FUDiabetes

DN’s Running and Other Mishaps Thread


#1

I had to alter the suggested title a little bit, in case something happens to the running part of this thread… then it’s a catch-all…

So I’m up. I have no idea what to include here… But I’ll wing it.

41 year young female. Type 1 diabetic for 15 years. Have been an athlete all of my life, and a pretty good one I might add, but my ability to just head out the door and perform whatever activity I’d like has been dwindling. Some might call that “aging”, but I’m not buying that. More likely it is the steadily decreasing lengths of workouts due to pain and inability to get my insulin right— and having to cut out too soon.

I’ve run since middle school and have always enjoyed being able to pour myself into that, too, but I’ve slowly abandoned that as an option over the last couple of years. With a pair of cysts on my tailbone and whatever impingement along my spine, running more than a couple minutes at a time has begun to create big problems. A recent trip to my old sports medicine doc turned up a lousy recommendation… that maybe I should phase it out altogether. Enter Eric.

I explained why I run/walk the way I do, which has all but destroyed any magic in it, and we’ve discussed a few of the issues. I’ve begun some core exercises, as recommended, and have started attempts at increasing my mileage. This part I’m just making up on my own… just adding more here and there but promising myself to walk at the first sign of pain. Things are already looking up, and I can say, confidently, that I can get in a solid 15 minutes before there is numbness in feet and other signs of difficulty. I have gone as long 2.5 miles before deciding not to push it any further. And that’s where I am now… at the very first part of consistently getting in a mile and a half or more before falling back to my old run/walk.

In addition to recommending core exercises, Eric has also helped me change my temp basal settings from one hour 50% prior to starting to 60 minutes ZERO basal prior to starting and remaining in a suspend until finishing. This has made a huge difference already in how long I can go before starting to go low. I am not so steady in the hours to follow, but I can handle those kind of rises the way I know how, with a little extra activity and a little extra insulin.

So that’s about it. I’m registering for a September 22nd 5k race, and I’m looking forward to committing to, and following to the best of my ability, whatever steps are recommended. Within reason. I will NOT eat Brussels sprouts.


#2

I want you to do the Tuesday and Thursday workouts on either a track or a treadmill. You are getting a treadmill right?

Also, you need to get some stability shoes. I think that will help. Keep going with the core work and stretching I gave you. Do not slack on core and stretching.

I still need resting heart rate from you. We can use that to look at some of the intensities and see when your BG will spike.

After each workout, give me what you did. Paces, reps, times, distances. And give me your RPE, which is “rate of perceived effort”, how hard it was on a scale of 1-10. 1 is easiest and 10 is extremely difficult. Usually, the hard workouts should not be harder than a 7 or 8. (9’s and 10’s are for race day only). The easy workouts should be a 3-5.

Be honest with me. Easy days are easy. Hard days are hard. If they are too hard or too easy we can adjust them.

  • Monday and Friday are base miles/recovery runs.
  • Tuesday and Thursday are more challenging - speedwork, vo2max, lactate, tempo.
  • Wednesday is off.
  • On the weekends, one day is long, the other is an off day. You pick the day that works best for your schedule.

This is the first week, so we might need to adjust things. These paces are based on your estimates you gave me. You need to let me know about them. Try them out, but then let me know.

Note the units on things like pace versus MPH (example, 8:00 would be minutes per mile, 8.0 MPH would be miles per hour). Also, you can swap metric if want, for example 400m is about 1/4 mile.

Recovery jogs between reps or speed intervals can be slow, but don’t walk. It should be a jog.

Here is your first week:
++++++++++++++++++++++++

Monday, July 9, 30 to 40 minute Easy Run
8:57-9:55 pace


Tuesday, July 10, 400m Speed Intervals
1 mile warmup at easy pace

8 x 400m at 6:54-7:18 pace
200m recovery jog between each one

1 mile cooldown at easy pace


Wednesday, July 11, Off day


Thursday, July 12, Tempo intervals
2 x 1.5 miles at 8:00 pace
0.5 mile recovery jog between each one


Friday, July 13, 30 to 40 minute Easy Run
8:57-9:55 pace


Weekend, July 14 or 15, Long Run
4.5 miles at 8:59-10:16 pace (go slower if you need to, try to run/jog all the way through instead of run/walk)


#3

Okay, and I’ll ask you some questions tomorrow, but before i go to sleep— can i run over the weekend?? I have been pretty lazy the last two days and need to get some kind of workout. Running is okay??


