Is it groundhog day? Here we go again. The plastic bags, the spreadsheets, the duplication (or triplication!) of every piece of gear. 2022 feels like it was yesterday. How many times have I run this course in my head?
Adamello Ultra Trail has been a 3-year-long project, and my support team silently screams for closure. It doesn’t come as additional pressure. It is a fact I choose not to ignore, because generosity should never be taken for granted.
Am I the same person? Basically, yes. I'd like to think that a person with more patience, focus, and relentless grit. At least that is how I feel when it comes to my type 1 diabetes management
I have decided not to make a big deal of values up to 11.0 mmol/L (200 mg/dL) to avoid overcorrecting and ending-up with a low that compromises my performance - and potentially my safety too. These numbers are a not great for anyone - with or without diabetes - but I can 'afford' one day of poor glycemic control a year ;-)
Glucose control the days leading to race day(s)
My go-to lowcarb foods which prevent glucose spikes and crashes
The race before the race
Thursday flies by with all the preparations, team briefing, bib pickup… before we know it is dinner time! I have decided not to change my eating routine; around 6pm I indulge in a nice steak, a tomato salad, and Greek yogurt. DO-NOT-CHANGE-WHAT-WORKS. Thank you Dr. Bernstein!
Surprisingly I sleep through the night without any nervous breakdown. I have been fighting a cold the past 10 days, which has given me the opportunity to physically recover from the run around Monte Rosa, and to get plenty of quality sleep ahead of the race. The mindset: ‘It is nice if you sleep well tonight, but it is not necessary’. So I do 😊
For the first day of racing – coming out of a very sedentary period – I reduce my morning basal insulin by 30%. Planning on a 40% reduction in the evening. Theory says I should eat some breakfast… I stick to black coffee, a keto cookie and a bite of ham. Dosing 1.5u rapid for the food + morning hormones + potential race excitement.
I don’t feel too much of anything. Longing to get started, to finally walk with my feet what my head has so many times gone over. It is not confidence, it is certainty. Finishing the race feels like matter-of-fact. It has been decided and I am just the one executing it. How strange, I had never felt this way.
Start Vezza d'Oglio -> Cortebona: Settling the unsettling
The atmosphere is both festive and loaded at the warmth of the start. I look for Marta Poretti, hoping to give her a hug before the start. She is such an example of tenacity and has infinite ultra-distance experience under her belt - I have long looked up to her. About a minute before the gun, she pops up behind me with her cheerful smile.
The first climb should not last less than 2h. I am moving well and contained, even proactively slowing down in the upper part not to over pace. The occasional chat keeps me entertained although I am too focused to engage in a proper conversation. I reach the top in 2h2'.
What a beautiful day! I don’t have to worry about overheating, running out of water, or putting on more clothes. The only issue breaking the harmony is my blood glucose. It keeps climbing and climbing.
I dose 2u ultra-rapid insulin halfway into the uphill. No effect. Another 2u at the top. At least it stops climbing and ‘sits’ at 9.0-10.0 mmol/L (160-180 mg/dL). Despite not being thrilled at the glucose value, I am proud of myself for not being pissed off at the glucose in the double digits.
Where are the other girls? Back in 2022 we raced each other in the downhills and flats before the first aid station and it was so much fun. A guy from Engadin runs behind me during the first technical downhill. we have a great time speaking about ski tours in the region. Later, I catch the second lady – aka the local – and decide to stay behind her. Passing Cortebona below 3h15’ would be a mistake.
Cortebona -> Rif Valmaza: overwriting memories
Oh but my legs feel so empty. What is happening? Are they sleeping? I’ve never felt so ‘disconnected’ from my legs. I decide to stop this nonsense by eating a banana at the aid station. Maybe it helps, maybe it doesn’t. We have many hours ahead to figure it out. Seeing my crew – including Tuca & Kilian - cheers me up momentarily.
Another big climb to bocchette Valmaza. I will take it one step at a time, especially because I want to move fluidly in the following rolling section. The favourite lady – winner in 2022 – drops the race and the local girl & I continue leading in disbelief.
The sky is overcast by the time we reach the Prisigai aid station. The mood has an evening touch, although it is just 2pm. I dig my nose into a plate of homemade minestra with cheese, dipping cubes of speck. Soup made glory!
The following section is misleading on paper. It looks like a flattish 10k cruising to Rifugio Valmaza. Far from reality. The first lady remains within eyesight the whole time, although I don’t even think about placing when we have +30h of running ahead. The trail is narrow and passing runners from the 100k and 60k races is sometimes tricky. At some point I am the one being passed by fellow 170k runners who seem to move much faster.
It takes me waaaaay too long to notice that the sleepiness and dizziness I am momentarily fighting is due to a hypo. ‘You’re stupid, Natalia’. I immediately swallow some bear gummies and dextrose tabs. Within 10 minutes I’m back in the game.
The downhill to the hut is short but spicy. It wakes me up.
