Full Day Of Eating And Running With Type-1 Diabetes: How I Managed Insulin And Nutrition On A Long Run
My dear reader, welcome back! Since my latest articles have been slightly more on the philosophical side, I though a good old practical, dirty article about diabetes management would be good for today. Thinking is great, but at the end of the day life is about action!
So here we are, unpacking what I did, how I ate, and how I managed the type-1diabetic in me on a “long run day” in preparation for my next marathon!
(I also made a video about all this!)
The Wake Up
I wake up at around 6 AM, with a blood glucose of 106, perfectly in range from the night hours. Today is the 17 of february, which means that I am exactly 30 days out from the Rome Marathon! And since today is my “long run day”, I will try to simulate the race conditions as much as possible.
In practical terms, I’ll do many things that are not routine for me, to get my body accustomed well in advance. I know on race day I will drink my coffee and eat something as soon as I wake up. I normally wait two to three hours to do so, but race day is a special day and today I want to get as close as possible to that experience.
My blood glucose is at 106, but I want it to be around 180 by the time I get out running to have a safety margin from hypoglycaemias. So I will exploit the combination of the “dawn phenomenon” (due to natural increase in certain hormones in the early morning hours) and a small snack to elevate it up to that level.
The snack is a 152 grams heavy boiled potato, which makes for 23 grams of carbs. My 24 hours carbs to insulin ratio from the day before is around 20:1, which means that one unit of insulin would handle 20 grams of carbs. On a normal day, I would then inject exactly 1 unit to take care of this potato. But since my blood glucose is low-ish and I am about to spend two hours on my legs at marathon pace, today I am going to skip the bolus altogether and see what happens.
Pre Race Snack
A normal person might rightly ask why the hell am I eating a boiled potato at 6 AM in the morning, and that would be a very fair question.
What else could you possibly crave at 6 AM?
Here’s the answer: in my previous marathon build, my pre-race snack was all refined carbs such as white rice for my carb load, and rice cakes and jam for my pre workout snack. The absence of fibre worked really well for my stomach, but not so well for my blood glucose which was more likely to spike.
That is why for this training block I am experimenting with whole foods. I am having potatoes for my carb load and potentially for my pre race snack too, and see how this new approach works. Potatoes do contain some fibre, but not such a big amount. They’re also fairly easy on the stomach, which makes them a good candidate to carb up without sending me to the toilet every 5 minutes!
I am all about whole plant based foods that are rich in carbohydrates and naturally low in fats. That is the essence of the Mastering Diabetes Method, the one that keeps me in range for 90% of the time on a consistent basis while averaging 650 grams of carbohydrates per day and around 30 daily units of bolus. Incredible insulin sensitivity is the mere natural consequence here, so even if for a specific reason (like a marathon) I happen to need to eat some not-so-whole foods like white rice in order to avoid stomach issues, I know my body can handle that without big drama. On these occasions, I feed the athlete first.
Race Nutrition
With a blood glucose of 180, I feel confident it’s going to be a good and safe run. I head out with three gels (around 30 grams of carbs each), which I am going to take every 45 minutes. With a 2 hours run on the schedule, I will probably only need two gels. The third is an extra one just in case.
Race fuel.
I take the first one after 45 mins, the second one at the 90 mins mark -45 grams of carbs in total - and nothing in the last half hour. I finish the run strong, with my blood glucose at 216 - right where I want it to be.
Post Race Meal(s) - Carbohydrates, Proteins, Leafy Greens and Plenty of Vegs
As soon as I get back, I immediately inject 9 units of rapid insulin. I know my recovery bowl will contain 140 grams of carbs. With a predicted ratio of 20:1, and considering that I’ve just ran for two hours, this might look a bit excessive (140:20=7). But I know what is about to happen: every time I finish a run I have a spike, as if my body recognized the stressor and the adrenaline kicked at once, so I am predicting a sudden elevation toward the 300s, which will come down immediately.
Always happens to me right after a run.
Since I need to tame that, I am injecting those 2 extra units (7+2=9), which will also serve me later in the morning when I know my blood glucose will be trending down and I know I’ll be snacking on some more apples.
I won’t wait the full 45 mins - 1 hour between the injection and the meal, as I would normally do with a high blood glucose, because right now recovery is more important than everything else and I want to feed my stressed body.
So after some stretching and quick shower I attack my bowl, which contains
3 large apples
1 banana
1 beetroot
80 grams of arugula (leafy greens help slowing down the absorption of carbs, preventing spikes)
Chia seeds, lemon, turmeric, pepper, cinnamon
…and I complement this with a splash of soy milk and some 99% pure dark chocolate.
As predicted, two hours later my blood glucose is trending down, so I snack on some apples before heading to a lunch consisting on cauliflower, potatoes, beans, and greens (250 grams of carbohydrates and 30 grams of proteins). Some other smaller bites of legumes, fruits and nuts ensure that I complement with some extra healthy fats and minerals, so that by the afternoon all the macros and most of my micros are covered.
As per plan!
For dinner, I eat a lighter bowl of mixed vegetables (steamed and raw leafy greens), some peas and one extra potato, just because I really love potatoes.
To summarise my carb intake, I ate:
20 grams of carbs before the run,
around 40 during the run,
150 grams right after the run (+ 200 extra with some fruit snacks through the late morning and afternoon)
250 at lunch
100 at dinner
For a total of around 800 grams of carbs. The proteins are 100 grams, and the fats 40 grams. The total insulin units for the day is 31, including 7 units of lantus. This makes for a mind blowing 28:1 carb to insulin ratio overall during the day. Crazy!
The glucose has been in range all day long and the body has all it needs to recover during a restful sleep.
Update on the morning after: exception made for the post-run spike (on the left), I’ve been in range (80-150, the grey area) for the rest of the day and night. Eating 800 grams of carbs and injecting 31 total units of insulin! 91% time in range during the entire week.
