In earlier posts, I documented how I started from basically nothing, to running a 5k in 6 weeks with type 1 diabetes, starting here, and finishing here. The main reason I wrote about my progress was that I found some great info for running with a pump (so not on multiple daily injections like myself) and with continuous glucose monitoring (so not solely finger pricks, like myself); but struggled to find anything by and for somebody like me.

Below I share 10 things that helped me. I am assuming that you are a beginner (like me at the time of writing!), but the below does contain pieces of advice that I think everyone can benefit from… simply from a going back to basics perspective. I really want to stress this list is not exhaustive, and have included some links to other sources of info at the end of the article.  Maybe you have a pump? Maybe you want to hear from someone achieving much greater things than my rather modest accomplishment? Maybe you want some real in-depth technical advice, rather than the mindset side of things I have leaned towards here? I’ve got you all covered.

This is quite a lengthy piece (something to bookmark), so I’ve created a numbered list below. You can click on each individually, and you should find your browser skips you to my reasoning behind that tip.

Any tips for running with type 1 diabetes in the comments, or suggestions of resources that would be great for further reading will help others reading this… so please don’t be shy. Please remember that just because I have linked to a site, it does not mean that they endorse this site or this post.

    1. Consult a diabetes specialist medical professional
    2. Have a plan
    3. Be prepared
    4. Start small
    5. Give a lot of thought to when you run
    6. Make safety a priority
    7. Keep the goal in mind
    8. Be kind to yourself
    9. Go slow
    10. Keep learning

1) Consult A Diabetes Specialist Medical Professional

 

Running with Type 1 Diabetes - Seek medical advice
His HbA1c was how high???

I can not stress enough that any advice you find on-line should be ran past somebody who actually has medical qualifications. As I state in the site disclaimer: I am not a medical professional, and anything I share is just something that has helped me. I talked extensively with the diabetes team at my local hospital about exercise before starting, and this is the most important thing in my opinion. Hence why its number 1 in the list!

For all i know, you doing any exercise at all might be very dangerous. (The chances are it is not, but your doctor/nurse will be much better placed to tell you!)

2) Have A Plan

Plan for running with type 1 diabetes
Whiteboard not required at this stage

Most importantly, you need to have some idea of what to do when you see your blood sugar reading before exercise. Diabetes UK, a charity that provide a lot of information about diabetes have some guidance at this link here. As always, remember their advice does not replace the need to talk to a medical professional, but its definitely worth a read. The current advice (November 2018) is not to start exercise until your blood sugars are above 5mmol/l or below 15mmol/l.

I’m not saying you have to plan out every run methodically at this stage. As I’ve already mentioned, I had a vague idea of increasing distances gradually to allow me to run 2.5 miles the week before my 5k (3 miles) – which I achieved. I also had the plan of running 3 times a week – which I didn’t quite manage every week… but because I was aiming for that I managed to run enough before-hand to manage to complete the 5K.

If you’re a complete starter then the NHS (National Health Service for any non UK readers) have a great free plan called Couch to 5K. You download the podcasts and it takes you to running for 30 minutes over the course of 9 weeks.

I’ve followed the whole program through twice in the past, so didn’t really feel the need to use it this time… but when I did use it in the past it was great and worked both times.

3) Be Prepared

Yes… all very boy/girl scouts-esque. But, if like me you can remember a life pre type one diabetes, you probably have had a massive shock in the sense that you can’t do something as crazy as eat anything with over a certain amount of carbs without doing a spot of mental arithmetic and injecting beforehand. Have you ever seen the wise philosopher Michael McIntyre talk about leaving the house before and after kids? Its not too far off what we have to go through when going for a run! No more ‘just leaving the house’ sadly!

