Pumping and Long Distance Running

Patient Expert

In less than three weeks, I'm running my first half marathon.   The timing is especially meaningful as I'll be marking a milestone birthday; I turn 30 years old at the end of January.

My unfortunate miscarriage last fall provided me this window of time to train for a race, since we'd have to wait a few months to try to conceive again.   I've been a casual runner for several years, but had primarily been swimming since my first pregnancy.   I'd wanted to get back into running for some time, but the possibility of a pregnancy in the near future was giving me pause about training again.   Therefore, with pregnancy out of the picture for awhile, I seized the chance and started looking for half marathons in my area.   Luckily, San Diego's weather allows for outdoor activities all winter long, so I signed up for a race on Valentine's Day, two weeks after my big birthday.

Although I was briefly derailed by blisters and then a bad cold the first week of the year, my training has been progressing nicely and I'm really enjoying it.   After suffering a terrible blister from ill fitting insoles, I invested in a good pair of running shoes, insoles that were molded to my feet, and great socks.   Having the proper gear has made all the difference.   I was also very pleased to discover that specialty running stores carry a wide range of appear with zippered pockets.   I spent a couple frustrated weeks looking for such gear in the mainstream stores, without any luck.   Since I need to carry my insulin pump, glucose tabs, and my continuous glucose monitor on my runs, zippered pockets are a must.

Diabetes-wise, my training has had a moderate affect on my blood sugars.   Since I typically run in the morning when my dawn phenomenon kicks in, I don't suffer many lows from running.   I did have to adjust my approach to blood glucose management while running when I boosted my mileage.   Previously, when I'd run 3 or 4 miles, I'd simply disconnect from the pump and deliver the missed basal insulin post-run.   I tried this approach during a 6 mile run and ended up high during the run.   I can't be disconnected for over an hour and maintain a steady, healthy blood sugar range throughout the workout.

So, I've started to run with my pump connected.   I'm still working out a plan for race day, but there are a few things I've learned.   When running longer distances, I can't focus on having a "good" number for the first few miles, without considering how long I'll be running.   For example, if my blood sugar is 150 mg/dl at the beginning of a run, I wouldn't bolus to correct it.   I know my blood sugar will drop throughout the workout, so my insulin delivery has to be modest.   On the other hand, not having enough insulin will certainly lead to a high number.   I'll likely balance some glucose intake and insulin throughout the race to give me energy and keep my blood sugar stable.   Obviously, I want to avoid going low during the race, so erring on the side of higher at the beginning should serve me well.