How I Run 100 Mile Races with Type 1 Diabetes

How I Run 100 Mile Races with Type 1 Diabetes

In 2014, I was diagnosed with Type 1 diabetes, a chronic disease in which your pancreas produces little to no insulin. I had just returned from a month-long trip to India and thought I had jet lag because I felt very sluggish and was very severely dehydrated. My mother is a doctor, so she emphasized that I get blood tests done. It was a super quick, quick diagnosis – within a day of being on insulin. Luckily, I was never hospitalized, which is something many people with type 1 experience when they are first diagnosed because symptoms begin quickly and can be severe.

The diagnosis came as a shock. I'm an ultramarathon runner, I run 50 and 100 mile races, and this was certainly not something I expected. The first question I asked my endocrinologist was: How should I continue running ultramarathons? It wasn't a question she had never heard before.

The percentage of runners who do these types of races like me is as small as it is, let alone with an autoimmune disease like type 1, so I really didn't have many examples. There were definitely doctors and practitioners who had a lot of doubt about my ability to continue running marathons. I'm also vegan and they tried to get me to switch to a high-meat diet to control my insulin levels and I just said, "You know what? I'll just figure it out myself." And I kind of have that. I had a friend who did 100 mile races as a type 1 diabetic so I was able to reach out to him and ask for advice, but what works for someone else may not work for you as everyone's level and needs are so different I had to figure this out on my own. I started looking into technology for Type 1 diabetics and I think within 10 days of my diagnosis I was on an insulin pump and a blood glucose meter, which gives me the freedom of not having to deal with injections.I can adjust my insulin levels as needed, which is very often.

Life as a type 1 diabetic is a 24/7 balancing act. My insulin pump is under my skin and something I literally have to think about all day. There is not a moment in the day that I am not aware that I am responsible for the way I walk, talk and breathe. There are terrible cases of type 1 diabetics who go to bed, hit a low point throughout the night, and never wake up again. People can die from this condition; it is a very real reality. As a type 1 diabetic, you give yourself insulin for every bite. You change your insulin levels for exercise. So when I go boxing, I know my insulin is going to go up because of the cortisol. I know it drops during a long run, so I have to reduce it at certain times. I have to eat sugar at a certain time, before, after or during. It's all about math and timing. I haven't eaten a bite in three years and haven't thought about my insulin-to-carb ratio and how much I should take, what I plan to do in the next hour, or what I did before.I don't think I've slept through the night since I was diagnosed because I have devices that tell me if I'm high or low or whatever...it's crazy. I can't even remember what it's like to not function without having to think about these things. Still, I think the transition would have been much more difficult if I hadn't been an endurance runner with such awareness of my body - I was already so aware of how I eat, how I move, and how I feel in every moment, especially when I'm racing and training.

Luckily, technology gives me the ability to adjust my insulin levels and reduce risk as much as possible. But I'm risky by nature. When I was approached by National Geographic to hike the Serengeti in Tanzania, I said yes. I hiked almost 200 miles with a group of people, foraging and living off the land - no tents, no food. My insulin was kept by the film crew, but other than that I received no help. I'm pretty sure I'm the only type 1 diabetic this has ever happened to. Yes, there were definitely really scary moments where I thought I was putting my life at risk. It may sound stupid, but I still truly believe in living courageously and I don't really consider myself a victim. I'm forced to be stronger because of it. (

Robin Arzon shares how a near-death experience inspired her to become a trainer

Still, it is unpredictable. During a marathon, people are often afraid of hitting the wall. I would say low blood sugar is a wall x 100, and it's a wall that can really put you in an emergency situation, which is what happened at the last Shape half marathon. My first was at the Tokyo Marathon in 2014. As a diabetic, you are at risk of your blood sugar levels becoming too low and too high. Of course, if you do an endurance sport, low levels are terrible because you don't have enough sugar to function, but it can be more easily remedied with Gatorade or sugar. But in both Tokyo and Shape Half, my insulin pump failed and I stopped receiving insulin, so my blood sugar spiked, and without insulin to lower your blood sugar levels, your body works way too hard. It makes it really unsafe for your heart to do something like a marathon, which already causes it to work pretty hard. The fatigue was like running with a refrigerator on my back - my organs were simply struggling.But because I'm also very stubborn, I still finished both races. At the Shape Half I knew I had one more loop of the park so I just slowed down and did it. I knew that if I kept it within a comfortable range I would be fine because I have a pretty high tolerance, but dealing with a setback was frustrating.

Type 1 diabetes is a 24/7 thing that completely annoys me. But there is an advantage: I have several opportunities every day to show myself that I always have a little more strength.

And fortunately, I can now help other people in my position as a member of the leadership council of Nick Jonas' nonprofit Beyond Type 1. It's really about raising awareness and creating a supportive, relatable community. A lot of the content out there is aimed at kids, but Type 1 can affect anyone at any time (that's why it's no longer called "juvenile diabetes"), so it's a great and necessary outlet for other adults out there. There is a lot of fear-based information out there. Some of it is practical, but a lot of it I don't agree with. I just don't think we can live in fear.