Regular Guy with Type 1 Diabetes Decides to Run a Marathon...

Ginger Vieira Health Guide
  • Rob is 46 years old, a father of 2 boys (15 and 18 years old). He grew up in Northern Virginia/DC area...and "hated it." He attended the University of Virginia, and immediately fled to northern New England where he's worked for LLB and a pharmaceutical company. He is also a registered nurse! He is an avid traveller of Europe and has hit every state in the USA except Arkansas and Kentucky. Today, Rob and his wife live in Burlington, VT.


    His hobbies included fly-fishing, travel, hiking, old cars, cross country skate-skiing, Kempo Karate...anything outdoors seems to get his attention.

    1. How long have you lived with diabetes? How would you describe your history with diabetes so far?
    19 years, diagnosed at age 27.  Symptoms first noticed while doing a 3 day hike on the Long Trail.  It was good to have an answer to what was making me feel so lousy, and to know that I can control it (no one else can do it for me).  It hasn't really stopped me from doing anything - be it backpacking for a few days or floating a wildnerness river in Alaska - but we have to always make special adaptations which includes carrying extra food/glucose tablets at all times and calculating expected fluctuations on blood sugar from activity and prior food intake.  Have never been hospitalized, but did need one ER visit a couple years ago when I accidentally injected 36 units of Regular insulin instead of the basal insulin. Now I use something other than a vial for the basal insulin and split it up to 18 units twice a day so that can't happen again. My  A1Cs have been good, ranging over the years from 6.2 to 8.2, average around 7.   Have looked into getting a pump but decided it wasn't for me.

    2. Have you always been athletic?
    Not really/sort of.  The last 10 years I'd say "yes", perhaps in part because the demands of job and family have become more routine and I don't feel quite right if I don't exercise.  Now if I don't get a good workout for 3 days it effects my mood.  Regular aerobic-type exercise stabilizes both the mind and body.  Humans (and other animals) have needed to be physically active for many thousands of years prior to the invention of escalators in order to survive.  Now we have hit an "evolutionary wall" physically, where excessive eating and inactivity have become commonplace.  That has to have negative consequences on many levels.

    3. How did you learn how to balance diabetes around sports?
    Knowing how carbohydrates (simple and complex), proteins, and fats effect blood glucose levels is critically important, and not too difficult.  We also have to know how the different insulins work as relates to onset, peak, and duration.  Using long-distance hiking as an example, where a steady and constant workout is maintained, you can get an idea by watching what both the exercise and the food (ie. granola-type bars with defined carb/calorie content) do to your blood sugars.  I always have a glucometer with me as well. 
    Rob and his son on a hike
    4. Is it easy for you now to balance during sports and do you still get frustrated sometimes?
    It is relatively easy, and using a long-acting basal insulin helps with that.  Usually I won't take any of the short acting insulins before sports - I want those to wash out of my system to help avoid "lows".  The only mildly frustrating thing is having to sometimes carry extra stuff (food, sugar, glucometer) with me, the amount of which being determined by the duration of the exercise.  If it's just a 5km jog, then a sleeve of glucose tablets and a Fig Newton is adequate.  When cross country skiing for a few hours, more food is needed.

    5. How or why did you decide you wanted to run marathons?
    That's marathon, singular, from May of this year!   It was a whim really, just wanted to see if it was doable for me before I get too old.  The winter skate-skiing keeps the cardiovascular up to snuff, the bigger concern was the joints and musculoskeletal.  Slow and steady did the job.

    6. What are the hardest parts about balancing your blood sugar during a marathon?
    Guessing how much to eat prior to the race, and then stopping periodically to test and see when my energy reserves were used up and needed replenishing.  I had cut my basal insulin by half the night before and the morning of the race, and ate a couple handfuls of cashew nuts 3 hours prior.   Sugars were good 30 minutes before the start, so had 2 bananas (carbs and potassium) and a quart of water.  About 5 miles into it was the first test, and sugars were running too high (around 300) but I knew that they would come down soon, so did notinject any insulin.  Sure enough, by mile 9 they were below 200 and by mile 13 I was starting to take the periodic food bar and Gatorade/water/sea salt to keep things at around 100.  This continued through the rest of the run, as my body was burning everything that went into it.

    7. Many folks with Type 1 are very worried about dropping low during exercise, what suggestions do you have to help someone get over that initial obstacle?
    Always, always, ALWAYS carry glucose tablets with you.  Not in the car, nor at your house, etc.  Carry them in your hand if necessary.  I bought a small fanny pack that almost feels like it isn't there, and put some food bars and glucose in that for periods exceeding an hour.  For shorter durations a small bit can fit in my shorts pocket.  I got scared once shortly after first being diagnosed, finding myself alone and 1/4 mile away from a fishing buddy in the remote Maine woods with my food in a backpack by him and nothing in my pockets.  I went "low", but made it back to my pack (in a cold, mildly disoriented sweat) before it was too late.  Will never allow that to happen again.

    You get used to it. What choice is there?  This is a disease which will treat you as well as you treat it.  Nobody can do it for you - the doctor and health care team are guides and coaches, but only you can navigate the day.  You can have a completely normal life if you so choose.  There are some diseases which, inspite of your best efforts, will hurt your quality of life substantially right from the start.  Fortunately that is not the case here - or at least not for awhile.  Eventually it'll probably catch up to me, but by then I'll hopefully look back, shrug, and have no regrets.


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Published On: August 17, 2010