At her running pace, it’s a ritual that she practices every 40-some minutes. Diagnosed with type 1 diabetes at age 10, Duckworth has long known to stay on top of her blood sugar — especially when exercising. The Manassas, Virginia, native grew up on the ice, and has been teaching ice-skating for a decade. But it wasn’t until six years ago that she became what her doctor calls a “supertester,” checking her blood sugar about a dozen times per day. She had decided to add marathoning to her bucket list, and during one early-a.m. session, Duckworth went on a long run. It took her out into the middle of nowhere, and along one particularly desolate road her blood sugar levels crashed. She called 911, but the paramedics couldn’t find her. Finally, a random car drove by. The driver was a dad with juice boxes in tow, and Duckworth swigged them as he drove her home. “It was the scariest experience of my life, and it showed me just how important it is to know your blood sugar and be able to properly adjust your insulin levels at all times when running,” she says. “It’s not about guessing and checking — it’s an exact science.” Since that hard lesson, she has earned her bachelor’s degree in kinesiology and health sciences from the College of William and Mary and worked as a research fellow at the National Institutes of Health. She wrote The Marathon We Live: Training for a Personal Best in Life with Type 1 Diabetes and started the Every Step Counts college scholarship program for students with type 1 diabetes. She is currently in her second year at the University of Virginia School of Medicine, planning to start rounds in the winter, and volunteering with the UVA Children’s Fitness Clinic.
Using Type 1 Diabetes Technology to Keep Her Blood Sugar Stable
She has also completed five marathons, most recently putting the 2018 Boston Marathon under her running belt. It was a race that, in many ways, felt a lot like that scary run that turned her into the “supertester” she is today. “At about mile 18, I was feeling light-headed,” Duckworth recalls. “I wasn’t sure if it was the cold or sleet, or all of the rain in my eyes, or the diabetes.” She had been using Abbott’s FreeStyle Libre continuous glucose monitoring (CGM) system — a device that’s worn on the back of the arm, inserting a few millimeters into the skin, and syncs regular glucose checks with a smartphone app to cut down on how often a person with diabetes need to perform finger pricks — during the first half of the race. But now the monitor showed its Check Blood Glucose symbol, a warning designed to have patients verify their blood sugar levels when inaccuracies, due to extreme conditions such as dehydration, could occur. “I decided to duck out of the course and go into a Gatorade tent to test my blood sugar,” she says. “It was a mess. My fingers were frozen, so I couldn’t really grab the monitor or test strip, and I was trying to instruct the guys in the tent how to do it. Then one guy knocks the meter into a full Gatorade cup. Broken.” No longer able to use her traditional monitor, she resolved that she was going to finish the race with the Libre. “I saw that my blood sugar was high, which meant my body wasn’t using the glucose it had like I needed it to,” she says. “I increased my insulin from my pump, and immediately felt the difference. Miles 22 and 23 felt so much better than 16 and 17.” RELATED: Your Top Type 1 Diabetes Questions, Answered Despite her stop in the Gatorade tent, Duckworth crossed the finish line in 3:40:55 — that’s a pace of 8:26 per mile. Still, she jokes that it was her worst time in a marathon. (Her best time is 3:25:00.) “After what happened in mile 18, I knew I wouldn’t PR [personal record]. My new goal was to finish, and I’m proud of accomplishing it.” “When you’re on the course and you have these terrible conditions, you realize that you have no excuse not to keep going,” she says. “You see athletes who get up extra early for the wheelchair race and blind runners navigating the course alongside guides. Even the spectators are battling these horrendous elements for hours to cheer on others. Everyone has their own challenges, and you’re more in tune with that during a race like Boston. You’re inspired by the fact that, yes, we all have our struggles, but we can all surmount them together.”
Preparing for Her Next Running Challenge With Her CGM System
When Duckworth began training for her first marathon, the goal was Boston. “Now, that goal just keeps evolving,” she says. Last year, she learned about the Six Star medal, awarded for completing the six races in the World Marathon Majors: Tokyo, Boston, London, Berlin, Chicago, and New York City, and is set on completing all of them. Next up: running the Chicago Marathon this upcoming fall with Abbott. She started training about a month ago. However, Duckworth recognizes that to do so her training will also need to evolve. “If I could get my nutrition and training a little more tweaked, I really believe that I could complete all of the World Marathon Majors.” Currently she is working with a running coach to increase her focus on slower runs (instead of racing every single one) and recovery efforts, such as rest days and foam rolling. Meanwhile, she is also adjusting her fueling strategy. “Instead of being so front-loaded with my carbs before a run, I am spacing out a similar amount of carbs over a longer period of time,” she says. “That alone has helped a lot with predictability and blood sugar swings, which I can see in real time with the continuous glucose monitor. The amount of insulin I take is always being tailored to my conditions — time of day, length of run, and level of insulin sensitivity — so I keep a log to help me learn from every run and find combinations that work well.” After all, just like she says, running with type 1 diabetes isn’t about guessing and checking. It’s an exact science. RELATED: 9 Type 1 Diabetes Blood Sugar Pitfalls, and How to Avoid Them
