Lakes in a Day 50 Mile Ultra-marathon with type 1 diabetes!

Every year I like to set myself some kind of physical challenge, it makes sure I stay active and really helps both my physical and mental health. Remaining active also helps me to manage my blood glucose in relation to my type 1 diabetes. My pancreas stopped producing insulin in 2012 and ever since I’ve had to manage my blood glucose using insulin injections and more recently an insulin pump.

Last year I spotted a tweet from James Thurlow, Race Director of the Lakes in a Day 50 mile Ultra-marathon promoting free entry to people with type 1 diabetes. I soon found out that James also has type 1 diabetes himself and he was looking to promote what can be achieved with the condition. Needless to say “Challenge accepted!”. Thanks James….. I think.

The Recces

Prior to race day I’d managed to get over to the Lake District to recce each of the three main sections of the course in three visits and generally fit in training when I could, fitting it around three children, house renovations and full-time work. I think it’s safe to say that I’d like to have spent a bit more time training on hills rather than the pan-flat vale of York. Lakes in a Day is regarded as one of the tougher 50 mile ultra-marathons in the country due to having 13,000 feet of ascent over the whole course. The route goes from Caldbeck in the north to Cartmel in the south and takes in the peaks of Blencathra, Helvellyn and Fairfield plus everything in-between. As the name suggests, the course must be completed in under 24 hours.

I’d camped overnight during each of the recce runs but decided to spend the night before the race in the luxury of the local caravan site. I set my alarm for 4am to make sure I could eat some porridge and make it to the bus pickup point close to the finish line before it set off at 5.45am on the 2 hour journey to the start line.

Pre-race Checklist

• Android Smartphone with “Android APS” app installed
• Dana RS insulin pump (compatible with Android APS) running as a DIY Closed-loop Artificial Pancreas
• Dexcom G5 continuous glucose monitor (CGM)
• Garmin Fenix 3 Sports Smartwatch (connected via Bluetooth to my phone)
• Lakes in a Day mandatory running kit
• 12 x Clif Shot Bloks (total approx. 600g carb)

Running with Android APS DIY Closed-loop “Artificial Pancreas”

I’d trained using my Dana RS insulin pump connected to Android APS running as a DIY Closed-loop Artificial Pancreas setup. I set a temporary blood glucose target of 9 mmol/l in Android APS and do a “profile switch” telling the closed-loop to reduce my profile to just 10% of normal. This forces Android APS to hugely increase my predicted insulin sensitivity and reduces the amount of insulin it will deliver to correct a rising blood glucose. It also forces Android APS to reduce basal rates and even stop insulin delivery if it sees my blood glucose dropping too quickly.

The Race – Start

I took my place on the start line at Caldbeck along with around 500 runners, including 13 other people with type 1 diabetes and at 8am we were off. I was running with my friend Graham and we’d decided to stick together for the whole race if we could.

Starting blood glucose of just over 10 mmol/l so all going to plan so far. I knew from the recce runs that there was no point jumping over puddles to keep my feet dry as we had a thigh-deep river crossing within 6 miles of the start. All I can say is if I wasn’t fully awake by that crossing I certainly was straight after, that river was cold!

The Hills

As I predicted the hill ascents were really tough, my body was telling me I’d not done enough hills during training. The good news was that the major climbs of Blencathra, Helvellyn and Fairfield were squeezed into “just” the first 30 miles before I got to Ambleside!

Check out this photo taken during the race by the awesome Petra who I met on the recce runs. The most glamorous ultra-runner I’ve ever met (and ever likely to meet). I’m sure she doesn’t break a sweat when she runs!

Hypo!!

My first big setback was seeing my blood glucose drop down to 3.5 mmol/l (officially hypoglycaemic) during the first big climb. Even running a 10% profile and gorging on Clif Shot Bloks my blood glucose wouldn’t rise. For the next 3 hours my blood glucose swayed between 3.5 – 4.1 mmol/l which was pretty draining.

My next major challenge beyond the big three climbs was descending the technical trail down from Fairfield into Ambleside in the dark with just my head torch, map and compass to guide me. I’d planned to get off the major climbs before dark so I lost a lot of time during the Fairfield section. I knew that the final 20 miles beyond Ambleside were more “rolling” hills than steep climbs so had planned to just grind out the last 20 miles. My main issue was, because I didn’t get off Fairfield before dark I’d lost so much time I was in danger of being timed-out and not meeting the cut-off time to be allowed to continue the race. I eventually managed to get into the Ambleside checkpoint 90 minutes before cut-off.

Success!

The final 20 miles of the race are a mix of running on minor roads, through woodland and down the banks of Lake Windermere. We were fortunate that the Lake District weather was kind to us on race day. The strong winds on top of the fells was the worst thing we had to contend with and by 1am Lake Windermere was eerily calm although I did have to wade through three sections of the lake where it had burst its banks due to the heavy rainfall in the preceding weeks.

The final miles were spent running when my legs could run and walking when they couldn’t, eventually finishing the race, 50 miles and 13,000 feet ascent in 21 hours 41 minutes at 5.41am!

Believe it or not my legs still felt pretty strong at the end, suggesting that I should probably have pushed harder earlier in the race. Even so, I’d just completed a mammoth course. I’d highly recommend Lakes in a Day for anyone looking for an ultra-running challenge. Who knows, I might be back to beat my time next year.

The only question now is…… “What next?” 😉