#4

Looking forward to following this thread. I started reading @daisymae swim thread from the start but so far only made it through 700 or so messages! I am amazed at her improvement in controlling BGs after incorporating @Eric’s advice.

I’m still a little unsure why using ZB is different than eating something right before running though. It seems like one needs insulin, basal, during the run in order to process the glucose? I actually tried the ZB out today. So bg was 112 at the start and 74 at the end, so really good for me as I usually go low by the end of the run. Anyway, looking forward to following this thread and hope I can apply it to my running :slight_smile: Thanks for starting it and sharing with the rest of us!

Also, what are the core exercises and stretches and are they daily? Any insulin changes required for them?


#5

I think 2 rest days per week is good for you. If you want just 1, we can work that in. If you want to move a run into the weekend so you have 2 on the weekend, that’s fine. Just shift the whole schedule over one day.

Simple rule - don’t do hard workouts back-to-back, put an easy day or off day between them.


#6

You can feed the basal throughout a run as a different strategy. For races over 1 hour, you would generally want to consume 30-60 grams per hour to fuel the activity.

But for just training runs, the advantage of a ZB is that you can do it for any duration - 30, 45, 60 minutes - and it can be easier than having to carry sugar around and constantly eat.

But yes, you can do it the other way too. A little food right at the start can help prevent a drop. But I would not ever recommend eating so much at the beginning that you have a spike that is followed by a drop. Because then you have 2 bad things.

They are just some exercises and stretches I sent to DN for her calf pain. I don’t think any insulin adjustment is needed because they are very easy.

DN, you can post them with the pictures I sent if you want.


#7

I just realized you misunderstood my question… I understand the weekly training program starts on Monday. I was referring to THIS weekend… I hate to do 5 days in a row without any kind of exercise, and I’ve just missed two. For this weekend, can I run? I could dance if running’s out… and, by the way, if you ever need dance training, we could start you up a thread. :grin: seriously… is it okay to run this weekend?

And of course I’ll copy the core exercises onto the thread. But tomorrow. After sleep. :slightly_smiling_face:


#8

Thanks, @Eric, for the explanation. It seems it is a balancing act to me. I usually eat 1/2 a banana immediately before a 1.5 hour run. This doesn’t produce a spike but I often go low just the same. I always carry gtabs and fruit jellies and often eat one or two of the little, fruit jellies (Swedish fish). So I’m going to try doing the ZB to see if that will prevent the lows. Yesterday I did ZB half hour before my run. I’m afraid if I do ZB too much earlier I’ll go high. And I hate running when high!:frowning:

Does consuming 30g while racing over an hour require a bolus??

Thanks @Nickyghaleb for posting the exercises whenever you have the chance, and thanks, @Eric, for all of the advice!


#9

Yes, no problem. Get going!


#10

It’s all in the timing! Just try different amounts of ZB before you start. And also keep in mind - the higher your BG, the shorter amount of time the ZB needs to be before you begin. For example, if you are 100 maybe you need a 30 minute ZB before starting, but if you are 120 maybe a 15 minute ZB is enough.

Depending on IOB and what your BG is, it may or may not need a bolus.

For 30 grams I would probably take anywhere from .15 to .25, depending on my BG. But if I am low, 30g would not need a bolus.


#11

Oh, okay. I kinda thought you were going to insist I rest up… but I guess that’s not necessary. :grin:

That’s great then.


#12

Should be here within the week.

Okay… and all of it looks good, but I do have one question about that 4.5 miles… yeah? That’s a good first week workout?? I’ll give it my best shot, but where do I stand then with the stopping at pain rule? At the slower pace, it may be fine, but in case there’s pain, how should I handle it?


