I am a 24 year old who has type 2 diabetes treated with oral medication, this year I decided to run the marathon, and I am one month into the training. As marathon runners begin to increment in distance, they begin to consume products energy bars for glucose. Would it be safe to consume these carb-loading products? Since these products are very high in sugar, should I take my medication prior to the event?

You don’t say which oral hypoglycemic agents you are currently taking to manage your diabetes. The effect that the medication has on your blood sugar management not only during the marathon itself, but also throughout your training progression, will depend on which medication it is.

You may observe the need to decrease or even discontinue the medication as your training mileage increases, and your body weight decreases. The caloric expenditure and training adaptations for running distances required in marathon training will decrease insulin resistance and improve insulin sensitivity. This will lower your blood sugars, not only during your training runs but for the following 24 to 48 hours. Unless you are severely insulin deficient (producing little or none of your own insulin), you will probably not need to take your diabetes medication during the race itself and may very well be able to transition off of (or decrease) your type 2 medication during the months leading up to your race. Please discuss this with your physician well before race time. Remember that you should not make any changes in medication therapy without your physician’s consent and guidance.

The glucose gels and energy bars used during distance running will most likely have very little appreciable effect on your overall blood sugar control, as you will be “burning these off” during your runs. Frequent blood sugar testing before, during, and after your training runs will allow you to pattern your response to these energy products. With frequent testing you will also easily identify the need to discuss medication changes with your physician when the time is right.

Congratulations to you on your commitment to exercise and best of luck with your race and training.

DMW