 

This list is not exhaustive.. and its written as someone who does not have a pump or CGM… but these are the things I found were necessary for running these under-5K distances (obviously non-diabetic essentials such as running shoes and clothes have been assumed!):

  • The fastest acting hypo treatments you can think of. I go for dextro tablets.
  • Your blood glucose monitor and testing strips
  • Your insulin pen and needles, in case of a hyper.
  • A phone, in case of emergency
  • A type 1 diabetic identification card that clearly states the need to call an ambulance if you’re unwell
  • A running belt that can fit all the above in

4) Start small

Start Small When Running With Type 1 Diabetes

And I mean really small! If you are starting out then you have no idea how your blood sugars will react. Sure, mine have decreased on most occasions, but not always.

What is really small? In my case, about a mile. But, I did run a marathon (however badly) back in my pre type 1 days, so even though I was ‘out of the game’, a mile was small enough to not seem like a massive risk. When I started working towards that marathon ( having never really ran seriously before) I did the Couch to 5K program, which in week 1 consists of alternating 60 seconds of running with 90 seconds of walking.

Not running as far as I possibly could, but just enough to see how my blood sugars reacted allowed me to progress on the learning curve without a single hypo. I did have a run where I dropped from the top end to the bottom end of the healthy range, but that was about as scary as it got.

If you are running with type 1 diabetes you need to be very aware of the risk of hypoglycemia and hyperglycemia and nothing will teach you about this better than actually running and keeping notes. On the day of the 5k I did a couple of things that had worked well for me… I ate a banana 45 minutes before the start and took 2 dextro tablets about 2 miles in… and I still dropped nearly 2mmol/l without any fast acting insulin on board. Imagine if I’d pushed myself that hard in week 1 without taking those precautions because I hadn’t learned they were necessary?

Even my goal of running a 5k was quite modest (I mean nobody’s going to build a statue of me just yet are they?), and having this very achievable goal allowed me to keep positive and believe that I could actually do it. Don’t go googling 8 week marathon training plan, or something similarly crazy, as you could be one hypo away from giving up completely if you set the bar too high initially.

Have crazy long term goals sure! (There are plenty of pro-athletes with type 1 after all!). Just be patient and determined and you’ll get there.

5) Give a Lot Of Thought To When You Run

Thinking about running with type 1 diabetes
Should I split my bolus for that takeaway later?

Insulin on board (IOB) is something to give serious thought to. My blood sugars drop much more rapidly if I run within 4 hours of a meal, so I try to run before breakfast as much as possible as it means fast-acting IOB is one less thing to consider. Also parkruns are at 9am, and most running events seem to be in the morning, so it means my training is as close to the real thing as possible.

I realise this is not always possible (After all, plenty of my runs were late in the evening), but as somebody starting out it makes sense to make the timing of your exercise a priority.

If you run without IOB for, say 1 mile, testing before and after at least you have a starting point of how your body reacts to exercise. If you run with IOB you have to start thinking about taking only a set percentage of your usual bolus injection, and it’d seem wise to me to leave this consideration until you have at least some idea of what you are doing. Doctors and nurses (and the link in point 2) will be able to give you good advice on this if you’re really stuck, but honestly? I’d at least consider waiting until at least a couple of weeks in. Would it be that impossible to say, just for a fortnight, pull out all the stops and get up early for 2/3 jogs a week?

Having said all of that, running in the morning works well for meBut I still dropped nearly 2mmol/l on the day of my 5k. And that was having taken the precautions I outlined in step 3… You might be much more sensitive to insulin than me, so always take care, no matter what time of day you are running.

6) Make Safety A Priority

Tying all the above together nice and neatly is number 6. It is sadly just a fact of life that there are some risks involved in exercising as a type 1 diabetic… but its still probably much less risky than doing no exercise!. As with our blood sugar management in general its all a delicate balancing act.

Tight Rope Walker - Type 1 Diabetes Managing Blood Sugars Analogy
Only slightly more challenging than managing your blood sugars!

 

In addition to steps 1 to 4, I’d at least suggest running somewhere you are familiar with and taking money for a taxi if you run too far from home (or easier.. just stay close to home). Admittedly, I got a little bored of doing laps around the same park near my house, but at least it was safe! I can always venture a little further afield now I’m more confident in my ability to avoid any unwelcome blood sugars.

