Ultra marathon runner Marcus Grimm sees part of his success in his openness to change his thinking to take on new challenges and ideas, which allows him to grow as an athlete as well as with his diabetes management. Grimm is also taking what he has learned and sharing his knowledge with others within the diabetes community. 

By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net

Marcus Grimm stands as an example of an athlete rising above his type 1 diabetes and going beyond the normal barriers in sports. His transition from triathlete to marathon runner to more recently an ultra marathon runner has been a gradual one, but it’s in his willingness to change that has fueled his evolution and growth as an athlete.

For example, Grimm wanted to do a triathlon for years. When he finally did it, he learned two important lessons. One was he never wanted to do another triathlon again, but the other, and possibly more significantly, was that he realized his passion and his strength was in his running. 

Since that triathlon, Grimm has focused solely on running. Looking for a challenge, he set his sights on the prestigious Boston Marathon, which requires participants to meet qualifying times in order to be eligible for the race. He succeeded in qualifying, and ran the marathon last year in record heat finishing it in 3 hours, 33 minutes, and 18 seconds.

Since completing the Boston Marathon, Grimm has focused on the ultra marathons doing races that are between 40 to 55 miles in distance. These ultra marathons often require athletes to run the distance of nearly back-to-back marathons.

After feeling confident with this distance, Grimm again decided to push his boundaries, and he recently completed his first 100 mile run. Grimm participated in the New Jersey Ultra Fest, and he completed the 100 miles in 21 hours and 28 minutes. (The picture above shows Grimm running the New Jersey Ultra.) 

For the uninitiated, running at such long distances can bring exhaustion, great physical pain, and inclement weather. In the end, it’s just the athlete dealing with these factors and competing against the time clock.

Grimm jokingly says doing the 100 mile race has made him really appreciate the 50 mile runs. Another example of his willingness to change his thinking and evolve is with his blood sugar levels when he is competing. He used to like to have his glucose run high, but he now prefers to have his blood sugar run closer to what someone without diabetes would have when performing. He believes it has helped maximize his performance.

His willingness to keep his mind open has also played a part in the evolution in his diabetes management. Grimm was on daily injection therapy for his type 1 diabetes for nearly 17 years before he decided to switch to a pump.

Grimm had been in good control where his A1cs usually were in the 7s. However, when he decided to try out the pump, it took him to a whole other level.

Years ago, he had gone to do his doctor to ask him about Lantus insulin when it first came out. His physician told him that Grimm’s insurance at the time wouldn’t pay for the insulin, but it would pay for a pump. He went on it wondering if he would like it, but he was hooked within a day.

More recently, Grimm has taken much of his knowledge from competing as well as his nearly 30 years with diabetes and has become involved in the diabetes community serving as a motivational speaker, advocate, and a coach. This June, he is going to be a Corporate Co-Chair for a local JDRF walk in his hometown of Lancaster, Pa.  He is the marketing director for Nxtbook Media, and Grimm and his company recently made a video for the walk. 

Grimm is also going to be coaching at Diabetes Training Camp this summer. He is going to be teaching campers how to become better runners and help them to manage glucose more effectively while exercising.

DiabetesCare.net recently sat down to speak to Grimm about his evolution in both his running and diabetes management and his active involvement in the diabetes community.

DiabetesCare.net: Tell us about your diabetes management?

Grimm: I have been on the pump for 12 years, and I have been on CGM for three years. The pump was a real pivotal change. I was always in decent control before the pump, and by decent I mean mid-7s. I wasn’t aware of how much precise control someone could achieve with being on the pump.

Literally, since being on the pump, I don’t think I have ever been above 7 and for the past few years I have been down in the low 6s. For me, it’s a tool that if you are willing to embrace it, it can really revolutionize control.

DiabetesCare.net: How did you get into running?

Grimm: In 8th grade, I was the last kid cut from the basketball team. And some of the guys on the team said they were going to go out for cross-country running. I knew nothing about it.

I got through my cross country season ok, and we were getting ready for indoor track and I told some of the other distance runners I was going to go out for basketball again. They encouraged me to stick with running instead of basketball.

I never went back to basketball and I had twelve seasons of cross-country, indoor, and outdoor track all through high school. I had a dream to letter in cross-country in college and I was lucky enough to do that.

I then took about a dozen years off when I got married and my kids were born. I just came back to it about seven years ago.

