The Running Doc’s Recommendations For Runners With Diabetes

Remember that your training sessions are the time to practice what you will do on race day.

Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members! Download the app.

Remember that your training sessions are the time to practice what you will do on race day.

Written by: Lewis G. Maharam, MD

Type II diabetes (sometimes called adult-onset diabetes; it’s where the body either doesn’t produce enough insulin or becomes resistant to the effects of insulin) is common and usually runs in families. Historically, it has been well controlled with pills and diet. Control of blood sugar is also important in reducing the risks of kidney, eye, and vascular complications that can result from diabetes. Usually, adult-onset results improve with exercise and weight loss in overweight individuals.

Type II diabetics are now being given new-style basal insulin formulas that last for a long time; the two popular types, which differ slightly in makeup, are called Lantus and Levemir. The principal advantage of these types of basal insulins is that one injection from a graduated flex pen provides a steady-state release over 24 hours. An additional benefit is that they do not require multiple blood sugar tests during the day—although, while getting used to using them, you should measure those numbers during the day and report back to your doctor with a log. After a while, a morning test and an evening test are all you will need to do. And the injection is done with a small needle that you can barely feel.

Exercising with this new insulin is also easier. Once you establish your needs, you won’t require a sugar test during your runs. Indeed, even though there are now testers as small as a pencil, I understand you may not want testing to interfere with your workout. The good news is that this insulin will help keep your sugars under control and not interfere with your training.

If you have Type I diabetes (sometimes called juvenile diabetes; it’s a chronic condition where your pancreas produces little to no insulin), you have been controlling it with insulin from childhood, and so you are used to testing and adjusting your blood sugars. If you need to test your blood sugar during a race, you should be sure to bring your own testing equipment. You should also test the equipment and your blood sugar in your long training runs prior to the race so that you know what to expect. Insulin pumps make the process of maintaining proper blood sugar easier and are suitable for running. Ask your doctor about them.

Please remember that your training sessions are the time to practice what you will do on race day. Everyone has a different insulin requirement, and that is why it is so important for diabetics to monitor their blood sugar during training runs long before the event itself. And when you get to the race, do not rely on the event’s medical team to test your sugar. Bring your own meter, and learn when you need to test yourself and how to eat. Remember, the goal is to make race day no different from a training run.

This article was adapted from the new book Running Doc’s Guide to Healthy Running with permission of VeloPress. From head to toenails, Running Doc’s book explains healthy running practices and guides runners to the right diagnosis and treatment for over 100 running injuries and related health problems. Running Doc’s Guide to Healthy Running is now available in bookstores, running shops, and online. Download a free sample and preview the contents at


Jan Frodeno Reflects on His Final Ironman World Championship

Immediately after finishing 24th place at his final Ironman World Championships, the Olympic medalist (and three-time IMWC winner) explains what his race in Nice meant to him.