I in no way want to put anybody off exercise, if you take the necessary precautions you will reduce any risk massively. If you can find someone else to run with it might just be a great way of being safer and making it more fun in one go.

7) Keep The Goal In Mind

There must be millions of words written about setting SMART goals, so I won’t explain what one is. If you’re not sure, this quick 1 minute video is good at quickly explaining them:

Now my target of a 5k (Specific, Measurable, Attainable) was set to try and stay as healthy as possible (the goal was Relevant to what I actually wanted). I also had a deadline (Time)

There were weeks when I felt really ill, and only managed 2 runs. But the pressure put on me by the clock ticking towards November 3rd, and the fact 5K never felt anything other than attainable, kept me both on my toes and in the positive frame of mind needed to achieve it. This does tie in with point 4 above (starting small), but that only accounts for the A in SMART, the other 4 letters are equally important.

Don’t think 5k is achievable? If you’re based in the UK please just go watch your local parkrun one weekend (map of events here). There are so many great people there who are proving anyone can do it Saturday after Saturday.

8) Be Kind To Yourself

Be Kind to yourself with type 1 diabetes

Anyone who read my journey from 0 to 5K would have heard me say this a lot! Cards on the table here… I am saying this for my own benefit as much as anyone else’s. My brain loves to throw negative comments my way; I think its trying to push me onto greatness… But for a type 1 diabetic, learning the ropes when it comes to exercise isn’t that straight-forward.

What I will say is look at any (sensible) running plan for running any distance as a beginner (5k, 10k, half marathon etc) and they will all build up gradually. And that’s for anyone! The person who has written that plan hasn’t written it for somebody who can end up ill (or worse) if they miscount their carbs, or who’s blood sugar can drop like a stone if they do something as crazy as walk to work on a nice summer’s day (was it just me who that happened to in this year’s heat wave??).

You will have challenges. Like me you might get ill. Hypos/hypers are prone to strike at any time, even if you do everything right. Now the following is terrible advice for a pro athlete… but for someone starting out its just plain common sense…

Real life will happen. You can come up with the greatest plan in the world (or one as simple as my ‘build up to 2.5 miles the week before the 5k’ plan), but things will get in the way… especially with type 1 diabetes. Have a hypo one day? Wake up with a blood sugar of 20 and ketones present? It might just be a good idea to miss a run that day.

Even if you make every run you plan to its still likely your brain is going to say negative things to you. Just do your best to force some positive self-talk (I went for ‘I am Marathon’, explaining why in my previous post). Tell your loved ones what you are doing. Share the hell out of it on social media. Celebrate every milestone along the way. (I mean, I even made a post about reaching 1.5 miles)

Every time you go for a run you are doing something positive to try and control your diabetes… Try to keep that in mind. If you’ve read this far it shows you are keen to look after yourself, give yourself some credit.

9) Go slow

Go slow when running with type 1 diabetes

If you want to run fast, that is great. You might be somebody who can easily see themselves running a sub 20 minute 5k. But tying in with point 4 – Start Small, it’d seem wise to take things one step at a time if you’re starting out. Why not just complete a 5k first? You can then celebrate the achievement, instead of having ‘failed’ if you ‘only’ manage the 5k in 20 minutes and 30 seconds.

Go slow, complete the event, celebrate… then set a goal time based on your first time.

Its vital you don’t let your ego get the best of you, (like I almost did!) start running far too fast, then have to stop with a stitch (or worse). I’m going to be completely frank… if you haven’t been running for most of your life then you won’t win your first park run. Just enjoy it for now; you can always ramp up the pace in the future.

10) Keep Learning

Learning about running with type 1 diabetes

First of all, about yourself. Everybody will react differently to different things. Keep detailed notes of your blood sugars before and after runs, and what food you ate (if any). It would seem almost certain that at some point you will have to start taking on some form of carbs to avoid hypos if you move on to running long enough distances; and the less guesswork over this you can manage the better. I eventually moved on to having a banana before a run, and taking 2 dextro tablets after 20 minutes of running; and this is still a work in progress, as I haven’t quite nailed it. (I dropped from 7.6 to 6.0 during my 5k)

Secondly, from every source you can find. I don’t want to put anyone off, but there is a risk to exercising with type 1 diabetes and the more informed you are the better. Have a good Google around the subject, and take a look at the following links/suggestions.

