Running with Type 1 Diabetes: How I Keep My Blood Sugar Stable


Editor’s Note: Doug is a member of the Beyond Type Run 2022 team—a team of nearly 50 people living with type 1 diabetes who ran the 2022 NYC Marathon on November 6, 2022. They’re on a mission to raise awareness and funds for type 1 diabetes, with fundraising open through the end of 2022. Congratulate Doug by making a gift on his fundraising page!

I was diagnosed with type 1 diabetes (T1D) on May 24, 1999, one month before my 21st birthday. When I was diagnosed, I only knew a few people with T1D. I knew there were support groups but at the time, I didn’t find any value in joining.

In the beginning, I didn’t take care of myself the way I should have. Family members would ask me how things were going and I would reply with the standard “good.” I recall an appointment with my endocrinologist when we were discussing complications related to T1D.

She took a piece of paper and tore it in half multiple times to demonstrate how it related to blood sugar control and living a normal healthy life with T1D. That was when I realized I could manage my diabetes and it didn’t have to be so scary.

How I turned to running

Somehow around the holiday season in 2010, I convinced myself I would run the Twin Cities Marathon. I was overweight and unhappy with my level of physical activity.

I’m not sure I believed I would finish a marathon, but I knew something had to change. I found a coach and a gym and set my plan in motion.

I remember my original training plan called for a walk/run mixture and on Saturday, the plan was to run until I had to walk. I still remember the first time I hit 2 miles; I was so proud of myself for achieving that goal.

I signed up for my second marathon before even completing my first marathon. I discovered I needed something to keep me motivated to train and continue with my fitness journey. I rotated between Twin Cities and Grandma’s Marathon from 2011 to 2013 and then decided on a new goal for myself: a marathon in every state!

This is one of the reasons I wanted to run with Beyond Type 1—it gets me to New York and I could raise money for a great cause that is personal to me.

What I’ve learned

I’ve learned about so many different things as they relate to T1D. During my first marathon, I was on multiple daily injections (MDI). All the other events I have run, I have been on an insulin pump. It wasn’t until I went on a pump that I learned about long-acting insulin and short-acting insulin. I recall during pump training asking where the long-acting insulin went (insulin pumps only use rapid- or ultra-rapid-acting insulin).

This was when I also learned about active insulin on board and how active insulin can impact physical activity. Learning about these things was very valuable in managing the highs and lows that come with working out and running.

The time of day I choose to run plays a role in how I manage diabetes. I typically run in the morning. I don’t eat before a run because I don’t want active insulin on board. I’ve learned what I’ll need to consume for different runs and have a plan for a low blood sugar, should it come up. I wear a medical alert notification and carry a glucagon, phone and low snacks. It’s a lot to think of but not impossible.

My strategy changes from a.m. to p.m. runs but either way, I try to have no active insulin onboard when I leave the house. I have strategies in mind based on what my current blood sugar is in comparison to how far I plan to run.

  • If it’s a short, 3 to 4-mile run, I generally try to start at about 7.8-10 mmol/L140-180 mg/dL and may have 15-30 grams of carbohydrates snack as I’m going out the door. As that spikes my blood sugar, the running will bring it back to a normal range.
  • For my runs in the 4 to 8-mile range, I try to start below 11.1 mmol/L200 mg/dL, but I’m not so worried if I am higher than that because the distance will bring me back into range. I really enjoy using UCAN for fuel. It’s 15 grams of carbohydrate and for longer distances, it works great to keep my blood sugar stable.
  • For runs longer than 8 miles, I will use UCAN 30 minutes before I leave the house and continue to fuel with some sort of gel combined with UCAN. I try to fuel every 45 to 60 minutes but generally fuel based on how my blood sugar is behaving.
  • When I run a marathon, I generally bring eight GUs and have a UCAN 30 minutes before the start. I typically use six or seven of the gels but always bring more than I need to protect myself in the event of an emergency low blood sugar

Who I’ve met

When I started running, I didn’t have resources or a community to confer with. I applied to be a chapter president of a nonprofit that’s no longer in existence today, but that was when I started to become associated with the Diabetic Online Community on Twitter, Facebook and now TikTok. A group on Facebook was being managed by one person and she asked me to help as an administrator of the page, now called Type One Run.

Running and T1D have opened the door to connecting with so much of the T1D community. I have run races to connect with other T1D runners. Being on the Beyond Type Run Team has introduced me to 50 new friendships this November 6.

I’m running events in Memphis, Tennessee and Roanoke, Virginia, in the next six months to connect with friends I met at Little Rock Marathon in 2019. If I’ve interacted online with someone, there is a good chance I’ll sign up to run a race near them so we can meet.

I love my online community. Last December, I mentioned I was considering an event and four people in that area immediately said they would also sign up if I did.

Why Beyond Type Run?

Running the NYC Marathon for Beyond Type 1 helps me achieve a couple of goals:

  • I’ll be able to cross another state off on my 50-state journey,
  • I can do some good by raising money for Beyond Type 1,
  • And I’ll be part of a team of my peers to represent the type 1 community.

I’m excited to be on a team and do this as a group instead of running solo. This is a great opportunity to share that all things are possible with the right support, training and effort. I’ve gotten great support through Beyond Type 1 thanks to the community, online articles and the Type One Run group.

WRITTEN BY Doug Scalia, POSTED 11/03/22, UPDATED 05/22/23

Doug Scalia has been living with T1D since 1999. He lives in Dayton, MN with his wife Stacey. In his spare time, he enjoys spending time with his many nieces and nephews. Doug also enjoys volunteerism for a variety of causes.