. I picked the levels up through putting in x3 10 second sprints down the last few roads, which may cause a reaction in the body through a sudden burst of energy that can temporarily pick levels up through naturally creating glucose – in being diabetic I don’t produce insulin like a normal person to deal with extra glucose. This seemed to work as I went up an entire level!

And my hair was looking beautiful! Uncut since late October and it will stay that way til late May if donations keep coming in… Run Forrest!

I took a hill challenge route through my local area and into Plumstead, which had a number of long hills on side roads away from the main road. The intention was to cover around 16 miles and 12 major hills. Early on in the run I was having extreme difficulties. My starting BG level was 17.1 and by the time I’d completed major hill no.1 I had a check and found I was at a level of 7.1 – 7 whole levels dropped. I’d even lowered my morning levermir to 8 units from the normal intake of 14. This baffled me a bit and another half hour later I was at 5.0 and only lowering. I wanted to avoid hypoglycaemic (low blood glucose) which happens under levels 4 and can, if untreated, lead to at worst going into a diabetic coma. Running and burning energy would obviously get me there faster. I decided to take the quickest route home, as I was lacking in energy supplies, and treat myself and restore energy, take out more energy supplies. I successfully done this and a few hours later I decided to go again and this time maintained above levels 7, when starting with a BG level of 12.4.

Day 3 was a longer distance route to Greenwich Park and Blackheath and back, taking on the extreme incline of Shooters Hill before returning on a route via Charlton.

Before I’d taken Levemir intake of 10 units in the evening, from my usual of 14. But I was finding my levels were dropping far too quickly still, so I decided to lower my evening long lasting insulin to 8 as well as my morning dosage. This appeared to have a greater effect, although at first I still had a unwanted drop! Around 30 mins in once again the drop took place, which had been a regular occurrence, and I stopped off at my Granddad Harry’s grave to have a check.

5.0 – not a level I wanted before taking on the incline of Shooters Hill and still being fairly early on in the run. I consumed more energy drink and had a stop to stretch for a while and saw my levels rise to 5.5. From there I decided to continue but keep a check. This is the part where I feel my change of long lasting insulin helped as I did not rapidly drop at all. I consumed a swig of energy drink constantly and aimed to match between half and full of my body weight in kgs (70kgs) into gs of carbohydrates for a hour, 70gs of carbs through energy supplies, in order to keep off a hypo. This was effective as I reached Greenwich Park with a BG of 5.9.

From there I had a slight problem in running out of my energy drinks, but I had some back up plan money stashed within my running glove. I went to a shop and realised that in Greenwich they like to bump up the prices and so didn’t have enough for another slow release energy drink, and had to buy a can of coke. Not ideal as a diabetic, but in reading over ingredients I saw that the can of coke contained 10.9gs of carbohydrates of which 10.9gs of sugars, then glancing at the ‘cherry coke’ can saw that it had 11.9gs of carbs of which 11.9gs of sugars. This means that the likely outcome would be an instant burst of glucose into my body, the sugars would act instantly to pick my bg levels up and from there I had to hope (with no supplies remaining) it would take me up enough to last for the remainder of the run. I was aware that nearly 12gs wasn’t quite enough for an hour longer of running and I probably had an hour and a half to potentially 2 hours more to go.

I picked up the pace away from my contained pace I intend to set for GBR 30/30 in order to complete the run sooner. I was quick, but how would my body cope? Was the energy boost at Greenwich enough? With a few miles remaining and having been out of energy supplies for a long while, I tested and found my levels at 3.5 – hypo! My main prerogative had been to avoid hypo’s from happening when running at all costs. Hypos means your energy is drained, mentally and physically. The blood flow in your body becomes complicated, lacking in blood flow to the brain which results in weird body reactions. I’ve lost my hypo-awareness and therefore cannot feel the effects happening such as shakes and shivers which allow me to know to deal with it, this causes more of a problem as I could just simply hit the floor without knowing. Mentally, however, I was aware. I’d pride myself by saying I’m a very bright young lad, so when mentally I am not operating with thoughts to my normal abilities (and my mind is always thinking things through) I know something isn’t right – hypo. I was finding it difficult to concentrate, which makes it hard to keep going to respects, harder to be self-motivated.

What do you do at a hypo level with 3/4 miles remaining and no energy supplies to pick yourself up on a run?

One life line option would be my mobile phone. I could have called someone to pick me up perhaps…

That’s quitting in my eyes. I always set out to see a job through. I decided to carry on. I wouldn’t advise diabetics to do such a think at a level of 3.5, maybe the 5 mark when feeling it is lowering and needed a pick up without supplies then yes carry on, but in already being a hypo I took a big risk. Running burns energy, at 3.5 I’ve no energy to burn and risk going to a much worse level – potential diabetic coma territory.

In continuing I made a decision to change my pace. 3/4 miles is a long way to run on/off sprints as my theory of quickly picking levels up temporarily works – I’d burn myself out completely in doing that on the back of a 20 mile run! I recalled playing football and in those days it went either two ways: highs or lows. Football is an adrenaline rush game, it contains sudden bursts of pace and changes of pace, and this made my levels often go up to 20s after a match. Seemingly odd. But it was down to the sudden bursts creating glucose in my body through adrenaline bursts. I decided to run the remaining 3/4 miles as though it was a football match, changing my pace from very slow to medium pace, the odd sudden sprint here and there, slow again and so on…

Mentally I could feel the lack of concentration, my mind somewhat numbing up and thoughts slowing down, harder to think… but I continued to run at a varied pace. I made it home successfully, the most important aspect.

My finishing level was 5.3!

I’d saved my own bacon. I felt like a young, diabetic Tom Cruise in Mission Impossible, defying it completely. No supplies to pick myself up, all natural and turning a hypo on its head to complete the run! I was well pleased!

I’ve got some survival skills on me, which will be crucial in running 30/30!

To avoid this over the next few days of distance running, I aimed to keep the hypos off by consuming more carbohydrates in my diet for breakfast. I kept the beginning levels between 7-14, mainly between 11-13, and kept repeated checks and consuming energy. I found that in lowering my long lasting insulin by half, 7 units in the morning and 8 in the evening, I was having greater success in my long training runs. I’ve yet to have another hypo whilst running, and have confidence in my skills to get out of trouble even when out of supplies! Although let’s try and avoid those situations…