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Workout Wednesday: Exercise Tips from JT

Hi everyone! A little background on me: I’ve been running ever since I was an undiagnosed diabetic who kept passing out in football practice in 8th grade. The football coaches told me I should try track instead, and I haven’t looked back since. I went on to run Division 1 track and cross country at Baylor University, topping out with weekly mileages around 100 miles/week, and I’ve never run a marathon, although I did get lost on a long run once and ended up running 23 miles.

Running, especially out in nature, has always been a great therapy for me to work through thoughts, put things in perspective and, of course, keep my blood sugar under control. That being said, exercising as a diabetic, particularly when you might be isolated and away from your favorite juice or fruit gummies (personal opinion: glucotabs on a run are gross), comes with its own set of challenges. I now coach a running group for Type 1 Diabetic teens and young adults in the Bay Area to help pass on the skills for managing my glucose I worked out during college.

So without further ado, here are some good tips for getting started with running as a diabetic!

  • Exercise often and early (even if you’re a morning grump):

I’ve never been a morning person, but in college we were more or less forced into 6:00AM training runs, and I didn’t know it at the time, but this was actually great for helping me control my diabetes!

Here’s why: Exercising increases your insulin sensitivity, so insulin I took after morning runs was more effective! This helped me counteract the dreaded “dawn effect”, which is a phenomenon where hormones released by your body in the early morning can make you resistant to your insulin and and potentially create high blood sugars. I actually didn’t know about the dawn effect until medical school, but after some careful observations with my pump and CGM I’ve verified that this occurs most mornings for me- how convenient that I was unwittingly able to deal with it all those years in college!

Exercising early will also help you avoid lows while you exercise. In college, I didn’t realize that insulin can actually hang around for hours in your system after an injection, so even if you start activity 1-2 hours after eating with a stable glucose and eat your normal pre-exercise snack, the insulin on-board can still cause accidental lows- and no one likes a low during a long beautiful run.

These days, I go for a run most mornings before I do anything else, and it really helps me get my days going right.  Whatever gets you excited and out of bed is great! Run, bike, swim, lift, walk dogs, anything. Just keep the things mentioned above in mind.

  • Reduce Your Variables:

As a diabetic, routine is your very best friend. We live our lives like one big science experiment: if I eat this, then this happens to my glucose; if I do this, I feel this way afterward, and on and on, until we build up a sort of second-nature intuition for how we should approach eating and activities. One way to make this easy is to limit the amount of variables you have to deal with.

My mornings all look pretty similar: I wake up, calibrate my CGM, suspend my insulin and go for a 6-10 mile run, I may have 10-15 grams of carbs (I love the Welch’s fruit gummies or Clif Bloks chews), and then I resume basal delivery and eat an egg-white scramble with lots of veggies and an avocado as well as a low-carb protein shake with a little almond butter added in. And then I’m ready to get out the door and go bury my head in a book all day at the med school.

This is certainly not the only or best morning routine out there, but figuring out what works best for you is the key. Starting our days off with a predictable set of tasks and a good blood sugar is good for us physically and mentally.  One thing I learned through college racing is that a good morning is often set up for success by the night before.

Getting your glucose under control after dinner and avoiding any late night snacks that might mess up your hard work will set you up for great over-night numbers and that glorious thing we are all looking to get more of- sleep!

 

  • Use the Tools Available to You:

There are many ways to go about managing your blood sugars as a diabetic, and by no means do you have to have an insulin pump, or CGM or artificial pancreas to get good control (one of my friends back in TX uses MDI and occasional finger pricks and still has the A1c of an extra-healthy non-diabetic somehow, needless to say I’m jealous), but I’ve found technology especially helpful as a diabetic athlete!

I tell all of my diabetic friends that if I had to pick one modern-day techy-diabetic tool it would be a CGM, hands down. Using a CGM has been shown to not only improve A1c’s for diabetic patients, but also reduce the frequency and severity of low blood sugars! That being said, make sure you only calibrate as the manufacturer recommends, so that the device can perform accurately. These are very nifty during that morning exercise session, but also make sure to treat proactively as CGM’s can lag a little, especially when blood sugars are changing quickly like they might be during exercise.

Getting an insulin pump was also a game changer for college training, because with a pump I was able to reduce or suspend my basal rate. With an injection of a long acting insulin, that medication will be active throughout the day- no way to turn it off, which can be problematic for a long distance runner. So for these 10-20 miles runs, suspending my insulin helped me to keep my sugar stable and avoid those nasty lows. Side note, when I was wearing both an Omnipod and Dexcom I felt like a robot in all the coolest ways.

Finally, the most valuable resource available to us as diabetics is the rest of the diabetic community! Type 1’s, Type 2’s, friends, families, doctors service doggos, everyone! And I think that one thing I missed out on in college, because I, like most teenagers, was too hardheaded to ask for help, is the wonderful support and encouragement one can find in this community. A community I’m now so happy to be a part of.

Hope all this helps! And if there are any aspiring diabetic runners out there, please don’t hesitate to reach out!

Much love,

JT

 

 

 

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