DiabetesCare.net: Was getting back into running a way to get back into shape?

Grimm: It was almost the basketball story all over again. I said I always wanted to do a triathlon. I had gotten into shape and competed in the triathlon. However, I was second to last in the swim; I finished in the bottom quarter of the bike portion; but I fared much better in the run of the event. That was my last triathlon and I have been running ever since.

DiabetesCare.net: How has running helped you with your diabetes management?

Grimm: I believe there are two ways in which it helps me. The first is exercise can help round out the edges. And what I mean by that is diabetes is one of those diseases where you can go into a meal, and if there are a lot of carbs or fat in that meal, it can really drive up blood sugars. If you have one of those days where you have exercised for a long period of time, the effect of the exercise is residual for the next several hours.  I did a half-marathon last Saturday, and later that afternoon, I ate some pizza. My blood sugar didn’t spike up the same. Exercise makes diabetes management easier for me. 

I think the second thing is nutrition. In order to be a good runner you need to understand how many carbs to eat. And as with many people with diabetes, I’m obsessed with the numbers. I will talk to a lot people about running and not diabetes, and people will ask me how many carbs do I consume, and I have it dialed into the exact grams. The average person who doesn’t have diabetes might say something like, ‘I might take a gel here or there,’ but carb counting goes hand-in-hand for a person with diabetes.
















Grimm taking a breather aftering completing the 2012 Boston Marathon.

DiabetesCare.net: You have run marathons, but why the decision to ultra marathons?

Grimm: Whether it be 5K, or a marathon distance, you get to a point where you feel like you can’t get much faster. So you might say to yourself, ‘let’s see if I can go longer.’ I think some of that has to do with my age. At 42, I’m starting to lose some of my speed. Going to ultras helps with that. I also think ultras are more diabetic-friendly. You are stopping at the aid stations, and you can test blood sugar and consume more fuel.

I will stop and test during training runs, but when it’s the marathon, it’s three hours of racing for me. I’m not going to stop.

DiabetesCare.net: You recently finished the New Jersey Ultra Fest. Take us through what that was like.

 It was an incredible day. I had done several 50 miles races before, and yet I was terrified of doing a 100 mile distance (he laughs).

One of the things people don’t realize going into a 100 mile race is your long run is not that long, and mine, for example was 39 miles. The truth is the body can’t handle you going out for a 60 or 70 mile training run.

It was a cold day for the ultra. The course consisted of 10 mile loops, and I can remember I hit the first 10 mile marker and I had a high blood sugar reading. I have done enough races that I knew it was all adrenaline. I took a little insulin to bring that down.

Then I went through 30 miles where it was too cold for my meters to give me a reading. Again, you are relying on training and what usually makes sense. It worked out great, because once my meters warmed up by mile 40, my sugar was normal.

It comes down to repetition and training. It came to a point where I knew it was going to get really tough. Fortunately that point didn’t come until mile 74 when I got nauseous—which happen in ultras. Then you got to rethink things. I wasn’t able to consume as much fuel, and I started walking at that point. I burned less sugar so I started running a higher glucose reading for the last 26 miles. I had a plan dialed in for running and I was doing a lot more walking at that point.

Overall, it was a wonderful experience. And like all my races, I didn’t feel like diabetes was my greatest challenge of all, it was doing 100 miles.

I had some tendinitis going into the race, and my wife said she was more worried about that or me becoming hypothermic—the stuff that would knock out any runner.

DiabetesCare.net: What was the course like?

Grimm: It was unimproved rail trail. What that means is that train tracks used to be there. The good news it is very flat and very straight, but the bad thing is there is no drainage system.

In northern New Jersey where the race was held, they had gotten six inches of snow a week prior to the race and there had been a very slow snow melt. There were a ton of spots where it was ankle deep ice water and mud.

For most of these races, you will get one-third of the field drop out. There were 100 starters for this race, and we had only 41 finishers. It was cold and wet, but even so, I looked at it and said you could go to another 100 mile race and it could be too hot or another where you are going up and down mountains. So, I thought I was glad to take my chances with the cold water.

DiabetesCare.net: How did you handle your food and nutrition for the race?

Grimm: When I race up to 50 miles, I prefer to use energy gels because you know the carb count. The problem is I can’t really stomach energy gels for more than 50 miles.

