As a long-term volunteer at Mile 20 of the New York City Marathon, I have seen many things that runners will do, or put themselves through, to get their bodies through that distance en route to the 26 miles and some odd yards of a marathon. Blisters, cramps, and bleeding are part and parcel for the course. So are dehydration, overhydration, and electrolyte depletion. At Mile 20, most runners visiting the medical station want a quick massage or some Vaseline® before heading back out on the course. While a few runners do drop out, most of those are able to wait for the "sweep bus" to carry them back to the finish line. Exceedingly few runners who require medical aid this far along the course need to be ambulanced out.
One thing that makes marathoners special is their dogged determination to continue on past what most of use would consider the boundaries of human endurance and pain; another is their ability to pace themselves. While a sprinter will put all his effort out at the start and run extremely swiftly, he will soon hit a threshold at which he cannot deliver oxygen, glucose, or glycogen to his muscles fast enough for them to meet the demands for speed. He will tire and either slow down or stop. The long-distance runner will train to a slower pace, one at which he knows he is able to power his muscles continuously for the four or five hours it takes the average marathoner to finish the event. He will train year-round, including intense lead-ups to each event, mixing short and long distances and active-recovery days. Like all event runners, marathoners are in it for the goal -- for the ability to say, "I did this" (and hopefully, "I did this faster/better than I've done it before").
In many ways, diabetes is like running a marathon. Let's face it: we're in it for the long haul. We have to pace ourselves through "daily training" that includes testing, food, exercise, and medication. We "train" year-round, in all sorts of weather, whether we feel like it or not. Sometimes we need an "active-recovery day" in which we "just go through the motions" but are less strict than usual; notwithstanding, we can never allow ourselves to stop training. Diabetes is not merely a lifestyle; it is our lives.
Some of us -- especially Type 2s who come late into the "sport" -- may not train as seriously, thinking we are dealing with a sprint or a middle distance run. Others are bound by so many other obligations that feel they are unable to train, or feel they are young enough to believe they can go the distance without training. At a marathon, this results in people dropping out along the first fifteen miles of the course with cramps, overhydration, or occasionally an immediately-life-threatening medical emergency. With diabetes, lack of attention may lead to dangerous highs and lows, complications, amputations, and/or premature death.
Like marathoners, we realize that there are obstacles to making it through to the finish line on our own power -- but that many of these obstacles are in our own minds, and can be overcome by focus and determination. Like elite runners, we may need the encouragement or fine-tuning of a coach -- be it our partners, our doctors or CDEs, or specialized diabetes coaches such as the folk over at Fit4D. Sometimes we will lag and slow down, taking some time to gather enough energy to make it over Heartbreak Hill; other times we will pick up the pace and feel as if we were sprinting through short parts of the course. And just like those runners, we need to learn how to best pace ourselves through the marathon that is our lives with diabetes.
