Marathon Running + T1D: A True Balancing Act


Every week on her podcast Diabetes Connections, Stacey Simms tackles issues and news relevant to the type 1 community. In the newest episode, Stacey talks to Mike Greenberg, a member of the Beyond Type Run 2019 Marathon Team. Michael discusses completing his first marathon, his love of comic books and wrestling and how his passions helped him tackle his diabetes diagnosis.

Stacey: Did you run before you were diagnosed with diabetes or is that something you started after?

Mike: I really started after… I understood at that point that aerobic exercise, cardiovascular exercise, was good in terms of managing your blood sugar and stabilizing your blood sugar while at the same time you need to stay on top of it because you could cause a low and you could also cause a high depending on what you’re doing. About five or six years had gone by between my diagnosis and my first half marathon and I think I was just looking for the next challenge and I thought it’d be really cool to run 13 miles with diabetes…

But after that I would slowly find other long races to do. And since moving to New York… I’ve been a lot more active with the New York Roadrunners who put on a ton of races throughout the year. And more use of continuous glucose monitors has made life so much easier. Running has become a great stress relief. I do believe that it’s good for my numbers overall.

Tell me about your interest in comic books… Is this something you had from when you were a kid?

Yeah, you know, what little kid doesn’t like superheroes?… I was always a Batman fan growing up and you see [my family] all dressed up in Spiderman. I have a friend who’s probably rolling his eyes at me because we always argued about who was the better superhero, Batman or Spiderman. Here I am dressed up as Spiderman now. But I love all the gear they have and especially when you compare it to the gear I carry with diabetes. I have my insulin pump, I have a meter, I have my glucose tablets. I have to carry all that stuff on myself, so to say. And, again, if diabetes is my foil, that’s how I fit that in.

If someone is thinking, “I can run a 5K, I’ve been thinking about a half marathon or a marathon” and they live with Type 1, what is your advice?

I think the best advice I have is to over-prepare. You want as much information as you can get about your blood sugar and you want as many tools as you can carry to treat either a low or a high in case you need it. Before continuous glucose monitors (CGMs), I would always test my blood sugar before I ran or exercised, doing anything. I always like to test my blood sugar after I ran and then again, a couple of hours later. With CGM it’s much easier… I typically start by eating something before I exercise and you could also, on a pump, you could do decreased basal rates for a certain period of time. If you’re on a pump, I generally don’t like the idea of disconnecting it anymore because I just… I’ve seen other patients forget to reconnect it or forget to turn it back on.

So I don’t like the idea of suspending it or disconnecting it. I like to leave it connected. If you feel like you need no insulin, there are more advanced pumps today, they’ll suspend for you if you need. I do like a temporary reduced basal, which you could start like an hour before planned exercise and that can be difficult to really fit into a schedule to exactly know… I don’t think most people function that way. I think it is a more spontaneous but in terms of suspending, I would much prefer to do a temporary of even zero for, say, an hour or two. And then you know the pumps going to it back on, as opposed to disconnecting or suspending it altogether.

So I eat beforehand, maybe 20 to 25 carbs. I carry energy gels or glucose tablets with me. And, there’s a lot of trial and error and experimentation to figure out what works for you. So in general, I’ve found that about every three or four miles, I need another energy gel, which is approximately 20 to 25 carbs and also depends on what my blood sugar is beforehand. And my blood sugar is 120 to 150 or even 120 to 180, I don’t eat anything before a relatively short run, and that has changed after the marathon for me.

If I’m doing under 5 miles, I don’t eat before a run if my blood sugar is, say, 120 to 180. If I’m below 120 I’ll have something. If I’m over 180, then I might actually make a tiny correction to make sure my blood sugar comes down. But then, you’ve got to be careful for a low. So again, it’s a lot of trial and error, making sure you have the knowledge of your blood sugar beforehand, during and after and then carrying those fast carbs with you in case you need it.

Do you think you’re going to run another marathon?

I absolutely want to do it again. I am one race away from qualifying for next year’s New York Marathon, which I think my wife was pretty supportive of. I think she will be pretty supportive of the next one. It does take a lot of time away from family, so I really give her a lot of credit for all the work that she’s done. But yeah, New York Roadrunners has a nine plus one program where if you do nine of a set of races and you volunteer to work at one of their races, they’ll give you a spot in the next year’s marathon.

So I do plan on running again and hopefully fundraising again. I look forward to it. And this is a couple of years after I said I would never do a marathon and I told my wife to never let me do a marathon… It was a diabetes thing where I felt like I had done the half marathon and I had proven to myself that I can manage my blood sugar and be healthy and have a good time running 13.1 miles as a half marathon, and that I didn’t need to prove it to myself that I could do anything more.

Honestly, this was one of the best days of my life running the New York City Marathon and I really look forward to doing it again. I don’t think I have ever agreed to do more than one a year. Even though I told my wife this past year that maybe I’ll do two a year. She looked at me like I was crazy.

Listen to the full podcast for all Stacey + Mike’s conversation:

WRITTEN BY Stacey Simms, POSTED 12/06/19, UPDATED 11/16/22

Stacey Simms created Diabetes Connections in 2015 and has been its only host and producer ever since. She is the author of The World’s Worst Diabetes Mom, Real-Life Stories of Parenting a Child with Type 1 Diabetes, and I Can’t Cook But I Know Someone Who Can, a benefit cookbook for JDRF. Stacey’s son was diagnosed with type 1 diabetes just before he turned two, back in 2006; she’s been sharing her family’s experience with type 1 diabetes (T1D) ever since. She is an award-winning radio news host and TV anchor/reporter with more than 20 years of broadcast news experience.