The Wendover Woods 50 miler on Saturday (25/11) will be my second
ultra since being fitted with an OmniPod insulin pump.
The first was quite an experience. I had started on the pump
only a few days before and was taking part in a charity run. The charity was MIND
and the run was a 1/3 mile loop at work. We, there was a team of us, were to
run a working day from 9-to-5 and complete as many laps as we could. This was
on July 5th and was in the middle of a seriously hot spell that we
were having. Temperatures were well into the 30’s for the day and there was no breeze and little shade.
At the start I felt great and was using a libre to monitor
my blood sugars. I had been advised to reduce my basal rate for the duration
but when I tried to do this via the pump it wouldn’t allow me as the doses were
already very small. I know I have small doses of insulin generally so just
assumed that this was correct. I started running and for the morning was ok.
Energy and repair both doing ok. What was happening though was my blood sugars were
going down too much and I was struggling to get them healthy. A combination of
heat and exertion.
I actually suspended insulin for a period and as I went into
the afternoon started to feel empty, incredibly weak and tired. I had to go and take a lie-down at one point and am sure I
nodded off. I was in much more of a state than I was expecting to be based on
previous experience and figured it must just be the heat. My blood sugar levels
then started to rise and I switched the basal back on. This made barely a dent
and the trajectory continued through to the end of the event. I was quite
broken at the end but had covered just short of 40 miles in that state.
A couple of days later I had a hospital appointment and one
of the people I was with was describing that their pump had not been set-up
correctly when they left the start-up appointment and had caused them some
problems. I checked mine and it was the same. I wasn’t getting anything like
the level of insulin I should have been as the set-up was just a low scale one.
A default one I assume. I set-it properly and from that point on it worked!
I had, though, managed to cover 40 miles with barely any insulin in me.
I had, though, managed to cover 40 miles with barely any insulin in me.
This Saturday will be different. The pump is set-up properly
and I know how to manage things. On pens it would have been straight forward.
I would have reduced my Levemir by 50% run and eaten all day and not had any
issues! This will be different. My strategy will be to reduce my basal by 80%
for 10hrs at the start. I will then monitor my sugars over the day using a
libre and adjust as necessary. I still plan to eat everything I can and with
barely a care as, frankly, ultra running is the closest thing I get to feeling
like I did pre-diabetes.
I have been experimenting with reducing my basal in this way
over the last few months and it works. It took me a while to accept this as a
way forward as was contrary to what I would do on pens. What this has enabled
me to do is where I am planning to run for a couple of hours, I reduce the
basal by 80% and then I only need maybe one gel or one pack of shotbloks and
my blood sugars are on the low side of 4-7 when I finish. When I extrapolate
that across 10-12 hrs of running this weekend then I will be eating more and
testing more. I also know that the line is not straight! It’s not a case of a
gel every two hours and bingo I will need to be consuming more and more
regularly than that schedule. I did reach out through the power of the web to
Robin Arzon of Instagram fame who is type 1 and has run ultra’s including a 100
miler. I asked her what she does with her insulin over these events and reassuringly
the answer was the same as what i have been advised to do and what I am
planning.
With that in mind the libre will be key for me this weekend,
faffing about with cold hands trying to squeeze blood onto a strip will not be
easy and while I will do blood tests to be able to just scan my arm as I move
will be great for on the move data.
It’s 2 days away now and I have gone from, at the beginning
of the week, thinking that I’m not ready to actually feeling pretty good about
it and actually a little excited. A day running in the woods? What’s not to
like.
As someone with type 1 diabetes there is a risk attached to
completing this type of event. There is for everyone but maybe for a type 1 you
could argue they are more significant. I acknowledge the risk and am not
gung-ho about this at all. What I do know is how to manage. I have lots of
experience of training and taking part in events over a number of years and, in
fact, realised recently that other than my first marathon (in 1997) everything I
have done subsequently has been as a type 1 diabetic. That includes half
marathons, marathons, ultra’s, a marathon swim and triathlon/duathlon. The key
to this is knowledge; when I am training
it is not only my physical well being in terms of muscle and endurance that I am
training it is also my understanding of my diabetes.
I am aware of it every step of the way and
know how it feels and what to do. I know my responsibilities and do not ignore
them. I sometimes even consider it an advantage as while other competitors don’t
have that worry they are also unaware of a key part of their physiology that could
affect their race.
Hitting the wall is, after all, just a low blood sugar.