Other Sources Of Information

I know its going to sound like a stuck record… but hey, it needs repeating. Just like my site, none of the below can possibly beat the advice of a qualified medical professional, who knows you and your medical history. That being said, the following helped me greatly when I was starting to think about running, and I’ll be digging through their archives for some time to come.

Type1Bri.com – In his blog Brian documented his journey from starting to run, to running the London Marathon. In this post, ‘Running On Insulin‘, Bri gives some great technical advice. Particularly useful if you have a pump, but I also found it a great help on MDI. I particularly like his assurance that ‘no run is a fail’ (See… I’m not the only one banging the ‘be kind to yourself’ drum!)

GamePlanT1D –  Looking for more inspiration that a bloke from Stoke in his 30s running his local parkrun in just over 30 minutes? How rude! In all seriousness, its important to have people to look up to. In this series of podcasts Sam Benger talks to some very impressive athletes with type 1 diabetes. UK readers will probably have read in the news about Rochdale boxer Muhammed Ali who had to battle with the British Boxing Board of Control for 3 years to get his professional licence, and another very notable guest is 5 time Olympic Gold Medallist Gary Hall Jr. The podcasts will definitely get you thinking about what is possible with type 1 diabetes.

Excarbs.com – A good source of technical information. In this post ‘Before Exercise‘ some really good tips are given which will apply to anyone looking to run with type 1. They also include a calculator that will serve as a guide to what to do regarding carb and insulin intake. (Please remember it is just that, nobody can guarantee what will happen to your blood sugars)

Facebook Groups – With a little imaginative searching you’ll be able to find a few that seem relevant. Try joining some, you can always leave the group if you find it full of people who aren’t your cup of tea. I won’t link to any… Solely because many have all sorts of rules in place. Don’t worry, if you avoid self-promotion, being rude and promising miracle cures you’ll be fine. The main benefit of these is you can ask questions that Google just isn’t helping you with.

And there you have it! Thank you for reading this far. If you liked what you read please leave a comment. If I’ve made any glaring omissions of advice, or resources, then please list them, and I’ll put any I find better than those listed into a follow up piece. If you disagree with anything I said, then please comment too. The more discussion we can get around this subject, the more people we can help who aren’t quite sure about where to start with exercising with type 1 diabetes.

If you would like to see the highs and lows of my journey to 5K, you can start here, or view my post on completing it here.

Disclaimer – It is essential that you do not take on board any advice given on this website without first seeking the advice of a medical professional. Any descriptions of different ways in which I manage my type 1 diabetes on this website, including in the comments, are given in good faith, and are shared merely as suggestions which should be ran past a doctor or diabetes specialist nurse. 

Published by Marcus Pezzaioli

I started www.diabeticstokebloke.com in September 2018 to document my attempts to get fit after a diagnosis of Type 1 Diabetes in April the same year. I believe sharing my story can help anyone who is afraid to exercise with type 1 diabetes, and show that it is not as complicated as it may appear from other sources of information out there. If I can do it, with no CGM and on MDI, starting out as somebody who does not fit the athletic profile whatseover; then anybody can.

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3 Comments

    1. Hi thanks for commenting 🙂 I’m going to write a review of a book that discusses the seriousness of complications that can arise from diabetes, and I’ll include a link to your story of your friend passing away as I think it’s important for people to know what can happen. Sorry for your loss; Thank you for writing about it and raising awareness.

      1. That’s a really good idea, Ano he was at Tesco once and started a hypo with the slurring and confused he nearly got arrested as police thought he was drunk, which is quite scary as people don’t think about diabetes in situations like that unless they know from experience, it’s scary… Good luck with your book I think that’s a great thing to do. You will have to let me know when it’s done and I’ll buy it 😊

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