I’m not proud of myself. Seven miles into a recent 12 miler across the South Downs, I came across an unopened Snickers bar in the mud, picked it up, stashed it in my bumbag (not proud of that either, but being a diabetic runner makes one necessary) and went on my way.
I was getting desperate. Hypoglycaemia has snapped at my heels for each of the 300 miles I’ve run since starting this project; now it was breathing down my neck. For every 30 minutes I spend running, my blood sugar falls an average of 28% (yes, I’ve worked it out); in this case it had fallen even more sharply. I had an hour to go and only a few glucose tabs left.
Hypos aren’t pretty at the best of times, but going low on a deserted hillside could mean serious trouble. And If a hypo in the South Downs spells trouble, one in the Sahara Desert, where I’ll be running the 150 mile Marathon des Sables 2018, would mean disaster. So how am I going to keep running without turning into a gibbering, howling wreck and dropping dead?
It’s a serious question. Hypos can kill. Before that they send you round the loop. I’ve declared my mother-in-law messiah and divined the meaning of life in hypoglycaemia’s grip. I’ve had violent convulsions, smashed my limbs and bitten my tongue until it’s bled. I’ve nearly died. This can’t happen in the Sahara. The Mrs would kill me.
So I can’t scrimp on sugar. “Always carry enough carbs for the duration of your run, and then some,” says David Moloney, a type one diabetic who completed the Big Red Run, a 250km race across the Australian outback’s Simpson Desert, in July. “Extremes in weather – hot or cold – cause my levels to drop faster than normal.”
This might explain why my blood sugar dropped like a stone on the day I scavenged that Snickers. It was late October, there was a cold wind blowing across the Downs and I was still in my summer running gear. Regular blood tests – Moloney checks his every half hour – will allow me to keep track of my levels, whatever the weather. In the Sahara, where temperatures often exceed 50C, they will be crucial.
The variables affecting blood sugar levels don’t end with the weather, of course. Insulin dosage has the greatest impact. Studies have shown that exercise increases the body’s sensitivity to insulin by 25%, so dosage needs to be adjusted on exercise days. I’m certain I had too much of the stuff sloshing around my system the day I picked up that Snickers.
Roddy Riddle, who in 2013 became the first (and so far only, as far as I know) type one diabetic to complete the Marathon des Sables, cuts his basal insulin dose by 80% during runs, allowing his levels to stay stable. Riddle has a key advantage: an insulin pump. “Pumps are definitely the way forward for sport,” he says. “Not sure I could have managed the MdS without one.”
Pumps are expensive. The NHS doesn’t give them to just anyone. I’ve already asked to be considered for one, but a host of criteria has to be met before the doc will sign on the dotted line. In the meantime, I’m following Moloney’s advice: “Practice over and over to find out what level of carb intake you need to maintain good levels.”
I’ve discovered that I don’t need anything like the amount of carbohydrates conventional advice says I should. Limiting carbs (but eating more fat and protein) means I can limit my insulin dose. And, because it’s this potent little hormone that causes the hypos in the first place, I’m able to limit the chances of going hypo when I’m running.
Take last Sunday’s run. After a breakfast of berries, nuts and Greek yoghurt, I set out for a 10 miler, having had just one unit of insulin (I’d normally have between two and four). I didn’t need a bite to eat – not a single glucose tab – and my sugar levels stayed within the safe parameters for the entire 10 miles.
To me it seems simple (but see my disclaimer below): Taking less insulin on days I’m running lessens the chances of a hypo. It also means I need to eat less when I’m running. Which gives some measure of hope about this stupid goal I’ve set myself. There won’t be any Snickers to be found in the dunes of the Sahara after all.
Disclaimer: You’d be an idiot to take any of the above as advice. I have no nutritional or medical training. I’m just a type-one diabetic with a stupid plan: to run 150 miles across the Sahara Desert. You’d also be an idiot to want to do that, but if you do, make sure you take proper medical (and psychiatric) advice.