My son is 14 years old and likes to run. He always runs with me or his father. When we ran a long distance, 17 miles, we had trouble keeping his blood sugar up during the race. When we were training, his blood sugar was always fine, but we never ran over eight miles. He had Gatorade in his hydration system to sip throughout the race. He took off his pump and his blood sugar was 150 mg/dl [8.3 mmol/L] going into the race. Although he ate three carbs while running, but his blood sugar still dropped to 60 mg/dl [3.3 mmol/L] and he had trouble getting it to come back up. How can he run and keep his blood sugar up? Are there certain foods or drinks that distance runners consume during a race or when training? He wants to run a marathon. My husband and I want to help him run it safely.

Your son might want to try reducing his pump basal rate (via the temporary basal) for an one to two hours prior to the start of an extended run, to further reduce circulating insulin levels during exercise.”Practice” this a number of times with longer distance training runs prior to race day. Extra blood sugar monitoring will be essential even during these pre-run hours of reduced basal to prevent significant elevations in blood sugar levels. Speak to your son’s health care team for assistance in this plan. Gatorade or similar drink is a good choice during the run. Some runners like the glucose gels during a race, as well. Long acting carbohydrate/cornstarch products such as Extend bars used in the diet as directed may also assist with maintaining levels. Recognize that running can “burn off” 15 to 45 grams of carbohydrates per 30 minutes of exercise. You and your son may wish to connect with other distance runners who successfully compete/train with diabetes. The Diabetes, Exercise & Sports Association is a wonderful resource in this regard. Here’s wishing you all success in your athletic endeavors!

DMW