In early March, as I sat in Pathophysiology class, I got the email with the subject: “You’re now invited to the 43rd Marine Corps Marathon”. It was a pretty daunting email to open. As I whispered “Look!” to my friend in class, I realized that it was time for me to go after something that I had been pretty afraid of for a while. Spoiler alert: I finished, but another spoiler: it was definitely not pretty.
Surprisingly, race morning was relatively (and ideally) uneventful. In my practice runs, I learned (through trial-and-error) that it was critical to start running with a slightly elevated blood sugar and also without any active insulin to avoid lows. I had put a 12 hour temporary target (preprogrammed to 150 mg/dL) on my 670G hybrid closed-loop insulin pump, and would set it again when I first woke up. On race day, this translated to a 5:30 a.m. wake-up, as I was scheduled to hit the starting line around 7:30 a.m. I had a serving of oatmeal with an apple, a tablespoon of almond butter, and some cinnamon - making sure I had some whole grains, protein, and healthy fats to carry me through the race. Given the early wake-up call, I needed a full cup of coffee and a bottle of water.
My race nutrition plan was straightforward: take a look at my continuous glucose monitor (CGM) every 3 miles, long enough that I could start to see the effects of some form of treatment but short enough to catch any dramatic changes. I ran with a Camelback “Marathoner” vest which had plenty of space for glucose tablets, water, and even my phone! The vest was filled up with Sports Beans to keep from bonking (or hitting a wall), just like any other runner. A packet of these beans was 25 grams of carbs, which I would have every other time I looked at my CGM. It was more fuel than most runners would need, but this was the combination that kept my blood sugar in a target range.
Plan for the best, prepare for the worst
The best laid plans, however, tend to go awry. There was about a 1.5 mile walk from the Metro stop to the start line. This “exercise” coupled with some nerves, dropped my blood sugar down to about 90 mg/dL with trend arrows indicating it was dropping. My plan of starting the marathon at 150 turned into me devouring an extra pack of fruit snacks. But I toed the start line, nonetheless, double-knotted my sneakers, and hit play on my 300+ song playlist.
The final stretch
I’ll save you the boring details of the final 12(ish) miles. It was a lot of song-changes, high fives from strangers, a quick stop to use the bathroom, but relatively smooth sailing. I know a few things: I will never eat another sports bean again, and I am hanging up my running shoes for the (near) future. I learned that marathons are hard, and adding diabetes makes it just a bit more interesting. If you’re thinking about doing a marathon and it’s something you’re passionate about, let this be your sign to sign up for one. (And Amazon has 25 bag boxes of sports beans here).