A Marathon with Diabetes: Trying to Control the Unknown

The past few months have been hectic, and Adam has had a number of infections, which means he’s spent a lot time out of nursery school.  So while I do enjoy spending my days snuggling with Adam and watching Penguins of Madagascar, I’d much prefer that he be healthy and that I get my work done.

But there’s another thing going on that doesn’t, per se, take up any time, but yet brings in chaos and angst.  It also leads to lack of sleep and is disruptive 24 hour a day.  Yes, I’m talking about blood glucose levels – specifically, Mike’s blood glucose levels.

Like anyone with type 1 diabetes, Mike struggles to keep his BG in a safe and healthy range.  One of his most important tools is exercise.  When he runs a lot, his BG is generally manageable.  So now, as he’s training intensely for a marathon, you’d think his BG would be great, however, it’s anything but.  In fact, I can’t remember a time in the last ten years that I’ve heard him complain this much about the numbers.

I can attribute some of the complaints to his desperate need to be in the best shape possible on marathon day.  He’s obsessing.  He has been training for many months, diligently, and without complaining about the 4:30 a.m. wakeups.  He’s been doing everything right.  But the thing about preparing for a marathon with diabetes is that blood glucose – the most important part of the equation – is the one thing that no amount of training can determine.  There are only imperfect formulas to success.  The factors that can throw off a run are not extreme weather conditions or a sudden injury.  It can be something as subtle and immeasurable as a sudden surge of cortisol in the body in response to pre-marathon stress and nerves.  And that may lead to a little surge in BG, which may lead to high BG at the starting line.  It’s like losing before you’ve begun and you can only guess why.  The precise reason lies within your mute cells.

The part of this that has been the most confusing is how and why on the days that Mike runs 20 miles or so does he have consistently high blood sugar?  Logic says he would have to eat constantly on such days in order to keep his blood sugar up.  But instead, despite the boluses and minimal carb intake, he hangs out around 200.

I understand how frustrated Mike is.  I try to be supportive.  I listen. I offer suggestions if I have them.  If it’s a low blood sugar incident, I offer to get food.  It’s all okay during the day.  The nights, however, are wearing me down.  Every night before he falls asleep, Mike sets an alarm to wake him in one hour for a BG check.  “If you hear my alarm and I don’t, please wake me,” he says. 

Mike doesn’t mean to place a burden on me.  But as soon as he says that, I assume the responsibility of making sure he wakes up when his alarm sounds.  I don’t have a choice.  If he doesn’t wake up to his alarm, it could be worst case scenario.  So I listen.  I stay up reading for as long as I can.  One night after 45 minutes, I woke Mike.  “I can’t stay awake,” I told him.  “Please check now.”

Mike did and his BG was 65.  Had I waited another 15 minutes, who knows how low it would have gone.  It felt a bit miraculous.     

Other nights Mike sets alarms over and over again throughout the night.  Usually I hear them and ask if he’s okay before I hear the pull-back click of the lancing device, the snap when it hits his finger, and the beep of the result.  I go back to sleep, something motherhood has taught me to do well.  I worry, though, that I don’t stay awake long enough to hear the BG reading.  I stress about being in such a deep sleep that nothing registers.   

Mike’s last alarm of the night goes off between 4:00-5:00 a.m.  He always responds to that alarm and tests his BG before he gets out of bed.  At that point, he goes to make coffee, and I’m wise enough not to ask if he’s okay.  With determination as his guide, I know that no matter which number diabetes has thrown him, he’s going to run with it. 

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and has continued to write essays and fiction while raising her three sons (and many pets).

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Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)