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Diabetes Forecast

The Healthy Living Magazine

Tackling the Tough Mudder Race

The Tough Mudder event raises funds for diabetes

By Allison Tsai

Melissa Nasits
appleuzr/iStock (muddy print); diogoppr/Thinkstock (mud splatters)

Jumping off the edge of a diving board with 10 feet of muddy water below, 41-year-old Melissa Nasits kicked off her grimy adventure. With her insulin pump in tow, she spent the next 3½ hours crawling on her belly through mud-filled tunnels, hoisting herself over wooden walls, and slipping past low-voltage electroshock wires before crossing the finish line of her first Tough Mudder. She and her pump survived.

“People said I wouldn’t be able to do something like this,” says Nasits, now 43, who was diagnosed with type 1 diabetes at age 30. “Not only did I do it, [but] I now run competitively.”

Tough Mudder, a 10- to 12-mile run with over 20 obstacles and 500,000 gallons of mud, is a national athletic event that some charities and nonprofits, including the American Diabetes Association, sponsor for fundraising efforts. Running these courses is a chance for people to prove their physical prowess while supporting a cause.

Smart Training

Nasits worked with her endocrinologist to nail down her cardio and weight-training regimen. She uses a heart rate monitor and a continuous glucose monitor (CGM) to see trends and correct her insulin dose, if necessary. She says her blood glucose can temporarily go high during intense bursts of exercise, so she’s careful to monitor her levels. She’s also cautious about going low, which can happen on long runs and obstacle courses.

No Holds Barred

Lauren Tibbits, 24, from East Lansing, Michigan, trained hard for her first Tough Mudder in September. “[I] wanted to get out there and show people that [diabetes] doesn’t have to hold you back from doing anything you want to do,” she says.

Tibbits, who was diagnosed with type 1 when she was 17, uses a basal-bolus insulin pen regimen. Correctly adjusting her dosage to account for strenuous exercise while training has proven to be harder than the workouts. If she’s going for a long run or a swim, she’ll eat a snack, delivering only three-quarters of her typical insulin dose to cover the carbs. She checks her CGM for lows, and breaks to eat glucose tablets when necessary. “There is no formula for all that, and there are so many different factors that go into dosing your insulin,” she says.

On the day of the event, Tibbits uses a waterproof fanny pack to store glucose tablets and gels. Her CGM transmitter is waterproof, but she puts an extra waterproof adhesive over the sensor to keep out moisture and mud and to help the sensor stay in place. 

Crossing the Line

Christian Carbonara, 39, from Fairfield, Connecticut, was diagnosed with type 2 diabetes last fall, which motivated him to run a Tough Mudder race.

Carbonara takes long-acting insulin via pen, a sulfonylurea, and metformin. His workouts include cardio and resistance training, coupled with uphill hikes with friends on weekends. So far, his attention to diet and exercise has paid off. Within the span of six months, Carbonara reduced his total cholesterol from 211 to 183 mg/dl (a score of 200 mg/dl or below is generally considered healthy), and his A1C dropped from 9.1 to 7.4 percent. 

Carbonara has done several Tough Mudders in the past, but this is his first with diabetes. Crossing the finish always stirs up a mix of emotions. “I’ve never finished and not cried,” Carbonara says. “There is something about being out on a course for four or five hours, and sometimes it’s cold and sometimes it’s hot, but you give it your all.”

Tips for Success

  • Secure Your Site. If your pump isn’t waterproof, try Melissa Nasits’s suggestion: Put it in a heavy-duty plastic storage bag (cut a hole for the tubing) and duct tape the bag closed, avoiding taping over the screen. Then secure it to a belt clip for pumps or cell phones, or put it in your pocket or a fanny pack.
    Kinesiology tape, which you can buy at your local pharmacy, is a good option for securing your infusion set—it’s gentler on the skin than duct tape and keeps the mud out.

    Even with extra tape, your infusion set can get tugged free as you crawl on your stomach through the obstacle course’s tunnels. Use a skin-prep product or adhesive for maximum stickiness on your skin.

  • Eat Right. Race-day breakfast for Nasits is always the same: hard-boiled eggs, multigrain toast, half a protein shake, and a cup of coffee. “I always try to do a good protein-to-carbohydrate balance,” she says. To help keep her blood glucose steady during the event, Nasits relies on a mixture of sweetened coconut water and regular water. The sugar keeps her from going low.

  • Pack It Up. With several obstacle courses now under her belt, Nasits has become an expert at packing her gear to protect it from the slimy conditions. Her waterproof Animas Vibe pump is zipped into the back pocket of her shorts, and kinesiology tape protects her infusion set. Nasits carries glucose tablets, test strips, and a meter in her backpack. She skips the CGM for the race because she’s lost it on the course in the past.

Are You Tough Enough?

If you’re interested in participating in a Tough Mudder event in 2017 and raising funds to fight diabetes, reach out to your local American Diabetes Association office. Find the Association in the charity listing for your state at toughmudder.us.realbuzz.com, or call the ADA at 1-800-DIABETES (1-800-342-2383).

 
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