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Lessons Learned

In this section, I intend to deposit my golden nuggets and a few other pieces of information that I have learned during my running adventures. There are tons of information that I would like to share with you and so to prevent a free flow grumbling of a lengthy post, I divided it into a few segments.

  1. Current Favorite Equipment
  2. Running Sugars Ranges
  3. Diabetes and running
  4. Event/Training/Running Lessons
  5. Running Digital Word Lessons
  6. Link and useful information

Current Favorite Equipment

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Current Favorite Equipment and other details
Training
ClothingShirts – Nothing Special, mostly the same Technical shirts from previous events.
Short – Nike 2-1 compression shorts, New Balance 2-1 compression shorts, Brooks 2-1 Compression shorts with side pockets
Shoes & SocksShoes
     Newtons – Sir Issac
     Brooks – Pure Cadence
    Brooks – Ravina
     Brooks – Adrenaline
Socks
    Various brands – sidewicks, nike, Compression Pro, Balega
BeltsSpiBelt
Single 16oz Bottle with two side pouches
Two 16oz Bottles with two detachable pouches, plus additional pouch in back
FuelLiquid
     E-Fuel by Crank Sport Crank
Gels
      Accel Strawberry-Kiwi, E-Gel by Crank Sport (Primary)
      GU Salted Caramel, GU Vanilla, EPIC Bison Protein Bar
Other
      Caramels (Kraft, Target, Lancaster (prefered)
      Block by Cliff
Data CaptureGarmin Forerunner 935 – running pod
Garmin Vivofit
Race
ClothingShirt – No sleeve Brooks
Champion simple technical shirt
Long sleeve Technical shirt from previous (Disney 2013 10k, Half)
Shoes & SocksBrooks – Adrenaline
BeltsSpiBelt (Anything longer than 10k)
Single 16oz Bottle with two side pouches (Marathon Distance)
FuelLiquid
      E-Fuel by Crank Sport Crank (For Marathon Distances)
Gels:
      E-Gel by Crank Sport (Primary) and GU Salted Caramel
Other:
      Caramels Lancaster
GeneralRace Bid Clip Belt,
$1 gloves (Dollar Store)
$1 beanie hat (Dollar Store)
Garbage bag or rain poncho (for when is cold or rainy)
Miscellaneous
Diabetes
Related
Pump Medtronic – Minimed 670G series
CGMS Guardian Medtronic
Insuline Novolog – Quick acting
Clothing110% Compression nicks for recovery after runs longer than 18 miles
Compression recovery socks
FuelVanilla Amplified Wheybolic Extreme Protein and Mega Men Sport Shake for runs longer than 16 miles
Cliff Carrot Cake or Pumpkin Spice Cake bar
OtherTowel, Sandals, TRY swimming suit, Trek Madonne

Running Sugars Ranges

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Here the ranges

 

GCMS
Measurement
TrendingRunning Action/desition
250 > Above   ▲▲
      ▲
─ Stable
      ▼
  ▼▼
Bolus Adjustment Required – No Run
Bolus Adjustment Required – No Run
Bolus Adjustment Required – No Run
Bolus Adjustment Required – Possible wait for start run
Bolus Adjustment Required – Wait for start run
220 – 260   ▲▲
     ▲
─ Stable
     ▼
  ▼▼
Bolus Adjustment Required – Wait for start run
Bolus Adjustment Required – Possible wait for start run
Bolus Adjustment Required – Possible wait for start run
Bolus Adjustment Required – Can start run with extra caution check every 1 mile
Bolus Adjustment Required – Can start run with extra caution check every 1.5 mile
120 – 220   ▲▲
     ▲
─ Stable
     ▼
  ▼▼
Adjustment Required – Start run with extra caution check CGMS every 1.5 mile
Start run with – caution check CGMS every 2 mile
Start run with – check every 1.5 mile – Optimal range 145-175 (165 sweet spot)
Start run with – caution check CGMS every 2 mile
Basal Adjustment Required – Start run with caution check CGMS every 2 mile
100 – 110   ▲▲
     ▲
─ Stable
      ▼
  ▼▼
Start run check CGMS every 2 mile
Start run with caution check CGMS every 2 mile
Basal Adjustment Required – Start run with caution check CGMS every 2 mile
Eat Carbs (10g-20g) Basal Adjustment Required – Possible start run with – caution check CGMS every 1.5 mile
Eat Carbs (20g-35g) – Wait to start run
below < 100   ▲▲
     ▲
─ Stable
     ▼
  ▼▼
Basal Adjustment Required – Start run with caution check CGMS every 2 mile
Eat Carbs (10g-20g) Basal Adjustment Required – Possible start run with – caution check CGMS every 1.5 mile
Eat Carbs (20g-35g) – Wait to start run
Eat Carbs (20g-35g) – No run
Eat Carbs (20g-35g) – No run

Diabetes and running

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Having diabetes should not be necessarily be a deterrent for you to go out and run. That is not to say, that you should just ignore what your current health, physical and conditioning levels are. To me, it is just another variable/knob/area that will normally be in auto mode it is a switch to a manual setting and requires personal attention. As a runner one of the challenges, fear and low points during training and events to me, is getting low sugars. Whether is just prior, during and/or after is frustrating. All runners know that recovery is as important as the workout and events. Because it will determine how quickly you will be able to perform the next activity. If the recovery gets compromised with a series of low sugars the body will not be able to recover as quickly and as efficient. It is frustrating, but it is fact of life that we have to proactively manage it but it should not be a show stopper.

