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Any running tips? BG tanking after runs

Discussion in 'General Discussion' started by Megnyc, Apr 21, 2013.

  1. Megnyc

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    I am having a new problem after long runs (let's define long run as 15+ miles). I typically put a 50% temp basal on for the 2 hours before a run, then just do a basal of .05 during the run. I usually start a run at 130 go up to 160 and then end around 130-140. I eat 8 carbs every 15 minutes and check the sensor bg every 10 minutes (the app I use says the time every 5 minutes). Lately, my blood sugar during the run has been the same as usual but 10-20 minutes after I stop running I have been dropping to 30 and needing 40-60 carbs (and 20 units of glucagon today :eek:) in order to get above 70. I only eat 80 or so carbs a day so that is a lot of carbs for me!

    I am in the process of training for a marathon so I would like to figure this out. My family is going to consult a CDE who has experience with athletes. But what is going on here? I have run 6 half-marathons with no problems. Is my body just incapable of running more then 15 miles? I have been reading a lot of running with diabetes blogs and no one else seems to have had an issue like this suddenly pop up. And the method I use right now has worked for more then 5 years. The only thing that has changed is I switched to humalog from apidra-- but I adjusted my basals for that.

    Does anyone have any ideas here? Would you completely cut off basal during the run? I would have ketones by the end but is that really all that bad?

    Thanks for any and all advice :cwds:
     
  2. Beach bum

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  3. Megnyc

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  4. C6H12O6

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    I would consult a doctor since you have posted that your BMI is in the underweight range.

    Honestly, it might be in your best interest to be more sedentary.
     
  5. schnoodle

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  6. TheFormerLantusFiend

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    Maybe with Humalog you get more tail and so the reduced basal isn't kicking in as much.

    Why not try a basal of 30% or something like that- somewhere between 50% and turning it off?

    Also, if the huge drop happens when you stop, maybe try a change to your cool down routine.

    I usually have the opposite of your problem.... about ten minutes after I stop exercising my blood sugar shoots way way up.

    I guess it may also be worth considering that running 15+ miles is not actually all that good for your body. In terms of health benefits from running, they drop off a lot past the one hour/day point, while risk of injury keeps going up.
     
  7. Helenmomofsporty13yearold

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    I think you are not eating nearly enough carbs before, during and after the run. Even runners without Type 1 need to carb-load. I read you can train your muscles to store more glycogen. Here's an example of what a 150 lb marathon runner needs.
     
  8. Megnyc

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    Thanks all.

    I just wanted to address a few things.

    1. I have the full support of my doctors. I am using a training plan developed by a coach who took into consideration my physical condition. I am still running the same number of miles a week I was running previously. Just 1 long run and several short and easy runs.

    2. I am technically underweight if you use bmi. I just don't think that is a decent measure of weight at least for me. It was designed as a way to compare sedentary individuals. If you were to meet me in real life you would think I was thin but not unhealthy at all. There are plenty of things my doctors worry about but everyone is actually satisfied with my current weight.

    3. I think diet is the real issue. I spoke to a CDE yesterday who works with athletes and he basically said I need to be eating at least 200 carbs a day and ideally closer to 300. I do attempt to eat a high calorie diet (2800 cal a day) but I flat out hate bread and most kinds of pasta. I have an appointment set up with the dietitian at our campus health center to attempt to get some ideas for high carb foods that I like (or can tolerate).

    If at any point a doctor or other clinician says training for a marathon is a bad idea I will stop running and get a second opinion. I am very thankful to be as healthy as I am right now and I won't throw that away just for a sport.

    Thanks again :cwds:
     
  9. Helenmomofsporty13yearold

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  10. schnoodle

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    Even according to the WHO growth charts, you are in the second percentile and still underweight.

    The WHO growth charts do not apply anymore at 20.

    I have never heard that BMI is inaccurate in determining if someone is underweight. Are the WHO growth charts also inaccurate at determining if someone is underweight ?
     
  11. Megnyc

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    Thanks :cwds:

    I found it by googling. It looks like I may actually need more carbs then suggested by the CDE. I guess I am going to start by getting 150 carbs a day and then going from there.
     
  12. Cookie Monster

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    Hi Meg,

    I hadn't read this thread until now as my diabetic son is only 5yo so not sure how much I could add. However, due to the nature of my son's disease I am fascinated by the challenges you face and how you overcome them. So I had a peek and I think there are a couple of points that I could make (although I'm sure you will have considered all of these and more).

    First, I think it is great that you are running and as long as you listen to your medical team AND your body you should be fine.

    One of the points that occurred to me is that you have absolutely no glucagon. No pancreas means no alpha cells so no matter how low you go your body won't produce any glucagon. So for carb-loading, you can stuff your liver to bursting with glycogen, but unless you inject yourself it's not going anywhere. I still think you should carb-load because if you do need to inject glucagon after a run you want plenty of glycogen available but remember it is not going to be available to you as it would be to most other runners. I think perhaps you should be taking more carbs immediately before and during your runs. I find I can't stomach a lot of food before a run but there are gels that are packed full of carbs with little volume. Just have plenty of water with them so they don't upset your stomach.

