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RADJournals: Iain MacDonald discusses ultra running with Type 1 Diabetes

I was diagnosed with Type 1 Diabetes (T1D) in May 2020 at 37 years old, a bit of a late bloomer for T1D. My journey with T1D has been hugely transformational in a very positive way so far. I have decided to really test my capabilities as an athlete and T1 Diabetic while fundraising for the organization that helps others like me. I have chosen to compete in the Tarawera 102km Ultramarathon as a way of testing my body to its absolute limit, physically, mentally and ‘diabetically.’ Training for my regular distances such as the marathon has been great, and I understand my body well in regards to my blood sugar levels. However, as my training runs have lengthened in time/distance my body has had other ideas.

First, I better give you a quick crash course on T1D. T1D is when your pancreas stops working and eventually dies. This means your blood sugar levels have no insulin (pumped out from the pancreas, keeping them stable) and your levels can go very high and very low in a short amount of time. For example, if I drink 3 cans of coke my blood sugar levels are going to skyrocket and the pancreas being its dead self is not going to help bring my levels down. A person with a working pancreas will sit between 4-8mmol – yes even if you drink 3 cans of coke in a row, but a T1D could go well over 30mml (that’s dangerously high) so we use insulin pens daily. Like a mechanical  pancreas of sorts. Personally, I use 17 units of 24hour slow releasing insulin called Lantus every morning, this tends to keep me in check until lunch time or dinner where I will then have 1-2 units of fast acting insulin(NovoRapid) to keep my blood sugar levels even throughout the night. I also have a high sensitivity to insulin (I know seems silly!) so my units tend to be a lot less compared to others, this can also lessen again depending on my training schedule as fatigue tends to continually drop my blood sugar levels for days at a time.

In short, my pancreas is dead/dying so I use a manual insulin pen daily to keep my levels in a ‘normal’ range while also being highly sensitivity to the insulin. A T1D can go dangerously high when eating large amounts of sugar/carbohydrates and dangerously low when not consuming enough sugar/carbs. 

Now back to the ultra-running! I have competed in every other distance up to the marathon but never anything longer. My first few long runs over the past few weeks didn’t go too well. I did 2 x 30km long runs and each time my blood sugar levels dropped dangerously low no matter how many carbohydrates I was consuming. This meant I had to go back to the drawing board with what fuel I was going to use over 102km of racing. My partner (Morgs) and I discussed it at length, and we were starting to get a little worried with how my body ‘diabetically’ would handle the distance without crashing. My highest risk during the 102km race is being so fatigued that my body cannot bring my blood sugar levels up to a safe range because even though I will be continually eating, my body will be continually using those carbohydrates as fuel for my muscles.

Thankfully last week I accidentally discovered my new go-to SUPERFOOD! I was on my way to the forest for my long and I was hungry (pretty sure that’s something I am going to constantly say until the 12th of February haha). I picked Morgs up from work – she works in the Café at New World and the Deli there does THE BEST hot chips I’ve ever come across. I grabbed a small packet of chips and on we went. I know hot chips 10 minutes before a long run – yuck for some! My blood sugar levels ended up being in a completely 'normal’ range for the entire run, no major lows like last time! Alas we have found the secret to my training–POTATOES. Now to test it out.

On November 28th I ran my first ever 50km training run in the Whakawerawera forest with Morgs on the bike feeding me roasted potatoes. I had my best run so far! Below are some stats about my blood sugar levels. I tested every hour to check how I was tracking so I could adjust my nutrition if needed.

Run: 17mmol 

1hr: 22mmol

2hr: 17.2mmol

3hr: 9.5mmol

4hr: 8.1mmol

Finish 4hr30min: 8.1mmol

Distance: 50km

Elevation: 1141m

Carbohydrates consumed: 424grams – 4.5 sticks of Tailwind and 3 medium sized potatoes

Up next, the Tarawera 102km Ultramarathon!


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