Tough Mudder and diabetes - first hand experience

On Saturday 17 November 2012 I took part in Tough Mudder North West held at Cholmondeley Castle in Cheshire, UK.  If you don't know what Tough Mudder is then google it, but basically it's a 10-12 mile assault course with 20-25 obstacles and lots of mud.  I'm a diabetic and in the months leading up to the event I struggled to find much information about how to cope with it.  As I've just done it and survived I thought I'd share my experiences in case they're of any use to other diabetics.

A bit of background about me.  I'm 37, I've been a Type 1 diabetic since 1981, and generally I've had OK control (HBA1C circa 7.5 for the last 10 years).  I'm 6'3" and weigh about 14st.  I never really exercised much, then on 1 September 2011 I went for a regular check up at the eye clinic at West Suffolk Hospital in Bury St Edmunds.  It was a total shock.  I'd had some minor laser treatment to my left eye in (I think) 2009 at Ipswich Hospital, but they'd said it was to be expected in someone who'd been diabetic as long as me and no need to worry.  I've always been terrified of losing my eyesight, so to be told that Thursday that I had proliferative diabetic retinopathy and that without extensive laser treatment I would be looking at 2-5 years before I went blind was a shocker.  Put simply, my life changed.

We (because this is a joint effort between me and Keeley, my wife) resolved there and then that I / we would do whatever it took to give me a fighting chance of keeping my eyesight for as long as possible, starting with looking after ourselves better.  That meant getting fit and healthy, so we set about building a gym at home in a barn we're very fortunate to have.  My Mum very kindly paid for it, and my mate Tim (www.extrafit.co.uk) advised me what to get and how to train.  I've got a Concept 2 rower, a squat rack with free weights and a bench, a static bike (£60 from the auction www.twgaze.co.uk) and a free running machine from a colleague.  Tim gave me a great workout programme combining cardio and weights, and I set about getting myself in shape three or four times a week.

Then in June 2012 my mate Ben of Watling Engineers (www.watling-towbars.co.uk) was entered into Tough Mudder North West by his brother - as a birthday present.  Ben appealed to his mates to help him, so four of us formed Team Extrafat and duly signed up for the event.  Shortly afterwards Kee told me that she'd mentioned it to a couple of the girls at the school gate (we've got two boys aged 5 and 7) and before I knew it they'd formed Team Tough Muvvers.  The gauntlet was thrown down and training began in earnest.

From the outset I was concerned what effect this endurance event would have on my blood sugar.  I researched as much as I could, and found some useful websites such as www.runsweet.com which is all about diabetes and sport.  I also started running as part of my training, something I'd never enjoyed and, frankly, got out of at school by playing the diabetic card.  So running and me were very uneasy bedfellows, but as I was going to be doing almost a half marathon I figured I'd better start learning.  I gradually built it up over a number of weeks, and in Sept/Oct I managed to get to running a 10k, then 8 miles, then 9 miles.  I actually went at it too hard (against Tim's advice) and, as he predicted, injured myself.  (A word of caution here - it costs £86.20 to enter Tough Mudder; budget at least three times that amount for physio treatment during training.)  One way or another though I learned how to run and - shock - even started to enjoy it.

Anyway, I started experimenting with blood sugar, carbohydrates and exercise.  My regime was to get up at 6am, test, drink a cup of tea, train (run or gym) at 6.20am until at least 7.30am, test, eat breakfast (three weetabix or two chunky slices of granary multigrain toast with two poached eggs), and at least a litre of water.  I'm on the pen, so I have Levermir before bed (22 units) and Humalog three times a day before meals.  Pre- 1 Sep 2011 I was on (roughly) 8 units at breakfast, 12 units at lunch and between 18 and 24 units supper.  I like food, and we eat a pretty healthy diet, and luckily I've never had a sweet tooth so if eight sausages, mash and peas doesn't fill me up (really) then I'd have some oats, sultanas, an orange and a yoghurt (natural or Activia fat free).  Like I say, I like my food.

When training proper started and I was running and interval training on the rower I was down to 3 units at breakfast, 6 to 8 at lunch, and 12 to 16 at supper.  I've also lost weight, but only going from 14st 2lb down to 13st 11lb - my body has changed shape a lot though, so much of the midriff fat I was carrying has slimmed down and I've put on some muscle.  I'm no Arnie but I'm a big lad and have always been reasonably strong.  My problem has been eating like I'm still 16 but not exercising.

The experimenting was interesting.  Even when I went for a 6 - 8 mile run having had no food beforehand my blood sugar would stay pretty much the same before and after.  So I knew that cardio on its own didn't make me go hypo over that period of time (just over an hour).  In the gym I was doing interval training on the rower (if you want a programme like mine look Tim up via his website www.extrafit.co.uk - through helping me has put together some excellent stuff about diabetes and fitness), folllowed by pairs of high-rep exercises to work on all-over strength and conditioning for maximum fat-burning.  I found that when I was exercising hard on the rower - some of the intervals were at 100% effort taking my heartrate close to max at 183 - and increasing the weights, my post-workout blood sugar was higher, and frequently stayed that way for the rest of the day.  This was perhaps to do with my exercises taking me to an anaerobic level and therefore dumping glycogen.  However what I did learn was that I could train hard and not go hypo, even having had no carbohydrate beforehand.  The big question was what would happen on the day when I combined stamina and endurance - 10 to 12 miles - with short, sharp bursts of resistance work, such as monkey bars, climbing over walls, or wading through knee-deep mud for extended periods.  I wasn't interested in recreating the event itself in training; instead I concentrated on getting myself as aerobically fit as possible and working on core strength while also learning to run.

