From robcarr@my-deja.com Thu Apr 19 12:03:42 EDT 2001

On Wed, 18 Apr 2001 20:42:08 -0500 (CDT), stevehargrave@webtv.net
(steve hargrave) wrote:

> I was
>wondering if any diabetic runners had any advice or suggestions for me.
>Is there any general rules of thumb as far as decreasing bg #s per mile
>ran, etc.  Thanks in advance.

Running (or at least some form of aerobic exercise) is very important
for the Type II diabetic. Running:

1. Lowers blood glucose levels on the average (more below)
2. Permits muscles to take up glucose without insulin
3. Improves the body's ability to make use of insulin
4. Decreases the total amount of insulin your body puts out in a day
(this is actually a good thing - as a Type II diabetic, you're working
your beta cells to death - literally. That's why Type IIs tend to
progress to needing insulin).
5. Improves emotional outlook (being a diabetic sucks).
6. Improves cardiovascular fitness (guess what the #1 killer of Type
IIs is?).

Running is not something you can do during track and cross country
seasons only, unless you can replace it with some other type of
aerobic exercise.

This leads to Principle #1

You are running for your life.

One of the implications of this is that you really need to avoid
injuries. You can't increase your mileage as fast as a non-diabetic,
because if you get a running injury, it will dramatically affect your
ability to control your blood glucose levels. This means you have to
train sensibly. Most of all, avoid foot and lower leg injuries. One
trick I've found for avoiding blisters is Thorlo socks. You also need
the correct pair of shoes. If you can get your gait analyzed at a
Sports Medicine Clinic, it's worth it even if you have to pay for it
out of pocket. Get your shoes at a running store if at all possible,
and preferably one with a treadmill so you can take them out for a
half mile to a mile to see how they are.

This also means that you need to stretch and stretch properly. 

Principle #2

You need carbohydrates - even sugars.

As a diabetic, you've probably gotten to think that carbos are your
enemy. In some ways they are, but as a runner, they're your best
friend. Fortunately, as a runner, your body can deal better with them.
You need them. If you are training with depleted glycogen stores,
you're not going to train very well and could be injured.

You need to consume carbohydrates before you run, after you run, and
maybe even during a run - at least if the run is over 1 hour. I find
that if I split a meal into thirds and eat 1/3 before I run and 2/3rds
after I run, I do quite well. I carry GU or sports drinks during a run
and use Endurox R4 after a run. I do believe the protein in Endurox R4
helps, but I've been known to eat Cadbury Chocolate Eggs after a long
workout - and still keep my BG under 110 mg/dl.

Principle #3

Test strips are cheap running equipment.

The only real way you're going to find out how your body is doing is
to test your blood glucose levels. Usually, my BG will go down, but
I've had runs where my final BG was higher than I started with. I've
seen my BG go from 230 mg/dl to 70 mg/dl after 3 miles at 11 min. per
mile. Other times, I've had a BG drop to 40 mg/dl and felt like
nothing was wrong.

This brings up an important point. After a run, since you don't know
what your BG is, it could be dangerously low. Imagine what would
happen if, after that run where my BG dropped to 40 mg/dl, I had tried
to drive some place. Running doesn't help your health if you kill
yourself in a car accident.

Test every time you try something. If you decide to use Endurox R4 as
a Recovery drink, test to find out if you can handle it. You may need
to use less than the recommended amount.

I usually test when I wake up, before I run, after I run, and some
other time during the day. On the other hand, when I've been trying
something new, I've used 20 test strips in one day.

Principle #4

Be prepared for the worst.

I really should have a running partner, but I don't. So, I carry a
packet of GU and have sports drinks available and the Endurox R4 in
the car (I drive to where I'm going to run usually). I tell my wife
how far I'm running and when she should expect me home. I run in
populated areas, although I try to stay away from vehicular traffic. I
figure that if I get into trouble, someone will find me and call 911
before my brain fries, assuming I wasn't able to catch the problem.
Still, a running partner would be great.

Also, know what you can do if you do get injured or sick so that you
can't run. You might have to modify your food intake, switch to a
different aerobic exercise, or something else. Talk with your doc
about what to do during sick days and under what circumstances you
shouldn't run - illness, high BG, etc.

Principle #5

Have fun.

I sort of wonder if this should actually be Principle #1. I have fun
running. I had an injury and gave up on running, and because of that I
became diabetic. I hate being diabetic, but I have to say the one good
thing about diabetes is that it forced me to get back into running.
It's a shame I didn't do it with less motivation.

If you have fun running, then enjoy running for your life. If you
don't like running, find something else aerobic to do. Life is too
short to be miserable trying to make it longer.

Principle #6

Weight Training helps diabetics

A lot of runners shy away from weight training. But muscle mass takes
up glucose, and it can do it without insulin during or for a while
after exercise. Use the weight training to strengthen your upper body
and add support for the joints in your legs.

Principle #7

You get Two Hours and Two Days from a workout.

For the first two hours after a workout, your body will be able to
handle far, far more glucose than it could normally. The muscles can
still take up glucose without insulin. Use this time to get as much
glucose into your system as you can without putting your BG too high.

For the two days after a workout, your body will still be able to
handle more glucose than normal, just not as much as you can during
the first two hours.  What this means for me is I don't let there be
more than 2 days between a workout.

Principle #8

You need easy weeks and occasional days off and variations in your
routine.

If you read all the running literature, they tell you to take an easy
week every once in a while. I'm convinced that this applies even more
to diabetic runners. Cut back the mileage one week. Let things heal up
and recover. At the very least you won't get sick of running.

A day off now and then lets you heal up some. I've actually found that
my best training is when I run every other day. YMMV.

Don't do the same workout day after day. Some diabetics think this is
necessary to help them maintain good BG control. If anything, it makes
it worse. Your body gets used to the set distance. The same muscles
get hurt. You get bored. Vary things - easy days, long slow days, fast
hard days, days when you just go out and run however you feel like it.

Principle #9

You need your doctor's OK for your running program.

As a diabetic, you are at far greater risk for heart disease. Just
because you run doesn't mean you don't have heart disease.

Talk your doctor into ordering a treadmill test with EKG and
monitoring of CO2 exhaled. If you have insurance, you might be able to
get the test for free. You can find out your VO2max from the test, and
that's a useful thing to know. Far more importantly, you'll catch any
heart disease early. Better you call "Roto-rooter" for clogged
arteries than find out in the middle of a run that your left ventricle
no longer has a blood supply. Trust me on this one - I've worked a
cardiac arrest at a road race.

Principle #10

Don't trust anything you read on the internet - confirm it
independently.

Take this list to your doctor. Ask him what he thinks. Check out
www.diabetes.org and see what it says about exercise. Read other
answers you receive here. Read and learn.

I believe that my advice is accurate. It's certainly what's worked for
me. But I'm also not you. You are, and you may need to modify things
to make them work for you.

As a diabetic, you will live longer, the more you know.

Principle #11

Never stop questioning.

Why? <g>

Rob