Preparing to Run a Half marathon

Type 1 Diabetes – How I Prepare my Blood Glucose Levels Before I Run

Hi, Paul Coker here from 1BloodyDrop.com. For those of you that don’t me, to mark my 40th year of living with Type 1 diabetes, I have ran 40 half marathons. And people on almost every single run and everybody that I’ve met before, during, and after have said to me, “How do you manage your diabetes whilst you run?” So I decided to create this website about that, and I’ve decided to create some videos to talk you through this.

So this first video on that very topic is going to be about how I manage my diabetes before I run, because if I don’t get the foundations right before I run, there’s no way I’m going to make the run. So what do I do before I run? My preparations begin days before I go out for a run. If I was just going out for a short training run, perhaps hours. But to prepare for a half marathon, I start my preparations three or four days beforehand. And I start by trying to make sure that my chances of going hypo are much lower.

What do I mean by that? Well I start by reducing my insulin dose in that period. I add more carbohydrates. We’ve all heard the stories of marathon runners going out and having a pasta party the day before. Well there’s some truth in that, but it’s not about a pasta party the day before. It’s actually about carbohydrate loading for many days before. So our glycogen stores are huge. Our glycogen stores will actually grow if we continually carbohydrate load, until they reach maximum size. But we’re not going to get that maximum size from one pasta party. So I’m talking about carbohydrate loading for days and days and days. And in particular, for at least three days before I run a half marathon.

What that means is that if my glycogen stores are huge, then my muscles have already got a great big store of glucose onboard that they can you whilst I’m running, which protects my blood glucose levels. That’s great.
The other thing thing I do is that before I run a half marathon, two hours before, I will eat a high carbohydrate meal, and I will give half of my normal insulin for that meal so that I don’t have a huge amount of insulin onboard whilst I’m running. The other thing that I’ll do is an hour before I run, I’ll actually reduce my background insulin. Now, if you’re not using an insulin pump, this is not easy to do, but you’re using an insulin pump, I suggest making a reduction in your insulin profile for your background insulin, your basal insulin.

Now, the starting point I would recommend, and the evidence suggests doing the same is 50% reduction in your basal insulin. Personally, I use 90% reduction in my background insulin an hour before I run. And if it’s a hot day, I’ll take a 90% reduction.

Now the next thing that I do is I maintain that reduction in my background insulin for the duration of the run until 30 minutes before I’m due to finish the run. The other thing that I do is I constantly monitor my blood glucose levels. Now I’m lucky enough to have a continuous glucose monitor, which I fund for myself. And if you’ve got one, I recommend that you use it. If you haven’t, I suggest that if you can afford one, get one. If you can’t afford one, at least look at investing in a FreeStyle Libre. They don’t have such a high setup cost, and you only have to buy a sensor when you want one. They work out about 50 pounds per sensor. Okay, expensive, but not the end of the world.

Now with those you can, just with a quick glance at a screen and a quick wipe of FreeStyle sense reader over the sensor, you can see what your blood glucose level is in this instant, and you can also see the trend that it’s going in. Now that’s really important, because if your blood glucose level is sitting there at six, and it’s heading down quickly, you know that you need to take some glucose onboard before you go into a hypo. And that’s also really important. It’s much easier to prevent a hypo than it is to treat a hypo and then carry on running.

And the other thing that we need to talk about here is what we actually do during a run. And that’s the subject of the next video.