Perhaps it was part of the BALCO protocol? The page mentions Barry Bonds. I wish I knew more of the details. Mostly I just track my TDD and post-workout will bolus.
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Haven’t read that yet, but I will later.
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I looked into it a while ago and at the time USADA said a TUE was necessary for either ‘National’ athletes or events sanctioned by an international body. At that point a medical diagnosis for insulin dependent diabetes was necessary but no specific test results.
In comparison to something like exogenous testosterone, the requirements for insulin in competition is quite low. I think it reflects the somewhat ambiguous performance effect combined with the major downsides of using it incorrectly. Ie, you’d be a nut to use insulin as your lone performance enhancer if you didn’t need it.
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1 last article!
https://sweatscience.com/carbo-loading-with-a-hyperglycemic-hyperinsulinemic-glucose-clamp/
The race series begins! Sunday is the 10k - I did that distance earlier this week with my best time yet 
The next week… adding more mileage to my long runs. I’m currently turning my pump off about one hour prior to running, eating a small snack right before I start, then turn my basal back on 3-4 miles in. I haven’t had to eat much while running, but I know I’ll have to start when my distances are longer. I’m nervous about taking any bolus insulin while running though!
The half is in August, so I still have 4 months to figure this out! (Hoping I’ll be running 13.1 within the next 2 months though - I’m mostly following the Hal Higdon plan.)
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Awesome @allison ! That’s really great!
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I’m so glad to hear you are training for the half marathon! I love to read of other’s strategies with running and exercise! 
Have fun with the training!!
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I never thought running would be fun - and I’m not loving it, but I’m not hating it, which is great! Thanks for the encouragement 
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It can be tough but it makes you feel great as you know!!! 
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You may not love it right now. And you may never love it.
But if you keep doing it long enough, eventually you will get to the point where the idea of not running feels like a much worse option. 
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Haha. Thank you. I hope that is the case!
The official 10k was this morning - best time yet - 1:04:35 
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Great run!! Congratulations!! 
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ROCKSTAR!!! You runners amaze me. 
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Hi everyone - I’m looking for some advice as my half marathon is just about 5.5 weeks away (!!!) and I’m having some trouble.
I followed one of the Hal Higdon plans, which tops out at 10 miles before the half marathon. As a diabetic I wanted to make sure I could do the whole 13.1 before the day of. Today, I made my longest distance yet, 11 miles 
My current trouble comes as post-run spikes. Please see my so, so sad CGM graph below.
Last night I was fighting lows so ate a LOT before bed (first red drop), then ran high overnight. This morning, I went too low (second red drop) so waited a couple of hours to run. I had my pump off for over an hour before I ran due to CIQ and then manually turning it off for an hour. I took a UCAN Edge gel before I started.
Unfortunately I sat at about 240 for most of the run. I had CIQ off and a really low temp rate for most of the time, but gave tiny (like 0.2 unit) doses as I went. Around mile 8 I had another gel and turned CIQ back on in exercise mode. I took 1 unit at mile 10.
The last 2 times I have run I have gotten this nasty spike after - I almost went to 300! I had to get on the treadmill and walk for 45 minutes and it’s still not back to normal (15 min after I took this picture).
Is it because I had my insulin off/low too long? I know I should probably fuel some more as I go but am afraid to eat too much/dose too much and go low.
Thank you for any questions, suggestions, etc, as always!
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@allison Sorry I can’t contribute anything but moral support here…no experience…but I admire your efforts and know others here will contribute to your inevitable success! I look forward to see pictures of the finish line with you crossing it!!
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Wow, thank you so much! That means a lot! 
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Eric is the one to answer these questions!! But I will give my 2 cents worth from my own experiences (and great help from Eric’s posts here on FUD!). For me, I rarely turn my basal off. BUT I am on Loop so the algorithm WILL reduce my basal to zero automatically when it sees I’m going low. Hwr, I never force a ZB in prep for a run. I prefer to run with a BG in the normal range and if needed, take in carbs during the run. Also, I try to run with 0 or < 0.5 U insulin on board. I understand you are uncomfortable taking in carbs during a run as I was, too. But it does help from going low and no bolus is needed if the carbs are small, fast acting. I typically take tiny sips of juice throughout a run if my BG is trending down. Then a mile before the end of the run, I will bolus a small amount of insulin to prevent the post run spike. For me this is 0.5U or 0U if I’m already trending low. Also, right before I start the run, I lower my basal by 30% and set a higher BG target. I will also take some small carb if I’m too low, maybe a sip of juice or a gel if I’m really low. Typically, using this override means Loop will give me no insulin, equivalent to a ZB, during the run, since my BG is lower than the target BG while running. I turn this override off at the same time I take the post run bolus a mile before the end. And then Loop takes it from there. It may give me more small auto bolues or suspend basal depending on BG. Probably the same as your Tandem pump??
