Diabetes Forecast

The Finish Line

By Stephanie Tomko , ,

Stephanie Tomko

I don’t have a clear memory of a day without blood glucose checks or carbohydrate counting. That’s what happens when you’re diagnosed with type 1 diabetes at age 4. I have spent the majority of my life managing this disease, but it wasn’t until three years ago that I figured out the secret to really living with it.

My lightbulb moment happened on a May day in 2013 as I readied myself for the Philadelphia Broad Street Run, a 10-mile race deemed one of the most popular in the country. It would be my longest race and the first that I’d be running with a continuous glucose monitor (CGM).

After a 5 a.m. wake-up and trek to the starting line, I quickly realized that my training regimen was not good enough to avoid pre-race high blood glucose. I felt hungover before the race even started. I’m not patient, so over the course of an hour, I bolused Humalog several times, until my CGM indicated my blood glucose was dropping.

When I started running, the arrows were still pointing straight down. I had overtreated the high and caused the opposite complication: hypoglycemia. I downed four glucose gel packs, but there was no change.

Panic set in—not panic that I was going to pass out in the midst of thousands of runners (which was imminent if those arrows didn’t change direction). It was panic that I would fail to finish.

As I approached the halfway point at City Hall, I spotted an ambulance. That’s when my friend asked me the most difficult question I’ve ever had to face as a person with diabetes: “Do you want to stop?”

No, I didn’t want to stop. I wanted to be in control. I wanted to finish. I wanted the diabetes to go away. But just as quickly as those emotions pushed me to keep going, I realized that the only way to finish was to stop. So we did.

My official blood glucose reading was 45 mg/dl after the glucose gels’ 88 grams of carb. I told the paramedic that I had to finish. Another glucose gel, some orange juice, and a bagel later, and I was ready to run.

That last 5 miles was not only the finish to my first long race, but it was the first time I had given in to my disease and gotten stronger—and it was the first time that I felt legitimately in control.

I crossed the finish line after 2 hours, 1 minute, and 4 seconds. Without a doubt, two of the most significant hours of my life.

Every day with type 1 is not a victory. There are still days when it gets the best of me. But I finally know that normal and perfect are not necessary for success and that sometimes to win a race, you have to stop running.

Stephanie Tomko tackled the Broad Street Run again this May, but this year she did it with a blood glucose reading of 108 mg/dl. She celebrated with her husband, Matt, and kids, Meghan, 10, and Justin, 7. She lives in Lincoln University, Pennsylvania, where she serves as the co-executive director of the Philadelphia chapter of the children’s charity Little Smiles. She blogs at t1andrunning.com.

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