Harry, in response to your question #2:
Great question! Marathon running distances can be difficult to navigate with AID systems. Actually, another colleague recently published a study with a few case studies from Marathon runners using AID technology. I can also send you that paper, but here is the link to the abstract: https://onlinelibrary.wiley.com/doi/10.1002/dmrr.70034
A few strategies:
- If you fuel with natural carbs – do you mean fruits for example and do you limit your carbs from processed foods? Do you use any electrolyte beverages like Skratch or other brands to replenish electrolytes? Some of those beverages have carbs in them and can be a good option to not only replenish electrolytes, but also prevent lows mid-run
- For AID settings, I would encourage you to set a higher glucose target (exercise mode) on your pump for at least the first half of the run (you can set this 1-2 hour before a long run to give your pump enough time to bring your glucose value up)
- You may try turning off the higher glucose target after the first half or in the last ¼ of the run because this is where some people start to notice BG spikes if exercise mode has been on for too long
- Some of the marathon runners I work with like to switch the pump to manual mode before long runs because they can reduce basal insulin by 50% for example until the end of the race and they KNOW what is happening with their insulin (it can be a little tricky with an AID system when you don’t see what’s happening in the background)
I also started a separate chat on our online community forum called DiabetesWISER to reach out to Marathon runners and get some of the communities’ tips and tricks around long distance running. You may appreciate reading some of the tips people shared here: https://community.diabeteswise.org/t/calling-all-marathon-runners-with-t1d/426