**DISCLAIMER: Everything that follows is based on personal experience, and does not constitute medical advice. It’s what has worked for me, but everyone’s different.**
After all the things we have advocated so far mainly being detrimental to your health (going to a festival, getting drunk, getting thrush), how’s about something a bit more improving?
I know there are countless websites and blogs out there dedicated to exercising safely with diabetes (Runsweet is one of my favourites) and in fact lots of Our People achieve incredible feats (may I point you to Roddy Riddle and his Marathon Des Sables, to Claire Duncan with her Iron Man Triathlons, to Gavin Griffiths with, well, everything). Special shout out to Paul Buchanan for setting up the brilliant TeamBG and its Facebook group Sporty Diabetic Type 1’s. A great forum for all things sporty. But I thought I would just add a Diabetic Shambles angle to the situ.
I can only talk about the sports I know (which are pretty basic ones: running, cycling, swimming, netball) but we are always looking for contributions so if you have anything on something a bit more exotic, please get in touch!
I started running in 2009 after entering a 5k (and here my tips begin). Enter a race! Set yourself a target! Tell people you’re doing it, that makes it harder to back out. Charity ones are often non-scary and cater for beginners (and there’s often a decent goody bag at the end for the food-minded amongst us). Runner’s World is a great website to find races nearby, of any distance. Race For Life is so popular, and with reason! The atmosphere there is great, with runners of all standards. JDRF and Diabetes UK sometimes have running events on and these are good places to meet other people with diabetes and also there are sometimes stalls from of the big diabetes companies. The Sporty Type 1’s Facebook group often organises meet ups at races so join the group on Facebook and you will be notified when this is happening.
Until you’re race ready, here are a few ways to get there. I’ve never tried it myself but I hear amazing things about the couch25k app. It’s a 9-week series of podcasts that guides you from not running at all, to being able to do a non-stop 5k.
And once we get to 5k, here is where I start getting evangelical. In 2010 I was introduced to parkrun by a colleague. At first I thought, that sounds frightfully serious, but I went along anyway because there was one right next to my house (there were only 18 events in the UK at the time, such luck!). What I found was amazing, 170 runners had turned up for a weekly free race organised by volunteers. I was welcomed, I ran, I finished, and I felt great. The parkrun phenomenon has grown and grown and at the time of writing there are 348 separate parkruns across the UK, with nearly 70,000 runners running this weekend. The ethos is great, and there is strong emphasis on it not being a race. It’s the single thing that has given me the biggest boost to my running in the last 5 years, and I would heartily urge you to check it out.
I need to take this opportunity to reach out to all of the people thinking: “I’m not a runner! More of a jogger”. If you’re going ANY faster than a brisk walk, you’re not just running, you’re a runner and don’t let any lycra person with neon shoes tell you otherwise.
For longer runs, here’s where we need to get serious. Find a running buddy of a similar standard to yourself. Talk with them about your diabetes and what they might see, and what they need to do if you start feeling wobbly. If your BG has been a bit ropey pre-run, let them know, it seems only fair. As a diabetic there is a lot of ‘stuff’ we need to take with us, so get a bag or a belt or something to carry some glucose in, and your meter if you don’t feel hypos coming on. Don’t forget your phone in case you do get into a jam (yes, diabetic ‘worries’ are the main concern but that doesn’t mean we don’t do ‘normal person stuff’ like falling into a hole and breaking a leg). Make sure there is an easy way to reach your emergency contact in your phone (iPhone and Android both have provision for this so have a look in your phone and get this set up).
Basically the thing about diabetes and exercise is that it can be quite tricky. I have a little saying (probably stolen from someone but I don’t remember who) which is: ‘Exercise makes your blood sugar go down, except when it makes your blood sugar go up’. Test before, and test afterwards. If you’re going for longer than half an hour, probably test during. It can help to record these BGs, along with what you were doing, in case there is an obvious pattern.
Hypo symptoms can be masked by the adrenaline of exercise, and so you may not feel your traditional hypo symptoms. Often, I just feel completely drained of energy and unable to continue but without the normal shakes etc. So if you feel drained during a hard workout, it could be a sneaky hypo. Catch it, quickly, because these can get worse quickly.
The advice from your team will be to stop exercising if you go hypo. Realistically, we know that this doesn’t always happen as we all just want to get out workout done. The Shambles advice here is to get safe as quickly as possible and carry on doing what you were doing. The usual hypo treatment of 15g and test after 15 minutes doesn’t work mid-run, so I usually just grab a bunch of fast-acting carbs (around 30g) and carry the hell on. Running gels are great for this, but make sure you get ones with a decent content of fast-acting glucose, because they are made for people without diabetes who need a sustained release of slow acting carbs. Mule Bar Kicks energy gels are great for this and even taste good! Available from running and cycling shops as well as Amazon. If you’re using this strategy, make sure to do lots of tests when you get home (I would advocate a night-time one too for added safety, but I know people are not always up for this).
(*I’m afraid I don’t have much advice for people on injections, but please, if you have some shambolic tips, please come and blog for us!)
If on a pump, there are a few tips which I learned at the Animas Sportsday Weekend in 2013 (another great event, worth checking out!). These have really helped me with some of my longer runs (I’ve done a few half marathons and all of the training runs too which are just as important to get right!). Try and start long runs with no insulin on board/active insulin, if you can. This means messing around with your schedule and mealtimes but it really helps as it means you shouldn’t have to feed insulin or prepare for a drop. Along with this, a large drop in basal is required, especially if you are going for more than an hour. I usually drop my basal by half, from 30 minutes before the exercise until the end. I have achieved some excellent numbers by doing this. I hope it goes without saying that I’ve also had some disastrous numbers. It rarely goes right every time. Do not worry about this. As long as you are safe, and you fix your numbers after, by getting out there you’re doing something good for your body.
I find that exercising first thing (i.e. before breakfast) doesn’t always end well, because of an adrenaline dump that is not countered by any insulin bolus. I may be alone in this, but it took me a little while to figure this out. So if you find that exercise first thing is making your BG shoot up, this could be it. And talking of BG shooting up, we need to touch on ketones. Exercising with a BG above 14 is not advised by medical professionals, and to be honest, you’d barely feel up for it. All I can add here, is work within your limitations. It should never be black and white. If your blood sugar is 15 but coming down, you know you can handle the distance, you’re taking all your kit with you, then who’s to stop you? Know your body, but be gentle with it.
On the subject of being gentle- look after your feet! Running is hard going, and blisters can crop up. An infected blister is not to be recommended, and could easily turn into something more serious without the right care. Vaseline on rubby bits, antiseptic and plasters if blisters form, and rest if they start looking manky. You only get one pair of feet, if you know what I mean. A decent pair of shoes are a good investment if you are running longer distances, and many shops will analyse your gait to show you the best pair.
When it comes to race day, my main tip is to enjoy yourself! A hypo will ruin your race, but running on the high side (I’m talking 8-14) for an hour or two shouldn’t be too bad and you can fix it later. You might find a raise in BGs from raceday nerves but really there’s not much you can do about these. A correction bolus for this could easily send you the wrong way, so be careful!
My favourite thing post-race is to have a pint and a massive lunch. You’ve earned it!
Standard advice for running, like stretching and hydrating still stands, but sadly diabetes must be factored in on top of all of the usual stuff. But that’s why I reckon people with diabetes are so awesome, from having a whole extra level of crap to deal with on top of normal life!
Coming soon in part 2
That time I got a bike and everyone said I should do a triathlon
That other time where I played netball for 3 years and never got my blood sugar right once