In 1994, the Academy Award-winning movie Forrest Gump showed Tom Hanks as the title character running across the country... for seemingly no good reason. Fast forward nearly 20 years and there's another guy running across the country. This time, he's doing it in the name of diabetes awareness.
Diagnosed with type 1 at age 3, Doug Masiuk, a 38-year-old computer consultant from Annapolis, MD, has been running the equivalent of a marathon a day since May. After seven months, he's now almost finished with his more than 3,000-mile journey across the continental United States. When we spoke with him this past Tuesday by phone, he was just outside of Allentown, PA, where he had stopped to do an interview with Runner's World magazine. This weekend, he's wrapping up his journey in New York City.
So of course, I had to find out why someone would be
crazy motivated enough to do be the first diabetic to run across the country.
Doug) I was diagnosed the day after Halloween in 1977. At the time, insulin came from animals, and there was some control with it. I've met a lot of type 1s who were on that regime and it was a lot more erratic than what we have now. I always walked around with a box of raisins in my back pocket.
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I would ride my bike, and play soccer and baseball, and do other activities. Games were fun... games are still fun! I played competitive soccer, and when I wasn't playing, I'd go running. But then you get caught up in career and life... and we all know diabetes likes schedules. It likes a routine. Exercise, diet, and medication. With my career, I was definitely lacking exercise. In my early 30s, I realized that if I wanted any chance of making it into my 80s, I needed to do better. So I started running, slowly at first. I kept going farther and farther. A mile, 5 miles, 10 miles, 17 miles... I discovered I had a gift. And the more I was running, the less insulin I needed. My diet also changed in that I ate really specific things, and I started understanding how my blood sugar levels affected my running.
Where did you get the inspiration to become the diabetic "Forrest Gump," running across the country?
Possibly from that movie, but it wasn't really something I thought much about. Maybe the seed was planted. Then I did research, and I saw that about 230 some-odd people have done it before, actually, so why not a type 1? It almost became a challenge and mandate.
Part of it also has to do with the rise in diabetes nationally and globally. With the number of kids and adults getting type 1 and type 2, diabetes is almost getting the status of being a war. There are 100 million people dying from complications annually. That's a big number! If I can run a marathon, then anyone can put in 20 minutes of exercise a day, because exercise is great for managing diabetes.
You just become more stubborn than anything, I suppose! Specifically, you're closely monitoring your diabetes all the time. The thing about running this distance is in the fuel intake. You start going out there with a 7,000 and 8,000 calorie-a-day diet. You are asking a lot of your body. So I use a Dexcom G4 (continuous glucose monitor), and that thing is remarkable.
After fueling at breakfast, I head out between 9 and 10 a.m. and run about 5 miles in an hour. Then I stop at the car and I test my blood sugar. Generally I don't need a snack, because breakfast is still on board, so then I run 5 more miles. Then I'll stop again, check and have a snack. At dinner, I'll go and eat as much as I can, and generally I don't even need any insulin!
I used to be on a pump, but I'm running so much that a pump is overkill for me. I'm on 6-8 units of Lantus a day and then dosing accordingly with fast-acting Humalog.
How did you test your endurance prior to running cross-country?
I had the idea and people asked, "How do you know you can do this?" Because it was so hot in the summer, I would wait until 4 p.m. and run 30 miles. I've been running since 2008, so I had already built up my mileage to those distances. Before CGMs, I just had to keep stopping and testing. I was lucky in that there is a beautiful bike path near where I live, so I was always within a few miles of food if I ate all the snacks, I could get something more if I needed to.
What did your training look like?
I had to figure out what my insulin needs look like. And you're just peeling it away and going down to less and less, contrary to what you're trained for — testing, eating and taking insulin. But when you eat and take insulin, and then you're 40 mg/dl, you have to keep changing things. The doctors and educators didn't exactly know either, because there aren't a lot of diabetics who run 30 miles all the time.
From that experience, my insulin requirement went to a quarter of what it typically would have been, just because of the volume of running I was doing.
Learning how to best manage diabetes with insulin, some of it gets made up as you go along. And if this is what you want to do, this is the experiment that you're willing to make.
You've also spent quite a bit of your journey meeting with adults and kids with diabetes. What do you share?
I talk about how everyone has challenges, no matter who you are. Our version of it is our diabetes. It's not to take away the serious nature of it, but also to never use it as a reason not to do something. It's not a cop-out. I also share that as diabetics, we almost have a duty and responsibility to pass (this advocacy) on to the next generation. Be leaders, lawyers, politicians, doctors. Raise families. We can live life and be productive people, but to do that we have to put forth that extra effort in the management of our health.
Also, don't take health for granted. When you have kids who have had it their whole lives, and are now in their teen years, there is some resentment. But they're in the U.S. in 2012, and there are a lot of people who have given us the ability to have this opportunity (through improved tools and treatment). I'm also reminded that for almost 100 years, researchers, scientists, pharmaceuticals, philanthropists, parents have all worked extraordinarily hard to make sure that the science is getting better so that we can go out there and do things like this.
What's been the hardest part?
Finding the right kind of nutrition. Being on the road and getting support from restaurants. Sometimes they'll donate food. I'm not a proponent of carb-loading, I think it's a little overkill. Challenges on the road are hard too, like how do you bring down a high blood sugar while you're running; it's not like you're sitting at home and you can take a unit. It's a frustration and challenge to make the right choice. Having a CGM and looking at the trend definitely gives you peace of mind.
There have also been some unexpected lows. About 5 or 6 weeks in, I would go out and run, and my blood sugar would fall all the way into the 40s and 50s. I would just eat tons of food and tons of snacks. It wasn't a dosage issue because I wasn't taking much insulin, but these unexpected trends are a part of life. Diabetes will defy all these things that you're doing — like it has a mind of its own! It almost seemed like no matter what I did, it wasn't enough. But it eventually just resolved itself after five days and everything just went back to normal.
Running a marathon a day for several months is very impressive, even for a non-diabetic. I'm just beginning to run, but I'm not sure I could ever do that much!
I don't put importance or significance in the number of miles. This is just what I can do. There's maybe a handful or 10 other people who can do that. When it comes to running, this is what we do. It's out there and it's extreme, and not a lot of people are able to withstand that. But I love running and love what it does for my diabetes. It doesn't feel like it's impossible and I'm proving that right now.
When asked what he'll do after he finishes in New York City this Sunday, Doug said, "I plan to go home and sleep." Doug is inviting anyone in the NYC area to come celebrate with him. You can find out more about the event on his website or get in touch with him on Twitter.