By the week before the event I was in reasonable shape, knew that I could run 9 miles, that I could row 7,000m in 28 mins of interval training, and that my core was stronger than it ever had been. I was no athlete, but I was confident that I had better fitness than five months earlier and that I had done as much as reasonably possible while holding down a full-time job, having enough daylight hours to fit in the training required, and working round (or resting from) injuries.  This is a photo of me at that point, just to show that I'm a normal bloke with a spare tyre (albeit a smaller one than it had been) who's trying his best.

The week before the big day involved 'tapering' - very light training, lots of stretching and plenty of water.  I did one three mile run and two one mile runs, plus yoga with Kee and the Tough Muvvers (quite an experience, but we'll save that for another day).  Plenty of testing blood sugar - I've always tested at least four times a day anyway - and watching what I was eating.

My plan for the day was sketchy to say the least.  I had no idea how intense the obstacles were going to be, how long the effect of the adrenalin would last for (it makes your blood sugar rise - I've found this out as I'm an auctioneer as part of my job, and the adrenalin from that always makes me high afterwards), what effect three hours of exercise would have, nor what the cold and wet would do to my blood sugar.  My attitude was that it's only three hours so if I run high for that time then so be it, but I didn't want to be too high (ie 15.0+) as I would feel crap.  By the same token I've always been wary of exercising if my blood sugar is less than 5.0 as the 'margin for error' is too small for comfort.  On some mornings during training I'd woken up hypo at 3.0 or less, but with four or five gulps of Lucozade (orange flavour, the ordinary stuff not Lucozade Sport) I would be ready to train within 15 minutes and have no ill effects. So I planned to eat my normal breakfast of three weetabix at 6.15am, reduce my insulin to 3 units (usual dose of Levermir the night before) and eat a mansize banana at about 8.30am.  Tim also took sachets of SIS Go Gel (www.scienceinsport.com) with him, four for each of us to have round the course, and I had a bumbag with two Hypostop gels in it in case of a hypo.  We had friends spectating as well, but we didn't know if or when we would see them, but I loaded them up with chocolate bars and Lucozade in case I needed it and we happened to find them at the right time.

The nerves certainly kicked in from the night before, and I was worried that I was going to send myself sky high.  As it was I needn't have worried because although the event was physical, it wasn't as physically challenging as I'd imagined.  Don't get me wrong, it takes it out of you but the worst bit (and the reason why it's tough) is the cold and the wet.  Within half a mile of the start we'd had to jump in a large vat of ice and get fully submerged.  I can only assume that being cold and wet for three hours while exercising burns up energy.

Tim sensibly suggested that every time we got to a water stop (every three or four miles) we have an SIS Go Gel.  The course marshalls also handed out half bananas on a few occasions and I had these as well as the gels.  In all I had one and a half bananas and four gels during the 2hrs 45mins it took us to do the course.

By the end I was physically done, left knee hurting, right shoulder bashed, cold to the core and cramping, but we did it and got the coveted orange headband.  I tested my bloodsugar and I was 7.9.  I'm almost as proud of that as I am of completing Tough Mudder, so I made Ben take a photo.

Conclusions?  I can only go on my own experience, but as I'm a diabetic and I've done Tough Mudder hopefully this might help someone:

1. You can do Tough Mudder if you're diabetic.
2. If it's cold and wet it will probably drain your energy so keep topped up and if needs be run higher than normal, but don't underestimate how cold it is.
3. I did Tough Mudder in Cheshire in November.  There are other Tough Mudders held in different parts of the country and at different times of the year.  Had this been Kettering in May I think my bloodsugar might not have taken such a hit as I might not have been so cold.
4. Tough Mudder is physically demanding, but it's no Royal Marines selection assault course (Tim should know; he's done it).
5. It sounds daft, but listen to your body and in training get to know the difference between feeling knackered from training hard and being hypo - it's not always obvious.
6. If in doubt, test.
7. Make a plan, however simple, and talk it through with your teammates beforehand (thankfully I've known mine for 20+ years so they're reasonably familiar with diabetes, to the extent that they were visibly disappointed not to have the chance to stab me with a needle in the event of a hypo)
8. Research UK websites - most of those to do with Tough Mudder are from the USA as the event started there, and the yankees speak a different medical language.
9. Talk to your diabetes support team at hospital or the local surgery if you like - mine are excellent, but I'd also say that this is a potentially specialist area of diabetes treatment and they may only be able to give you general advice.
10. Prepare for the worst (ie have Hypostop with you) but plan to succeed.

I hope that a diabetic might find this while searching the internet about Tough Mudder, as I tried to do, and that it might give them confidence to take on a challenge like Tough Mudder.

Above all, if you're going to do it train hard and enjoy.