Diabetes Technology: Friend or Foe?

Today I finished the Philadelphia Marathon, proud at “toughing it out” and running the whole time – though slower than expected and with way more diabetes challenges than necessary.

In the last 14 years of my life with type 1 diabetes, and as a runner/triathlete, I have learned that “winging it” with diabetes usually doesn’t work.  To have a great race, it’s always better to be prepared for all the crazy moments diabetes can toss into the mix.

I’ve found that simulating the race day environment beforehand with the same clothes, food and insulin teaches me what will work best.  Diabetes doesn’t always work logically though these training efforts illustrate patterns that I can adjust and retest before race today.  This strategy has enabled me to successfully finish numerous marathons and Ironman triathlons – even getting faster despite aging.

Well, I’m a crazy busy person (like everyone, right?)… and this time I didn’t use the discipline to do what had served me so well in the past.  Additionally, I realized that I had become dependent on my Dexcom CGM.   Well, if it is moving in the wrong direction, I can fix it, can’t I????

Before today’s race, I took more carbs in than normal through an electrolyte drink and too little insulin.   I spiked to 365 by race start and it took me 7 miles to get it down into the low 200s.  By then, the damage was done.  I was out of it, dehydrated and started to slow down.  I stabilized my BG and the next 6 miles were OK.  Then I started going low and averaged a blood sugar of 60 for the last 9 miles of the race.  How could this happen with this great technology?  Here is what I learned today and humbly share with those of you athletes, or family members/friends of athletes with diabetes.

  1. Most athletic events, whether a marathon or after school soccer workouts need to be treated as a big deal, especially with diabetes.  To succeed requires focus, concentration and determination.  With all the things to think about during the event (clothing, weather, hydration, nutrition, logistics, pace, etc.), mental bandwidth is stretched.   There isn’t enough time to continually monitor every aspect of diabetes with all this other stuff going on.
  2. I forgot to turn on the alert feature of the CGM which may have helped me correct the problems I was having sooner (reference bandwidth problem in #1).
  3. We are responsible for ourselves.  I own my experience today based on what I did.
  4. A CGM, (while a great tool), shows trends.   It is not an accurate representation of what is happening at the actual moment.  By the time the extreme high or low has happened, chances are it has been that way for a while.
  5. While using diabetes technology like a CGM enabled me to not stop and “waste time” testing my blood sugar during a race, it also gave me a false sense of control and bravado about not being as prepared through simulations.
  6. Testing my BG during a race forced me to focus on diabetes completely for that moment rather than glance at a CGM screen and moving on.  In the end my high and low blood sugars cost me more time than stopping to test.
  7. If I want to race the best that I can, I need to take my diabetes planning as seriously as I do my training.  That means, simulations, recording notes in my logbook, fixing, repeat…over and over so I can control it…not let it control me in a race.
  8. And, despite all of these issues, today I finished a marathon while living with diabetes.     Something to be proud of and something to share.

In the spirit of us all being in this together, I hope that sharing my race experiences today will help you in successfully achieving yours.

David Weingard, Fit4D CEO