13 Tricks I Learned To Go From 0 to 26.2 Miles With Type 1 Diabetes


Editor’s Note: Erika 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. They’re on a mission to raise awareness and funds for type 1 diabetes, with fundraising open through the end of 2022. Congratulate Erika  by making a gift on her fundraising page!

It still feels like a dream, writing this, with just under two weeks until I run the 2022 New York City Marathon with the Beyond Type Run team.

I grew up in New Jersey and I’ve spent a ton of time in New York City—from the hipster neighborhoods of Brooklyn to the delicious ‘hidden gem’ restaurants in Queens. Although I’ve had my fair share of runs through Penn Station and Port Authority to catch trains and buses back home (probably with a plethora of low blood sugars), nothing prepared me for running all five boroughs…with 50,000 others.

When I say nothing prepared me, I mean nothing. I have never run a race before.

Here are 13 tricks I learned to go from 0 to 26.2 miles with type 1 diabetes.

It’s okay to hate running. I did.

Yes, I am about to run 26.2 miles, or roughly five and a half hours worth of running through the Big Apple and I used to hate running. But running the marathon meant so much more to me than the physical aspect. It’s about showing the world that living with type 1 diabetes will not stop me from doing anything I set my mind to.

Do your research. ✏️

Before I started training for the marathon, I started running weekly. I followed a Run with Hal program for basic running. It had me running three times per week in lengths of about 1-3 miles. It was during these first couple of months that I built an important base of stamina, endurance and overall physical fitness.

This can also be applied to diabetes tips and tricks for running long periods of time. Do your research, and read stories from other runners! Although there is no one-size-fits-all, it’s helpful to hear from others who have done this before (hopefully you’ll refer to this list and this guide too).

Run, log, then recreate.

As my runs got longer, I became more and more attentive to my blood sugars. Would I go low? Yes. Would I go high? Yes. The more practice and knowledge I gained, the easier it was for me to manage my diabetes while running three times a week—something I had never done before.

When I’d have a good run/good blood sugar day, I’d write everything I did that day down, like meal times, run time, insulin on board, etc.

Let every mile motivate you.

Every mile that I ran during my training, I felt more empowered and more excited about the 26.2 I would run on November 6. As someone who hated running growing up and who has never run a race before, this was a huge shift in my mindset. As many marathoners will tell you and you will read online, it is a mental game or mental race just as much as it is physical. If you can sit comfortably with your thoughts while you’re running for long periods of time, you can finish a marathon.

The less insulin on board, the better. 👍

For me, running with less insulin on board made things much easier across the board. I strived to have little to no insulin on board ahead of all of my runs.

Find your sweet spot.

As you run more, you will find the sweet spot for your starting blood sugar range. Some people choose to run themselves a little higher than others ahead of their runs. This will take time and practice but you’ll get it. For me, I like to be between 7.2-8.9 mmol/L130-160 mg/dL.

Always pack for lows. 🧃

Even if you are running a short distance, you should always have some sort of low blood sugar treatment with you. Maybe you can fit a glucose gel or a few glucose tablets in your pocket. The point is: always be prepared. Diabetes can be unpredictable in everyday life, now add 26.2 miles to that.

Skin Tac is your best friend.

I have never run a race before and neither has my Dexcom. My little buddy was not prepared for the sweat and salt dripping off of me during my long runs in the summer sun. I quickly learned that I needed to use SkinTac (a sticky wipe on my skin that helps the Dexcom stick more) and an overpatch too (also because there are so many cute designs and colors—and diabetes should be cute!).

Hydration = 🔑

As anyone who has ever run a race before will tell you, hydration is key to a successful marathon. I underestimated how important hydration would be at the beginning of my training but quickly learned that I needed a game plan. I started to run in areas with water fountains or places I could stop for a water bottle. On very long runs, I asked my dad to follow me with the car (he’s truly the best).

But here’s the kicker: blood sugar, insulin and low blood sugar snacks all work more effectively if you are properly hydrated. This was huge for my training both during and after my runs.

In addition to all of these benefits, staying hydrated prevents cramping, and yes, I did cramp up a few times before I got the hang of it. There are tons of tools online to determine how much water you should drink before/during a run depending on how much water you typically lose.

Stretching is crucial before, during and after running.

I have always been semi-flexible, I grew up going to ballet class five nights a week and then that became yoga five nights a week. I completely underestimated how much this could affect my body’s ability to run comfortably and how I would be risking injury! Always stretch.

Let yourself recover.

There is a lot going on with your body while you are pounding on the pavement and throwing back miles like it’s nobody’s business. Giving yourself the appropriate amount of time to recover after any run is important.

Here is what worked for me:

  • I never run two days in a row.
  • I never run if I’m feeling too exhausted/not well/on a blood glucose (BG) rollercoaster.
  • I took advantage of ways to relax my muscles like using a muscle gun, going to yoga, hopping in a sauna or jacuzzi, massages, visiting a physical therapist and cryotherapy.
  • I listened to my body when it needed more rest.

Take care of your feet! 👟

I can’t stress this enough as a person with diabetes who also happens to have flat feet. I was diagnosed at age 4 and never thought much about my feet growing up. But as I’ve gotten older, I’ve learned the importance of being mindful of wounds, cuts and blisters. Naturally, with my long runs, I was expecting some rubbing and potentially some blisters.

After my longest run of training (20 miles!), I walked away with a couple of blisters on each foot, so I went to a podiatrist (who sees many patients with diabetes) to get them looked at. He told me to be prepared for blisters on race day, and to take advantage of the medic tents on the course, if needed. He also recommended I get silicone toe sleeves for my toes.

Now, what worked for me might not work for others, but I did find that paying extra attention to my feet helped me to prepare and prevent any damage to my feet.

Make sure you research and find the right shoes!

Wearing the proper gear is important, but having extra support will always come in handy. The use of KT tape or Rock tape changed things for me. This tape is meant to help stabilize certain parts of your body, especially after an injury. I started using it after I hurt my foot, but I wish I was using it the entire time. I primarily wear a piece underneath both feet, a piece around the arches of both feet, and then a long piece that runs from the arch of my foot up to my calf.

Simulate race day with food timing, insulin, etc.

Something someone mentioned along my training journey was timing runs at the same time I would run them on race day. I had only been running early in the mornings because of the summer heat, so this was going to be different. But I knew it would help me to practice waking up, eating breakfast, insulin on board, hydration, digestion and more if I simulated a similar race. Once I started doing this, I felt confident that I could run the full 26.2 miles.

As someone who has never run a race before and who lives with type 1 diabetes, I have faced my fair share of challenges. But, I have also learned that there simply is nothing that will stop me from achieving my goals. Not diabetes. Not 26.2 miles.

Meet the 2022 marathon team and consider making a donation here.

WRITTEN BY Erika Szumel, POSTED 10/28/22, UPDATED 05/22/23

Erika has been living with type 1 diabetes since 2000 and has strived to be an advocate for the diabetes community ever since. Every November she shares her thoughts and photos on living with T1D on Facebook to help raise awareness for the disease. Erika earned her BA in Visual & Sound Media at Seton Hall University in New Jersey and began her career as a TV producer. Living at the Jersey shore, Erika is a lover of the little things, the ocean and pork roll.