In making decisions I, similar to the table above, make the call on when to run, how long, what to fuel when to fuel and whether or not is safe to run. During my very early runs and especially long runs, I take extra equipment, fuel, and liquids with me. This in part made it harder to run due to the increased weight but makes it for better training effort. It was part of the learning process to understand how I was going to achieve my goals. Today, I will carry with me and extra gel during my training runs. Depending on the workout, I will normally check my sugars prior to leave the house, check the trend using my CGMS, have a snack if necessary and pay close attention to how I have been feeling that day.

The key is to gather and use the available data to you and pay close attention to your body. Some additional preparation might be needed because sometimes you do not know when or why a low or high might hit.  I am very fortunate to have the benefit of being in a Continuous Glucose Monitoring System (CGMS) that allows me to visually see trending and readings. But even with that in hand, I need to pay close attention to many other factors like if you are still digesting your last meal or snack before heading out and figure out if an adjustment is needed. I need to go over the training plan and set a plan of attack in advance.   

Things to consider:

  1. When was the last time to I ate carbs, type and how many of them?
  2. The type of workout and duration Do I need additional gels? Do I need to fuel now?
  3. Insulin how much? And how long ago?
  4. Hydration, do I need to drink more prior? Do I need to carry water or energy drink?

In my case when I am on the low side of my range I consider the following options in preparation for my run:

  1. Eat some amount of carbs if low: (Granola bar or oatmeal cookie) or (Some fruit juice or piece of candy)
  2. Temporary basal 30%-70% or normal. For about 30min up to 1:30 <- One benefit of having a pump
  3. Suspend mode (I prefer to do a temp basal with the minimal bolus setting) <- One benefit of having a pump
  4. If high sugars depending how high I will do a bolus adjustment. Full if it is a short run, and start reducing the amount of the bolus the longer or the effort intensity of the training run.

During the runs I carry an extra gel or two in addition to the normal fueling plan, depending on the distance I am going to cover. Even if it is just couple miles I will do my best to run carrying with an emergency gel with me. It is also important to be aware about how your body is reacting and how it feels during the run. Even with having a CGMS I have been in a situation in which my sugars are dropping rapidly but the CGMS has not reacted fast enough to warn. (For an example check my Marathon event in 2016)

  1. I will do a very low temporary basal and continue to monitor after taking every 1/4 mile
  2. Depending on the trending information and how I feel, I will take the extra gel
  3. I will slow down a bit to give some time for the sugars to come back up
  4. Will take a second gel if I have it and need it
  5. Will start to walk, but I try to keep moving even if it is a very slow pace
  6. If no more sources for fuel/carbs area available I will then consider a call for pick up. (Yes, I have done that)

For easy short runs, very minimal support: These runs are at a reasonable pace and effort. For me, these are 35-50 minutes runs. In normal conditions, I will only carry my cell phone and one energy gel that I will use if feel sugars trending down. I take action quickly to make sure I do not drop too low if I am midpoint or early in my run. If I am close to home base I will look at the trend to determine how fast the sugars are dropping and if it is possible I can finish the run without using the gel. A tiny detail is that home base, in 65% of the cases, it is actually home.

For track work: I have the advantage of running by the home base (in this case the bench at the track) every 1/4 mile I can easily bring extra stuff to make my workout more enjoyable. Sugar-free energy drink, some caramels, ice bag and couple gels. My track workouts could total around 8-11 miles when including at least a 1 1/2 warm-up miles and a 1 1/2 cool down miles. Since the track workout is hard, I feel that it is necessary for me to bring liquids to hydrate well enough during and after the workout.

Long runs I will have the extra gels, extra fluids, the glucose meter in the area or near me (Car, station), protein snacks. I monitor once in a while the trend information and make adjustments as I go. All runs are important, long, tempo, pace, easy run, and including recreational runs. They offer you with an opportunity to learn, adjust and enhance your approach to diabetes. Identify issues early and discern between normal pain, tiredness, weakness of an event or run versus a glucose trending rapidly in either direction.

Event/Training/Running Lessons

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After a few years trying a few methods I am coming to the conclusion that the training plan it is your personal plan that you believe will follow and like. It depends on your goals and limitations there are awesome resources like ones in fellrnr.com which have nice details and comparison of different approaches to training.

The first year when I was training for my 5k, Half and 1sr Full Marathon, I was just concentrating on increasing my endurance. To me, the most important run was the Sunday runs, the long run. Moving from 2,3,5,8,10,12,14, all the way to 24 miles on that long run, provided me with the benefits or understanding how my body, including my glucose readings, reacted to fuel, effort, temperature, humidity and more importantly the recovery aspect of the training. Knowing how much adjustment I needed for fuel intake was very important to have a successful run.

Running Digital Word Lessons

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Running Digital stuff

Link and useful information

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Link and useful information