You know how I rode through Death Valley with great blood sugars? And how I did a half ironman triathlon with no diabetes problems? And how I had an amazing ride to the top of Mount Wachusett and back with lots of power and great diabetes mojo? Yeah, the outings aren’t all like that.
This is the story that proves that—no matter how easy being an athlete sometimes might look—diabetes can be a tricky disease to manage. Worse than being difficult, it’s occasionally dangerous. The line between A-OK and disaster is a fine one. (This dispatch isn’t meant to scare anyone, and I apologize in advance if it does.)
I’m proud of the fact that diabetes doesn’t keep me from training. I’ve had high blood sugar (but no ketones) before exercising, and I’ve used the outing (along with some insulin) to bring my BGs back to a happy place. I’ve also been lower than what makes me comfortable and had to delay exercise a bit to let the food I ate kick in. I exercise at these less than ideal times because hitting the pool/gym/road/trail/treadmill and putting in the time, miles, and laps is the only sure way to get better at what I do.
Just because I don’t let diabetes keep me from starting an outing doesn’t mean that I’m necessarily going to finish it the way that I would like. Recently, as I’ve fiddled with my insulin settings and nutrition, I’ve had hypoglycemia bad enough a couple of times to make me call it a day. On my last long run before the 70.3 triathlon in Maine, I had to walk the last mile back to the office in a bit of a stupor.
Then there’s what happened last week. Lisa was in Nevada, spending some time with her mother and grandmother, and I was home alone. Being alone doesn’t really bother me, diabetes-wise. (Not having Lisa around is another matter altogether). Since I have Spanish class on Wednesday and was heading to Death Valley on Thursday, I decided to make Tuesday my long run day. I prefer to run on a weekend morning, since I find it easier to manage diabetes and exercise when I haven’t been bolusing insulin, but I’ve been doing workouts after work for years now, so I didn’t think too much about it.
And, boy oh boy, had I been bolusing insulin on Tuesday. I’m gradually feeling more confident giving myself all of the insulin that a very high carb meal requires, but I’m still kind of chickenshit. As a result, I went through a good part of the afternoon with high blood sugar after eating delicious Indian food for lunch. Because of the highs, I gave myself a small bolus just before running, and when I started what I intended to be a nine mile run down the paved rail-trail in town, I had multiple units of insulin still working their way through my system.
The beginning part of the run from my house to the trail—about 3/4 of a mile—is always enjoyable; it’s downhill, and I have to hold myself back from setting the bar too high for the rest of the run. It was just warm enough to go running in shorts if I also wore a heavy long-sleeve shirt. The shirt was was vivid yellow, and I wore a headlamp because it was going to be full dark by the time I got home.
I was having a great run through the late evening light and the twilight. I had to turn my headlamp on just before the turnarond point, 4.5 miles in. My pace was good as I ran through the tunnel of light I was throwing onto the trail. There were still a couple people on the trail on my way out, but by the time I turned around the trail was deserted.
About three miles from home something didn’t seem right. Despite having eaten a couple of times, I felt a bit lethargic. My view of the world started to look off, and I couldn’t tell if it was due to the headlamp or the darkness or something else. A half mile later I was in the deepest, darkest part of the woods on the trail. The temperature had dropped quickly when the sun dropped, and little clouds of steam shone in my light whenever I breathed. That’s about when I started seeing flickering lights whenever I blinked, a sure sign of hypoglycemia for me, and I realized that I was listing a little bit, too.
Cold, dark, alone, hypoglycemic . . . I knew I wasn’t going to die on the trail, but it was still a bit scary.  For one thing, I was still two miles from home and one mile from where the trail intersects a road, and I didn’t like the idea of trying to hold off the “I’m going to pass out” feeling so far from possible help. Plus, hypoglycemia triggers the fight/flight, adrenaline response, which makes me feel a bit nervy. Immediately upon stopping I ate a full tube of glucose tablets, which I admit was probably overkill, but I knew that I was already pretty low if I was seeing The Spot. All the while I was walking my baby giraffe wobble down the trail. It was too cold to really stop moving, and I just wanted to get the last two miles home out of the way. For good measure, I ate the extra energy gel that I had in my pocket.
When it became pretty clear that I was going to be okay, I ran the last half mile. In the end I arrived home about 30-40 minutes later than I had intended and pretty chilled. Perhaps the worst part of this experience, though, was the hit my confidence took. What’s going to happen the next time that I go for a run in the afternoon? What will happen the next time I exercise with high blood sugar? Should I go running on the trails after work anymore? Should I just stick to the treadmill?
Well, I’m pleased to report that today, for one reason or another, I had higher blood sugar than I would like to admit . . . and I went for a run . . . on the trail . . . (but not in the dark) . . . and nothing bad happened. Granted, I only ran four miles because it’s a recovery week, but my BGs didn’t move more than I wanted, despite the very small correction bolus I gave. Whew! Confidence restored.
1 — This is not the first time I’ve written “I knew I wasn’t going to die . . .” on this site. Unlike this time, I have some nice pictures from that first not-near-death experience. [Back . . .]