How to run safely with Diabetes
I recently read this Runner’s World article about running diabetes. It covers a lot of ground with glimpses on a variety of topics, including type-1 versus type-2 diabetes, insulin-based treatment versus no treatment, how to use carbohydrates to fuel a run and when to check the blood glucose.
The article doesn’t expand much on what I consider the most important topic: how does running affect your blood sugar, and how to enjoy a run without fear of hypoglycemias.
There are a couple of mentions I’d like to expand on, based on my experience as a type-1 diabetic who just loves running, and wants to do it safely, for as long as possible, while maintaining steady and optimal blood glucose levels.
The impact of running on blood sugar
I’ll start with a direct quote from the article:
“If a runner is taking a hypoglycemic oral medication or insulin, the risk for hypoglycemia (low blood sugar) is higher. If a runner with type 2 diabetes is not taking insulin or hypoglycemic agents, the run may require less monitoring.”
Indeed, one should be super careful with medications around run-time. In the past, I have often been in head-scraping circumstances right before a run: either I was too high (say, a glycemic index of 250), or too low (say, around 90). In the first case I would inject some insulin, in the latter I would take some sugars.
But what if I take too much insulin and I go into hypothermia during the run? And what if - as it happened many times - eating some sugar would skyrocket my blood glucose levels during the run?
Running, as any other aerobic activity, is likely to affect your blood sugar levels, but the degree of its impact is an entirely different matter.
One thing is to move from 150 to 120. Another thing is to drop from 250 to 50 due to a poor guess with the insulin dosage. Another thing again is to start a run with blood sugars level of 90 and finish the session at 300 (yes, it happened multiple times!).
One quickly realises that running can become an immense source of stress when one’s glycemic index is so unpredictable, because every run poses the same questions: What do I do? Do I inject a bit of extra insulin? Eat a bit of sugar? But what if that will ruin my training?
The solution here would be to have stable and predictable blood glucose levels to begin with. A situation that reduces all the guessing game and mentally relieves us from the stress of collapsing during a run outside.
I have good news: stable and optimal blood glucose levels are totally possible, even for type-1 diabetics. Let me quickly share my experience.
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How to enjoy every run with diabetes
With time, I realised that all this confusion was caused by my not understanding how insulin works. In this regard, the article only mentions that
“Activity passively allows glucose into the cells, reducing the body’s need for insulin. This allows for increased insulin sensitivity—which in turn can make glucose levels lower. Often, activity (as part of a healthy lifestyle) can improve glucose regulation, Kirpitch says. “.
but doesn't add much practical advice when it comes to regulate glucose in the blood. I’ve been plant-based for 7 years, but I was still eating in a suboptimal way. I did not understand that high fats intake cause insulin resistance, which is the reason behind unstable and unpredictable.
Then I came across the Mastering Diabetes method, and adopted their suggested high-carb plant-based diet.
The approach is very plain and simple: stick to whole plant based foods, which are high in carbohydrates and low in fats. No need to seek fancy and expensive “vegan” meat substitutes, no need to come up with complex recipes.
This resonated with me, since I am not very good at cooking but like to eat a lot of tasty stuff!
What green light foods do to your blood glucose
I kept, it VERY simple ever since I began: plenty of potatoes, legumes, fruits and whatever other green light food entered my rotation. The only “rule” I follow when putting stuff on a plate is that the food comes from that list (with some exceptions of course…I still love chocolate!).
Since the foods are delicious, affordable and colourful, it was very easy to stick to a whole food plant based lifestyle. Besides the improved mood, productivity and overall quality of my daily life, the shift in my blood glucose levels was radical (and quite exciting to witness!):
my time-in-range (the amount of time spent in the ideal range of 90-130) went from 65% to 95%,
my A1c went from 7 to 6.3,
my insulin dosage halved,
all within one month.
The impact of whole plant based foods on running
Coming back to running, this shift in my diet had the biggest impact. Going high-carb, low-fat increased my insulin sensitivity and drastically reduced all the random guessing I had to do before and after every run in the past.
Running does help to regulate my blood glucose, but the bulk of its steadiness is guaranteed by the way I eat. In pretty much every run I did so far, if I go out with 130, I come back with a very similar level. My CGM is a testimony for that, since in most cases it looks like this:
A typical day in the life of a high-carb, plant-based and happy type 1 diabetic.
The best part is that this is not a “diet”, but an enjoyable lifestyle that is very easy to stick with long-term. And - very important to me - I LOVE the taste and the quantity of the food I can eat.
It is difficult to describe how important this is from a mental standpoint. When every bite of food is a joy and you are in control of your blood glucose your life changes.
If you add to that that you are confident that you will be able to enjoy every run, considering how important running is for mental health, the benefits compound very quickly.
Your take-aways
If you can’t be bothered reading the text wall above, just read this:
A type-1 diabetic can and must master its diabetes. This can be done by reducing insulin resistance and increase insulin sensitivity via a whole food, high carb plant based diet.
The lower your insulin resistance, the more stable your blood glucose levels, the easier it is to stay in a safe glucose range during a run.
You lower your insulin resistance by eating low-fats plant based foods, which you can pick and choose from a comfy list of green light foods.
Now please do me a favour: go eat some amazing food (I’ll pick some apples and bananas for today!), put a smile on your face and enjoy your run.
You can do this. I’ll see you at the next marathon!