This strategy may not work for you since we’re using different gear and we are different! But from your graph it does seem like the ZB pre run is causing high BGs. And you probably need a bolus near the end of the run to prevent post run spike.
I am so excited for your first half marathon! I know you’ll enjoy it and you have time to get comfortable with this longer distance. I hope the weather will not be too hot on the big day!! We’re in a heatwave here of 100+ degrees real feel which makes my runs tough but hey, it’s summertime
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Thank you for your thoughts! (Also hoping @Eric has some ideas for me )
Re: pumping - I try to normally start with a good BG but yesterday was a mess from the night before, which I went so low and ate WAY more than normal to recover, so then I was rollercoastering for the next several hours. I keep the Control IQ turned off while running so it doesn’t give me any boluses without my knowledge - I’m ok giving myself some, as long as I am aware it is happening! I ran a very low temp rate (25% I think) for most of the run; maybe that was too little, especially since I started way higher than normal.
I did do a 1 u bolus at the end but the big spike came after I had showered and eaten my lunch, so it wasn’t immediate.
I was SO thirsty yesterday while running, which didn’t help. How do you carry juice? I have a running hydration vest but no bladder. I carry my phone in one pocket, pump in another, car key in another, glucose tabs in one, and gel in another. I don’t have much more room! Lol
I have been learning more about how important fueling is for most runners doing these long distances - it will be around 2:30 for me, which is so long to go without water, at least (and yes, I know there will be fuel stations on the race course).
Thank you again!! Hopefully it will be much cooler (it’s been 70-80 here)!
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Hi @allison!
Congrats on getting to where you are! This is tremendous to hear!
You have put in all of the hard work. Don’t worry, the race will be easy in comparison to everything you have done so far!
The spike on the run - I looked at your graph, and this is what I noticed (my edit in red):
It looks like the spike is simply from what was happening before the run. I know this is not always easy to do, but being flat before you start makes it all so much easier.
I know everyone has their own tricks to have flat BG. We spend our lives trying to have flat BG!
So there probably isn’t anything useful for me to tell you, and I apologize for just restating the obvious. But being flat before you start makes it all so much easier.
Whatever time you have left between now and race day, for whatever time the race starts - work on getting that pre-race time dialed in the best way possible.
The hours leading up to whatever time of the day the race starts - practice those hours every day! Get those hours dialed in, and the rest becomes super easy.
But I know the other important thing you are working on is the post-run spike.
Let’s get into some biochemistry. This is not really diabetes stuff, it’s just normal body processes for everyone. Totally un-diabetic sciencey stuff here. Bear with me for the chat.
Let’s talk about glycogenesis - the formation of glycogen from glucose.
You used muscle glycogen during your run. Your body wants to replenish that! It wants to replace the used muscle glycogen and create new muscle glycogen. That’s glycogen synthesis.
Insulin initiates glycogen synthesis. That is normal for everyone. And what stimulates insulin? High blood sugar! Same for everyone.
So this all makes sense because you spent a few hours with no insulin, and then when you are finished, your body has a natural inclination to want to replenish the muscle glycogen that was used by your legs. The only way to get glycogen back into your leg muscles is with glucose and insulin.
Obviously, your liver is supplying your glucose after the run, right? We can see that spike post-run!
It expects your pancreas to do its part.
Liver dumps out glucose, which should then stimulate your pancreas to release insulin, which then stimulates your muscles to create new glycogen. The only thing here that is not working correctly is your pancreas. Everything else is doing what is should be doing, right?
Still with me?
So the simple thing about all of the biochem stuff 
above is this: Post-run - take insulin and eat!
(And also, if you don’t fuel during a run, you need even more glucose after the run.)
I know it sounds wrong, but it is not.
No doctor will ever tell you - after you finish running 2 hours, you need to take a bunch of insulin!
But the only way to get glucose into our muscle cells is with insulin and carbs.
Again, everyone has different ways to manage, but what I do is make sure my zero basal turns off a little before the end of the run. And right after I finish, I take a big bolus. (As long as I have access to carbs too.)
If you do that, keep an eye on it after and test and you can do your CIQ or whatever to manage it post-run. And if it is a long run, you may need to reduce your basal for half a day or maybe even longer after the run.
Don’t be afraid of carbs and insulin. As long as you are awake and able to check BG, you can cover it if you drop. And the CIQ will help you too.
And one more thing to add - your muscles will get the glycogen one way or another. If you don’t eat after your run, it will continue to suck sugar out of your blood for days! I think it’s actually safer to help your body get it over with as quickly as possible.
Did all of that make sense? Any questions about that stuff?
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