marathon1Heart disease and stoke account for 65 percent of deaths in people with diabetes… 

It’s Sunday morning and its early, but me and my friends have been up since 4am. We walk towards the starting line of the AFC Half Marathon. My heart is beating fast – part nervous, part excitement. “Ready?” I ask my friends. “Lets do this” they reply. Our gait changes from steps to strides as we cross the starting line, the first feet of 13 miles that lay ahead of us. 

Diabetes causes between 12 and 24,000 new cases of blindness each year… 

Miles 1, 2, and 3 seem to glide by effortlessly. My friend Betsey and I chat about funny runners, the song we’re listening to, and how beautiful our city is. We coast mostly downhill, and as we trot by the mile 4 marker, we pop open packets of carb gel to keep our energy up. My legs feel strong, my lungs wide open, and my face is towards the still rising sun in the east. America’s Finest City indeed.

More than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes…. 

Mile 6 – we’ve been running for an hour and my legs are starting to feel heavy. Our pace is steady – we’re holding at just under 10 minute miles, but I’m starting to feel it. The pain in my right leg has moved from just the side of the kneecap to the entire knee. I ignore it and tune back in to my music. An older gentleman cruises up next to me. “I like your shirt” he says, nodding towards the “I RUN ON INSULIN” logo on my back.

I grin and pant “Do you have diabetes?” 

“No, but my son does” he says. We share a smile and words of encouragement, and we press on. The 7 mile marker comes in to view. More than halfway there, I think to myself. 

Having diabetes doubles your risk for depression…

As Mile 9 approaches, my body is screaming for a break. We’re approaching the furthest I’ve ever run in my training, and my body knows its limits. I remind myself that in less than an hour, this will all be over. I’ll be done, and can retire to the couch for days if I do so desire, but I have to finish. I’ve trained 10 weeks for this, and if only to prove it to myself, I will keep running. Betsey and I have ceased chatting. We’re focused only on putting one foot in front of the other.  

People with diabetes are two to eight times more likely to die from stroke than people without diabetes… 

At Mile 11, the course begins to wind through the streets of downtown, and soon takes a sharp uphill turn. I see the thousands ahead of me climbing up that hill. Only two miles left, but I don’t know if I have it in me. Two short miles stand between me and the finish line, and I’m running out of gas. I dig deep. I curse the course designers for the hill. Dozens around me have slowed to a walk. I run on, head down, focusing on keeping my legs moving. I don’t know what my blood sugar is. I don’t know what song is playing in my headphones. I just know I keep running.  

Diabetes is the leading cause of kidney failure…. 

I round the street corner on the final leg of downtown. The ornate entry bridge of Balboa Park is up ahead, filled with runners. The crowds on the sidelines shout encouragement, waving their colorful signs, clapping and cheering. I don’t hear their words, I just look straight ahead. Quarter mile. One-tenth of a mile. Feet away from the end. My legs are numb, my heart feeling as though it might pound out of my chest, my body pushing itself to the very limit.

The banner ahead reads “Finish Line….” I cross, and raise my fists in the air. 13.1 miles behind me. 13.1 miles in the face of all the odds. 13.1 miles carefully titrated, dosed, carb-counted, tested and adjusted. 13.1 miles run with the strength of 24 million people with diabetes behind me.  I run on insulin.

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Congratulations on your glorious accomplishment – both the run and the writing. Your blog truly reflected the entire run, mile by mile. I feel your pain on the last climb, and the burning desire to finish, drowning out the body’s demand to cease and desist. I know after training 7 weeks for the 2009 TDC, I felt the same combination of pain/joy at 29 miles of the 32. But crossing the finish line is so sweet, with fans and volunteers cheering you on! Hope to see you Tuesday at the TDC 2010 meeting. Till then, “Keep on Trucking”!!

CONGRATS!! Great job!!

Beautiful!! Love it, Good work Lady!

Yeeeaaaaaahhhhh, Lex!

Congrats Lexord!!!!!! Now stop pounding the pavement, will ya?

big 🙂

Amazing and inspiring! 🙂

Alexis, I’ll add to the chorus of people congratulating you on your accomplishment and your heartfelt written summary of what was going through your mind. Very enjoyable to read!

I’d be interested in the results of your mid-course test, as well as afterwards. Did you end up really needing that carb gel? How much do your levels drop after 13 miles?

I know with me it goes down about 20-30 points after the 5 miles that I usually run.

FANTASTIC!!! Didn’t you feel like you were simply AMAZING after crossing that finish line?? I did mine in May and I was so overcome with emotion, pride, that I literally welled up with tears streaming down my face. Yes, I was crying! I will remember that moment forever!! It’s so rewarding to work toward a goal like that and then complete it. It’s YOUR PERSONAL JOURNEY!!!

I am so proud of you 🙂

Andrew thanks so much for your feedback! It was so hard, but so awesome and I’m glad I did it.

To answer your question, I did NOT need the carb gel at all. In fact, I ended up with really high BGs after the run, and it was due to a bit of unpredicatability with the whole situation. What threw me and my usual formula off was the fact that I woke up with an unusually high blood sugar that morning – 307! I don’t know if it was because I didn’t sleep well, or nerves, or what, but it really screwed me up. I had to bolus a bit, because it was so high, but I was really afraid I would get low with any insulin on board, so I continued to run very high right up until the race started (about three hours between when I woke up and when we started running, plus I had to eat something.) I was so focused on running that even though I had my kit with me, I did not test while running, which in hindsight was a mistake. I popped between 18-28 grams of carb with the gel at 4, 7, and 10 miles, and my off-the-charts high BG at the race end showed me that I hadn’t even needed them
I as definately nervous and wanted to follow my pre-set plan so badly that I really erred on the side of high sugars to make sure I made it through.
Next time, I am going to be sure to just stop and take 30 seconds to test, so I know where I’m at!

very cool! so inspiring. Congrats!

Alexis, let me follow up on your running with high BG. Do you feel any more ‘sluggish’ running with high BG like that? I’m obsessive with data analysis and I’m now trying to zero in on what’s the optimum BG level for running. For instance, I know that if I test high (> 200) before I run, I can’t bolus because having that extra insulin in me really knocks me for a loop while exercising. But at the same time I find running with it over 200 also slows me down. It’s maddening!
Trying to figure this out has me feeling like I’m walking up an M C Escher staircase! With additional insights like yours, I might be able to figure it out. Thanks.

Hey Andrew – yes, I did feel more sluggish and really tired. The thing is, it was hard to know if that was from the high or just from running – it wasn’t until after the run that I knew how high I was, yet another reason why next time I will be sure to test somewhere during the race – that was definately a mistake, but hey, you live you learn! For me, the optimum number for running is the 150-180s – I feel safe and strong in that range, but that’s pretty narrow I know!

I totally hear you on the MC Escher staircase, I want to get this down to a science so bad, but its hard with all the factors. Take this last race for example – I had the right breakfast, the no-bolus rule, etc. and then an unexpected morning high threw all that out the window. It is maddening, but the best thing to do is trial and error. Let me know what other insights you have, I also find those helpful!

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