    The other point is your weight. BMI is only a rough guide. Paula Radcliffe, the women's world marathon record holder has a BMI of about 18. If the docs are OK with your weight then you should be too.
    Putting on weight is always going to be difficult for you with exogenous enzymes etc, etc. This may be an issue when it comes to running as a main source of stored energy is fat reserves in adipose tissue. My guess is that you are probably a little short on these ;) This could be the reason that after a certain mileage you just run out of usable energy. A bit of a long shot but maybe you could investigate with your medical team supplemental feeds that are high in medium-chain triglycerides (MCTs) rather than long-chain triglycerides (LCTs) that are easier for your body to absorb without enzymes. That might give you a bit more usable fat supply.

    *I should probably put a disclaimer about none of this being taken as medical advice but I get the feeling your too smart to take the thoughts of some unqualified stranger on the web without getting proper advice first ;)

    On a more practical note I'd suggest joining a running club so you don't have to run long distances alone (also a great motivator to get you out the door if you are meeting others). There are usually clubs suitable for all abilities. Also, for your long runs it might be an idea to tell people of your plans. And run with a Medic Alert bracelet or something just in case something did happen (I always work on the presumption that if you've got it you'll never need it:))

    Good luck for your marathon. I'll be keen to hear how you do.
     
  13. C6H12O6

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  14. Cookie Monster

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    Good point.

    It makes sense as Meg is not having problems during her run but shortly afterwards which suggests to me that she is not running low on glycogen reserves but as the epinephrine tails off after a run, then glucagon would normally kick in to keep the glucose levels right. So a lack of glucagon would result in lows later. The glucagon injections working show that she still has reserves of glycogen in there.

    Perhaps reducing basal rates for long periods afterwards would help. And eat lots.
     
  15. Megnyc

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    Thanks. I hope your son is doing well! I am happy to try to answer any questions you have about living without a pancreas but I am sure you know as much, if not more then I do.
     
  16. BrendaK

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    I'm a runner with type 1 and ran my first marathon last year. I'm on MDI, not pumping.

    Typically I eat a 30-40g breakfast (2 waffles w/peanut butter) about 20 minutes before I run. No bolus.

    I eat a GU at mile 5 (25g).

    I sip on Gatorade alternating with water during long runs. (about 20g total)

    At mile 10 I'll eat a Bonk Breaker nutrition bar (around 30g)

    At mile 15 another GU (25g) if I'm running past that.

    Have had great success with blood sugar numbers. But you can see that I have about 140 grams of unbolused carbs for that much running.

    It looks like you are just not eating enough for the runs.

    My 12 year old D son who DOES pump will turn his basal down to 50% and eat the same carbs I do. He ran a half marathon last year and it worked great for him. He has only gone low a couple of times ever training.
     
  17. nanhsot

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    What an informative post, thank you for taking time to post these specifics. As someone on MDI and not pumping, do you ever alter your basal shot the night before a big run or marathon or anything?

    Not diabetic here but really envious of you guys who have completed marathons. It's one of those totally out there dreams of mine that will likely never be realized. I think I'll start training for a half and maybe the bug will get me and I'll go for the whole meal deal! I'm stuck in a 4 mile a day/3 day a week rut right now and these longer runs really pull at me.
     
  18. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Once I got up to 18 miles or so I would give myself 60% of my lantus dose before I ran (at 6:30am) and the rest after. For the marathon itself, I gave myself 60% of my dose before the race and did not give the rest after. Did not need it! I didn't need to bolus for anything the day of the marathon and very little for the next 3 days.

    The marathon had been a dream of mine too and I ended up being invited to be part of a training/fundraising group with a friend. It was life changing -- in a good way - which is why we're doing it again this year. My teammates became family -- such a great experience. If you ever have a chance to train with a group, I would highly recommend it.
     
  19. nanhsot

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    There is a group here in my town, many of whom I work with, who train regularly and do marathons. It's just kind of daunting. Based on the info in your signature I have a good decade+ on you. I work out regularly and for age am doing pretty good...but I'm still...OLD! I just started P90X again this week and have recommitted to my running again (and I do yoga 2x per week too). But there's just something about long runs that pulls at me.

    Thanks for the encouragement, I do need to just go for it.
     
  20. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Oh DON'T feel that way! Our training group was ALL ages!! And ALL abilities!!! There were some super pro athletes in the group and people who ran a marathon who had never run more than 3 miles before. I have only been running for 2 years myself and have never considered myself a runner. But yes, it's those long runs that I just love and the proof of progress -- when you run farther than you ever thought you could -- that just keeps me going!
     

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