For this race, I was 100 percent dialed in for solid food. They had two aid stations approximately at the five mile mark and then back at the area where we finished the loops. I was consuming a lot of pretzels, potato chips, and energy drinks. Potato chips are nice because you are getting some electrolytes because you are getting some salt. 

With diabetes, I was thinking is this going to be too many carbs, and how was I going to react to these foods? I had situations where I got down to as low as 75 mg/dL, so I would have to eat a little extra and then I had some times where after the first 10 miles I was up to 200 mg/dL, so I took a little insulin.

DiabetesCare.net: So you ate the food provided at the stations at the race?

Grimm: I had brought along fig newtons, but in the end, I decided I was going to eat the food they had out for me.

At mile 90, the greatest thing happened. it was 1:30 in the morning and it was about 22 degrees out, and one of the volunteers who had been there for several hours, comes up to me with chocolate chip cookies that had come right out of the oven. They had a kitchen there, and it was the best thing in the world to have two of those cookies.

DiabetesCare.net: How often were you testing throughout the race? 

Grimm: I did test every ten mile loop once my meters warmed up. I had my CGM  with me the whole time. However the problem I ran into was my blood sugar was so high at mile 10 that my CGM was out of whack. As soon as I left that first stop, the CGM gave me a message to recalibrate it. I knew at that point, it was not going to happen for 10 miles.
I was doing a combination of CGM and testing.

DiabetesCare.net: I am curious about your preference when you are running, do you like to have your blood sugar run a little high from a performance standpoint?

Grimm: I know that five years ago, that would have been something I would have said yes to. I would have liked my range to be between 130-170 mg/dL. In the past year and a half, I have been experimenting with getting closer to 100 mg/dL. My philosophy has been that this lower number is what someone without diabetes and their blood sugar number would likely be. I do believe I perform better between 100-120 mg/dL. However, you also have a risk of going low, which can really sabotage things.

I don’t feel bad about being in the 130-170 mg/dL range, but when I’m truly trying to maximize performance, the slightly lower range is what I do my best at.

DiabetesCare.net: Now that you have the experience of doing the ultra, would it be something you would like to do again?

Grimm: Since doing the 100 miler, it really makes me appreciate doing the 50 mile races. Doing 100 miles is not only a huge undertaking for the runner, but it’s a huge undertaking for your family. My wife and kids were out there, and my mom was home and she was worried. I love the 50 mile distance, and on the right course, I can knock that out in 8 hours. And I trained for it without being a huge burden on my family. I will do more 50 miles races. 

DiabetesCare.net: You are going to be coaching at Diabetes Training Camp this year. What are you most excited about?

Grimm: I’m helping out as an assistant coach, and I’m totally thrilled. The camp helps people with diabetes in learning how to exercise and mange their glucose. I’m very excited the camp is so close to my house. Some of these courses will be in areas where I go all the time. To be able to go out there with a group of people with diabetes on courses I have run on is going to be awesome!

DiabetesCare.net: What advice would you give to someone who has diabetes, and wants to exercise, but is concerned about things like hypoglycemia?

Grimm: The first thing I would tell people is to go to the Internet and do some research on the topic. You can find someone excelling at any sport with diabetes. A couple of years ago, a guy reached out to me and he is one of the best standup paddle boarders in the country. This guy does 6 mile races in Hawaii, and he has type 1 diabetes. It is just amazing to me he has figured out how to manage that.

The second thing is figuring out your ideal blood sugar while exercising. People can begin by getting their blood sugar elevated a little bit, so you have got room to figure out what works best for you.

Lastly, with diabetes you have to be willing to test. You have to test before, during, and after training or athletic events. You have to be willing to test and put the time into it. Sometimes with this disease, we worry. And it’s not about worrying, it’s about testing. This will allow you to accomplish anything. 

DiabetesCare.net: In addition to Diabetes Training Camp you are also involved in diabetes advocacy. Can you talk about any fundraising events or initiatives you are participating in?

I recently signed on to be the Corporate Co-Chair for this year`s JDRF Walk. I`m the Marketing Director for Nxtbook Media and we just finished producing a video for the walk, which can be seen here.

I love getting to meet diabetics and parents of diabetics through JDRF. I believe speaking with parents of recently diagnosed kids is one of the greatest things that I’m allowed to do through my work with JDRF. My kids don`t have diabetes, but I can completely empathize with the parents` worry and hopelessness and I try to provide them with a sense that things will be ok.

For those interested in participating in the JDRF Walk with Grimm, go here.