There are benefits and drawbacks to following a ketogenic way of eating, and since 2014, this area of weight loss and nutrition has received as much praise as it has criticism. People swear by it, and people swear at you for thinking it is a good idea. This back and forth exists as much in the realm of diabetes as it doesn't outside of it. 

On our final few miles to half-way, I no longer wanted to continue in our ascent to the north rim. I ran with Gina and Karen that day, and I didn't want to keep holding them back. They already had to stop for more blood sugar checks than was kind. I told them to keep going without me.

It was magical, the scenery. There was a moment before mile 10, as I passed this small lake, a pond really, serenity consumed me. The nature around me was full of contrast. It was a different perspective, red earth next to lush green vegetation, both draped with a fresh snow coat, next to the water.

We arrived by plane, a small one, onto the dirt landing strip. We got out of the plane, and the pilot unloaded our luggage, got back in the plane, and flew away. The kids and I stood there, with baggage, like in a movie, stranded.

For healthcare professionals, family, and friends who still look at the diabetes athletes in their lives and think they are taking the easier path by remaining active with their disease, it is simply not true. Exercise sensitizes the insulin in your body, and that impact is another aspect of living with diabetes that requires management as a single activity has an effect metabolically for days.

The kids on this adventure were ages 9-12 and there were 12 of them. They traveled to SB from all over the US. Living with type 1 diabetes, these kids just spent the last year paired with a mentor triathlete living with type 1. The triathlete spent the year training for the Arizona Ironman.

Ultra training and ultra events remind me of the adventure of living with diabetes. You can attempt to control the circumstance, but the experiences demonstrate that dependence on a false-certainty for a particular outcome might be more hindering than helpful.

In 2007 I would move to more of my life with diabetes than without diabetes. I counted 100 days back from the day and selected 100 people to honor during an hour run or walk each day. I sent an email or a snail mail letter acknowledging their influence, enjoying a daily moment of appreciation. Friends, family, coaches, teammates, doctors, my children and professors made the list.

During a low blood sugar event, I feel a heightened sense of survival. Low blood sugars and injections are two aspects of living with diabetes that I aim to minimize. A low blood sugar event puts your body into life or death mode from a physiological perspective. Stress responses are triggered, cognitive abilities diminished, and every negative experience from previous low blood sugar events is remembered. There are times I wake up at night drenched from head to toe in sweat, as though I just completed an eight-mile run. I'm disoriented, shaking, and cold. At times my tongue goes numb. The symptoms are an immediate call to action. To remain reasonable is paradoxically challenged. I dislike low blood sugar events a lot. A lot, a lot.

First, I grabbed a syringe from my diabetes bag and filled it with enough insulin to bring down my glucose levels. I took the injection into my thigh right through my jeans. I have never had an issue with drug use, and I mean no disrespect for anyone who has traveled that journey. But when I take an injection with this kind of haste, I feel desperate. Once I deliver the injection, I get a sense of calm as I will now be ok. I know it will take upwards of an hour to have a meaningful impact but just knowing brought me relief. I needed insulin, and I needed it quick.