Running a marathon with T1D

Short Description
My Journey taking on the 43rd Marine Corps Marathon
Contributor
Lizzie Considine, Georgetown University CDN Chapter
Tags
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breakfast table

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.

Components

Blurb Title
Plan for the best, prepare for the worst

Blurb Description

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.

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Race high five
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Prerace blood sugar
Description

I figured that a pre-race low would probably be the end of my bad luck for the day, but no one likes a straightforward story. My first CGM check at mile 3 showed a stable blood sugar, so no treatment was needed. Mile 6 still showed a stable blood sugar, which was pretty unusual for 6 miles in. I knew, however, that if I did not have diabetes, I would need to eat something just about now anyway, so I ate my first pack of beans and bolused for half of the carbs. Mile 9 and 12 had the same flat sensor glucose, so I decided at mile 12 to eat another pack and bolus for half. Under a half mile later, I could feel my blood sugar dropping. I had triple trend arrows showing my blood sugar was dropping by 3 or more mg/dL per minute, and I still had some active insulin from the beans pack. I started with 3 glucose tablets and slowed my pace down to a trot (read: walk), waited 10 minutes and still was dropping. So I had one pack of beans, waited some more, then another pack, totaling around 65 grams and tried to get moving again.

Starting up again was the most difficult part of the race. I knew my family was waiting about a mile ahead, and by this point I was over halfway through the race. But slowing down to a walk added lots of time and made my legs feel like bricks. I dragged each leg in slow motion around the capital lawns. I don’t remember seeing too many spectators, funny posters, or cool scenery from these few miles.

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The final stretch

Blurb Description

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).

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lizzie
Title
Elizabeth Considine
Description

Elizabeth Considine is a junior at Georgetown University. She is in the School of Nursing and Health Studies, majoring in human science. She is the co-captain of the Club Triathlon team and wants to be an endocrinologist when she grows up!