#13

I don’t know how consistent your numbers are, but that ZB has not gotten me the same result every time. The first day, I could definitely feel the effects of the missing insulin, but the feeling faded 15 minutes in, and my BG never rise above a 130. The next two passes I required an extra 15g of carbs prior to heading out the door. I was not fond of the idea, but so far it has worked well.


#14

Okay, thanks, I’ll keep in mind! 30 minutes ZB worked well yesterday as I was about 100 when I suspended and 112 when I started the run. I use xDrip+ to track my BGs but I don’t keep very good notes, so I’m only looking at the graph and history to see what my values were. I’m not running today, but will run on the beach early tomorrow and will try the ZB tomorrow for the first time on sand! Because I start to rise immediately after my run, I thought to resume the basal while still running. So run an hour then have the basal resume as normal with 1/2 hour still left to run. Does that make sense? That’s what I did yesterday. I ended up going from 74 to 122 in the half hour after completing the run so not too bad.

Wow, that is not much insulin for 30g. I would normally take 2U for that but racing I guess is the reason it is so little? I have never given myself insulin while running. I don’t carry my omnipod with me so even if I need to give a bolus, I couldn’t:(


#15

Wow, those are pretty inconsistent, especially needing extra carbs on ZB. Well, I suspect I will have inconsistent results like you, too, as NOTHING is very consistent with my BGs either!:frowning:

I mainly want to try to reduce the amount of lows I get while at the same time, not going high!!


#16

I was basing it on the questions, when I asked what your longest run was. It was somewhere around that before pain, right?

But if pain is a factor, we gotta get that fixed, because it will always be the limiter on what you are trying to do.

So it depends on the pain. You mentioned shin splints, hip, and knee. Are you doing your core work?

But really you should see a physical therapist for all of that. It’s not easy to figure out and fix remotely.

You are seeing someone for nerve blocks next week, right? What has the doctor said about it for expectations? He said you can run, right?

If you can’t do it without pain, you should not do it. (I don’t mean the “being tired” kind of pain, but the physical pain)

The ultimate goal for the long run is building your mitochondria and muscle endurance. So you can do that partially with a bike ride of sufficient intensity, or swimming. But we want to build toward you having an elevated heart rate of at least 90 minutes about once a week.

After you feel the pain when running, does walking not hurt? If that is the case, if you have hills, you can walk briskly up hills to keep your heart rate elevated.

So for now see how far you can go without hurting. If you can’t get 4.5, do 3, or whatever you can get. But get yourself to a physical therapist soon and see if they can help you with it if the doctor and nerve blocks are not helping.


#17

Yes, it makes sense. I resume my basal sometimes with a mile or 2 left. Sometimes bolus for carbs with a mile left so I can have something right when I am done.


#18

Definitely haven’t gotten 4.5 miles so far… I think I’ve gotten 3, and that would be once. But there has been an improvement, and that is from about a one mile run to a pretty consistent 2-2.5 mile run. By that point, there is definite numbness and the beginning of some pinching. But I was getting only a mile before… so definite improvement.

I stopped seeing the sports medicine guy because he is too far away. I haven’t pursued PT just because my schedule is pretty packed. I do get the first round of nerve blocks on the 13th, and he does want me to test it out as soon as possible… so next day.


#19

Yes to all. Pain on runs has improved since starting it, resulting in longer runs.

Walking after the pain has started can be painful and take a while to subside. When I’m full swing, the pain can be so bad it goes throughout the day and keeps me up at night. This is where I was the last period of running. But again, I have already increased distance so far, and things have not escalated. So I’m hopeful.

So for the long runs, I’ll just do what I can and let you know how it goes… right?


#20

Yep on the long runs, do what you can.

But you should pursue doing PT. Seriously. Be aggressive with your rehab. See someone who knows what they are doing with it. And get the stability shoes too.

If you can do a hard 1.5 miles without pain, let me know. If that is the case, we will just build the house backwards.