Wednesday, January 28, 2009

Running With Diabetes (or How NOT to Kill Your Dad on New Year's Day)

My dad has Type 1 Diabetes. Less commonly referred to as "Spontaneous Diabeticus" (actually, singularly referred to as such, by myself) he became diabetic within a year after completing the Big Sur Marathon at the age of 43.

You can imagine my mother's excitement following my 2006 announcement that I would compete in Ironman Arizona. Does Spontaneous Diabeticus run in the family? Do big athletic accomplishments awaken a dormant gene that otherwise does not affect fit members of my family?

Like it or not, my dad's diabetes has had a profound effect on my life. Mostly for the good. And after a decade of running with my dad, one would think I'd know how to be prepared for a long run.

But no.

Ready to kick off 2009 in style, I suggested we run around the mountain my parents live on. The run should be about 10 miles, I thought, an hour and forty minutes. When my padre and I run, we usually run 1 hour and 20 minutes anyway, so it shouldn't be a big deal, right?

Don't ask me what I was thinking. I wasn't hung over. Maybe the prospect of running through familiar neighborhoods made me forget that a 1h40min run is not a small undertaking.

About an hour into the run, padre started stumbling.

That should've been the first sign. I attributed it to his generally ridiculously tall stature. It takes longer for brain signals to get to his feet than it does for mine to get to my feet.

Then, padre wanted to walk.

That's normal. It's a long run. We can enjoy the scenery.

Then padre said he was just sooo tired.

That's normal, it's New Year's day. Staying up until midnight will do that to you.

Then padre got goofy.


I began frantically scanning homes to see which ones looked the most inviting and most likely to have orange juice in the fridge. I scanned the cars driving by to see if I recognized anyone. I didn't have a cell phone, ID, money, food or anything on me like I usually do for long runs (in the mountains, no less! What's money going to buy me in the mountains?)

The houses at that point were all gated estates, difficult to approach.

The firehouse/police station was a half mile away. It was my best bet. But do I leave padre to sprint over there to get help, or do I make him trudge along with me? He was stumbling badly enough that I didn't want to leave him alone. We slowly made it across the street to police property. Then I left padre in the driveway and bolted inside.

"Do you have any sugar!?"

The only person inside was the 911 operator. "Um, we have Splenda," she said. That was not going to work. She called EMTs while I ran outside for padre, who had continued stumbling in the direction of home, which also happened to be the direction of the fire station. He was hell bent on making it home without anyone's help--he certainly didn't want mom to come pick him up. He had 2 miles to go.

I ran up to the fire station and told them to come quickly, while padre sat down under a tree on the side of the road. His blood sugar was 35. (80-120 is normal.) EMTs told padre they usually treat anything below 60 with an iv. Padre opted for a couple of packages of gooey glucose.

Mom and coachubby came to pick us up.

We had run for 1h 17 minutes. Our usual run. But that didn't include walking time. By the time we reached help, I figure we were out there for a grand total of 1 hour and 40 minutes--hardly too long for padre to exercise. We'd gone mountain biking longer than that earlier in the week.

So what gives? What can a diabetic and his athletic accomplices do so nobody ends up trying to steal citrus from stranger's trees in an attempt to squeeze the juice into the diabetic's mouth?

  1. Run with sugar. This seems simple enough, but if you're like my dad (smart but stubborn), you may convince yourself that your blood sugar elevates when you're exercising. This is true--the liver's natural response to exercise is to break down readily available fuel to keep you going. However, if you go too long, or miscalculate the insulin you take before exercise, you may be in for hypoglycemia. Take a GU, or two, or three with you--each of you--or some sugar tablets. Padre's blood sugar was high before we went running, which was not the norm, so he took insulin before we ran, which was not the norm, so he got super hypoglycemic while running, which is not the norm.

  2. Overplan your run. (This is wise even if no diabetes is involved.) Think you're only going for an hour in your immediate community? You never know what might happen out there, even if surrounded by neighbors. Bring fuel for an extra unplanned hour of exercise, just in case.

  3. Learn to recognize the signs of hypoglycemia. Trembling, weakness, and tiredness are all beginning signs of hypoglycemia. When it gets worse, the diabetic may stumble, slur speech, become confused--or basically seem drunk, for lack of a better explanation. (These symptoms are then followed by what could become a deadly coma.) By the time he reaches this state, sugar must be digested immediately, hence your readiness with the GU and sugar tablets, right? Don't make my mistake and run without them--ever. Even if you're not going far from home.

Team Type 1 in Bicycling Magazine

Other tools can help diabetic athletes keep their blood sugar ranges normal during strenuous activity. Not too long ago, Team Type 1, a professional cycling team comprised of mostly Type 1 diabetics, was featured in Bicycling Magazine, along with a new monitor that displays blood glucose information collected by a sensor inserted in the jersey pocket. It appeared this new monitor collected data from sweat, unlike other monitors that require a subcutaneous sensors.

Remember, bonking doesn't just suck. If a diabetic bonks, he dies. While it's his responsibility to monitor his own blood sugar, attempting new athletic feats may leave your diabetic athlete friend in new monitoring territory he wasn't quite prepared for. That's where you come in--to help should he ever not be able to make coherent decisions himself.

Now you know why $5 from each of my superawesome Triathlete Diva jerseys goes to Team Triabetes.

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