NYC Marathon: going the distance with diabetes

Zoe Heineman finished her fifth TCS New York City Marathon this past Sunday on November 3, 2019.  The New York City Marathon course is tough even without a chronic condition like type 1 diabetes.  This year more than 50,000 runners from all over the world took to the streets of New York City.  Not everyone finishes!  Even for elite runners, it is the most difficult marathon with hilly stretches over 26.2 miles.  We got a chance to talk to Zoe about her success, endurance and courage.

 Tell us about your first marathon?

In 2013,  I was invited to accept a charity bib for the NYC Marathon by a non-profit I support. Entrance to the race included a training program. Although I had not run any distance longer than a 5k, the invitation appealed to me. I wanted to get in better shape and needed a challenge. The New York Marathon was a sort of a dream I had to do one day.   It was an opportunity to train safely as part of a group of women with a coach in NYC’s Central Park, three mornings a week. I made a deal with myself that I wouldn’t try to prove anything out of pride, and that if at any point I became injured or stopped enjoying it, I would stop.

About a month before the day of the marathon I started to worry about what might happen if I had severe hypoglycemia out on the course.  I contacted New York Road Runners (NYRR), who organized the event to request a running companion, such as a diabetes nurse or my nephew. NYRR told me I couldn’t pick just anyone I wanted, but they directed me to Achilles, who provides guides to athletes with disabilities. Achilles guides run with athletes in mainstream races, such as marathons and triathlons.

How hard is running with type 1 diabetes, honestly?

Running with type 1 diabetes is much harder than running before I was diagnosed with type 1 diabetes at age 24.   If my glucose is high, my energy level is lower, and I get tired much more easily.  Most of the time running drives my glucose lower, and therefore, I have to be prepared to stop and eat glucose until it goes back up to a safe level.  Sometimes, unpredictably, it has the reverse effect.  If my glucose spikes while running I usually keep going and take a little insulin if necessary.

I carry a bunch of stuff in a fanny pack which is a bit of a hassle, but it’s worth it to be able to run with peace of mind knowing that I am prepared for anything.

What do you carry when you run marathons?

For the marathon this year I carried:

• Glucagon, Basqimi now that it’s available
• Jelly beans in a plastic baggie
• 15 Gels (“Vanilla Accel” and “Maple Syrup Tap Endurance”)
• Glucose meter
• Lancet and landing device
• Fast-acting insulin pen
• Two pen needles
• One Tru steel infusion set
• Two alcohol swabs

Plus:

• Hand warmers
• Toe warmers
• Phone in an arm band
• Ear phones
• iPod shuffle
• Strips for the meter (I carried 18 strips with me, loose in my pack)

Like every day, I also wore my insulin pump that shuts off if I go below 75 mg/dl; my CGM, and a watch that keeps track of my pace and heart rate. I made a training playlist for each year that I have run the marathon. I play that in just one ear, on the left, so that I can talk with my guide who runs to my right.

How was the NYC marathon for you this year?

This year was an amazingly clear, sunny and cool weather day, which always helps.   With diabetes, running in hotter temperature tends to drive my glucose lower.    I felt great overall, feeling smart that I had rented a room in a hotel only 2 blocks from the bus I had to take at 5:15 am to the Runners Village.   I always enjoy the crowds along the route, especially seeing the kids some of whom wear their Halloween costume for a repeat performance, and the people with funny signs like “This seems like a lot of work for a banana” and “You Run Better Than Our Government” and “Stamina Is Sexy” are some of my favorites.  This year, there were 2 people dressed as Jesus, one running barefoot with a cross on his back.   The other was along the route of mile 25 in Central Park, with a sign that read “The End is Relatively Near.”  It is a rare view of the city only available to the marathon runners, from the 5 bridges you cross to the streets that on any other day are clogged in bumper to bumper traffic with honking horns.

When I see the Engineers Gate entrance to Central Park at East 91st and 5th Avenue, I suddenly realize the end really is near, and I have almost done it again.  All my training and running has brought me to the point where I am about to finish the toughest marathon in the country, with the most uphill challenges.   A warm wave of emotion that brings a tear to my eye, realizing that despite diabetes, or maybe because of the endurance I have built over the last 30 years, my body is able to do this. The mere fact that I’m able to run a marathon still astonishes me every time I cross that finish line.   Timewise, my finishing time was 5 hours 57 minutes, only 22 minutes slower than my personal best of 5 hours 35 minutes in 2015.  More importantly, to me, diabetes-wise, it was my best marathon ever, because I did not go below 92 mg/dl, and most of the race I stayed between 92-125.    That is a huge improvement over past years, when my levels went as low as 45.     I have never passed out during a run.   I have passed out from a hypo a few times, but not since I started running.     I believe that running has helped me become more in touch with my glucose levels and helped me reverse unawareness.

What’s next?

Next year is the year of Vision, 2020, and I have decided to celebrate my good vision by participating in 20 running or triathlon events, including of course, the 50th anniversary of the New York City marathon on November 1, 2020.      If you want to join me, I invite you to join Achille International and start working out with us on Tuesdays at 6pm and Saturdays at 10am in Central Park  Contact Michael Anderson with any questions manderson@achillesinternational.org or visit www.achillesinternational.org to find a chapter near you.

When Zoe is not running, she works for Oxurion, NV, a Belgian biopharmaceutical developer dedicated to helping people with retina conditions preserve their vision.  Also,  Zoe started a not-for-profit initiative called Ha! short for Hypoglycemia Awareness,  whose mission is to train First Responders to recognize and respond to the symptoms of severe hypoglycemia in public.