Rotterdam Marathon, The Diabetic Version

Rotterdam, the second largest city in Holland and the largest port in Europe, feels like a small town.  I arrived there on Friday morning, two days before the marathon, checked in to my hotel and went to the Expo to pick up my number and chip for the race.

On Friday all was still quiet, but by Saturday morning Rotterdam felt like a convention for runners. Our hotel, like all the others, was packed with runners from all over Europe. Rotterdam is a great place for a marathon for many reasons: it’s flat, cold and there is really very little to do or see, so you are not tempted to spend the entire day walking around and getting tired legs before the run. I went on a boat tour which was a good way to see some of Rotterdam (the port) without moving. I spent the rest of the day around the hotel and the Expo, soaking up the marathon spirit.

My BS was pretty much under control. Eating on the road is always tricky. I figured out which bread I could eat for breakfast (and how much insulin it required). But dinner was difficult. I decided that Asian food, not diabetic or running friendly to me, was definitely out. I didn’t want to eat heavy French food or any beef, and I was scared of eating fish or seafood.  (I know none of these decisions are rational.)  So I was left with Italian, which is what I ate on the eve of the marathon.

There weren’t many choices on the special Marathon Menu.  I basically had to choose between pasta and pizza.  I went for the pizza, and a salad.  I took my insulin (a little more than usual) and walked around for awhile. I checked my BS before going to sleep (2.5 hours after eating) and it was 205 (pizza is always a mistake), so I took 3 units of insulin to correct and went to sleep. At night I went low, and I woke up in the morning at 238.  I felt terrible and I looked bad too, since when I hypo during the night I wake up the next day with bleach white circles under my eyes.

I was awake several hours before the race, and I figured I had plenty of time to set things right. I took my insulin, enough to cover the food at breakfast and bring me down to around 150- or so I thought.  (At breakfast I ate the sandwich of bread and cheese that I’d tested the day before.)  I drank some coffee and tried to relax. The dining room was packed with runners, some of whom had brought their own food with them. It looked like the average body fat level in the room was 5%.

I went back to my room and with a good two hours before I had to leave for the race, I started to prepare myself. I attached the numbers (“bibs”) to my shirt and the chip to my shoe. I tried to relax and go over my plan for the run.

About a half hour after getting to my room (and an hour after taking insulin) I started to check my BS. It was too high. I started to stress and check it obsessively every 5-10 minutes. It wouldn’t go under 200. At around 10:15 I took 1 unit of insulin. I checked my BS for the last time before leaving (at 10:30) and it was still 210. I assumed that it would be fine by the time the canon shot started the race.

The event was fantastic – 8000 marathon runners and even more 5K and 10K runners. There was music, and flags, and it was very well organized. It was also really cold. According to CNN weather it was 45°F but “feels like” 38°F.

It took 8 minutes for my group, the 4-4.5 hours marathon group, to start running after the canon went off (they use a small antique canon to signal the start of the race). I was slow from the start and didn’t really speed up much even when I tried. I don’t know if it was the wind, the cold or my BS issues but I was far from my best form. I reached the half way point 5 minutes later than I’d planned. The race was great, however, with locals cheering along the sides of the road throughout. Even when we went through a large park there were people waiting along the way with their bikes and cheering.

Although my heart rate (HR) was a little higher than usual I didn’t think anything was wrong until the 31^st K (19^th Mile) when I suddenly noticed my HR was above 190.

I was alarmed and stopped for a couple minutes to try and lower it. I didn’t feel low or bad in any way but my HR wouldn’t go any lower than 175 so I continued to run hopping it would just come down if I ate something – in case it was a response to a BS low.   It didn’t come down. In fact, it kept rising slowly, over 200 then 205 and eventually over 210…was it trying to keep score with my post breakfast blood sugar?

I was scared which didn’t help. But I wasn’t going to stop unless I had to. I kept waiting for the wall to hit me, which is what happened at the 35^th K (22^nd mile) in my last marathon.   But this time I passed the mark and was fine. I passed 36K and was still fine. I tried to speed up a bit towards the end and finished at 4:07:59. Not what I had hoped for but still a personal best. I did not feel disappointed. I was happy to finish the race running, smiling and not in an ambulance (not only because I was not insured). I was also cold.

I ate throughout the race, as planned and at the end I ate 2 extra dried apricots. My BS was 91 after the race which is lower than it should have been. Apparently, I ran most of the race low.

I haven’t given up my dream of running a marathon in under four hours. I have a few months before I start training for the next one, and I have a lot of homework to do.

Michael Aviad

Michael Aviad is co-founder of ASweetLife. He was diagnosed with type 1 diabetes in 2002. Michael was born in Santa Barbara and grew up in Jerusalem. He studied law and after passing his bar exam went on to get an MBA with a major in finance. Michael worked for many years as an economist. He and his wife Jess, also a type 1 diabetic, have three sons. Michael loves to run and is always training for the next marathon.

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