Rif Valmaza -> Case Viso: even robots feel happy when cheered on
It’s cold and broth sounds like a good plan. It is served straight from the hut’s kitchen. I don’t want to eat too much here as we will be running downhill on dirt roads for the next 4k. If I recall correctly, my splits are closely matching those of 2022. That is a good sign.
Out of the blue a blister bursts as I run on the dirt road. Self-care first! I stop and take care of my feet. In the meantime, a girl who seems to run a very different race passes flying by. I am impressed.
We hit the marathon mark at Santa Apollonia. My crew and I had agreed to skip this passing point as we will meet at Case Viso aid station in less than 2 hours. But deep down I am wishing they decided to come anyway to lift up the mood. I spot from afar a man clapping at every runner that passes next to him. I know that man is my dad. He is not only my number 1 fan, but also a fan of the sport and the ambiance of these events.
Getting to Case Viso should feel like doing paperwork. The uphill feels slower than last year – but who knows if the watch agrees! What’s wrong with the big toe? Oh man, I cut the nail too far in! I can’t believe how painful it feels every time I kick a rock… I hear a drone following me in the last section of the runnable downhill. It is fun to let the legs go, although my head is already going through the to-dos at the big ais station coming up.
Case Viso -> Valbiolo: you will never walk alone
It is 7pm and I won’t see my crew in the next 5-6h. We are switching to night mode: heavy lamp, long sleeves, double buff… I eat boiled potatoes with olive oil and salt. My glucose is high before eating so I dose 3u ultra-rapid to correct the high and cover the upcoming carbs.
The promise of a clear night – unlike the traditional fog at Passo del Tonale – raises my spirits. When the night takes over, I am mesmerized following all the moving lights and makes me feel accompanied by fellow runners, fellow travellers. On this climb in 2022 I met a French man living with type 1 diabetes. I smile at the memory of our long chat in the fog. It was a funny exchange as he only spoke French and I… well, not really lol.
My insulin-guessing exercise turns out to be either an overdose or bad timing between the insulin and the glucose entering the bloodstream. The hypo hits soon after leaving the aid station, when Jorge is still walking behind me. I really can’t take 3 steps without breathing heavily leaning on my poles. A gigantic date will solve it. The texture of it is disgusting.
Climbing towards Passo dei Contrabbandieri – the highest point of the race – is a joy. The pass is lightened up by dozens of fire torches. I cross 2 runners moving in the opposite direction and they recognize me ‘Nataliiiiiiia, sei tu???’ ‘Siamo Mario e Cinzia’. I am THRILLED to meet them. These two are made for each other and know how to have fun in life together. We met in these same mountains almost a decade ago… we hug and kiss. I continue upwards.
At Malga Valbiolo I inject the evening basal insulin. Yes, despite all the running, the body still needs a supply of insulin to run basic metabolic functions. Soup and bresaola make for a tasty evening snack.
I don’t want to stop for too long at the refreshment points until Ponte di Legno (halfway into the race).
Malga Valbiolo -> Ponte di Legno: re-writing a frustrating ending
Running down to Malrasina, the issue with my toenail magnifies. I am overloading the opposite leg – which is the one with the troubled knee - in an attempt to protect the hurting toe. How am I supposed to keep running for +20h like this? I tell to myself that we will figure something out when I get to Ponte di Legno.
My stomach is upset. It struggles to cope with the soup. It is not too bad, but I know too well how unpleasant it can get. At a brief stop at Passo Tonale, the kindest volunteer makes me a glass of hot milk (even with foam!). When the technical downhill comes, I am so focused on not hitting my toenail that the meters pass quickly.
The constant Dexocm alarms remind me of the high glucose. As I am not sure if it is due to food or the stomach sickness, I opt for caution and correct with ultra-rapid just slightly. As dark as it was, I still the remember the crazy hypo I had in this part in 2022 for overcorrecting....
Meanwhile in Ponte di legno, the best crew is ready to take on whichever challenge I throw at them! Sooooo grateful for their support and love.
I arrive to the Ponte di Legno aid station a bit damaged but hugely determined to turn things around. The bright lights of the sports centre throw me out of night mode. My crew is ready to help! I had asked them to bring hot water and make a peppermint tea. Food-wise I will stick to plain rice with tomato sauce. No more food mixing. I get creative and sort my toes with more hope than belief. The luxury item of the stop: a toothbrush! Glucose sits at 8.0 mmol/L - 145 mg/dL
From now on, every step contributes to the countdown towards the finish line. The first lady is about 30 min ahead and the third probably about the same behind me. I leave Ponte di Legno excited to re-enter the night and grateful for my crew, which I shall meet again in 4 hours. The spirits are high!!!
WE ARE SO DOING THIS, TEAM!!!
Stay tuned for part II!!!!
In the meantime, I BEG you to sign the petition below to Urge Novo Nordisk to Continue Producing and Supplying Insulin Detemir (Levemir). Levemir is the basal insulin of choice for those who, like me, need to adjust doses daily due to our active lifestyle. We are lost without it and Novo Nordisk has announced its discontinuation!
Inspiring, I won't say insane because you're doing this will full knowledge of what it takes. I am in awe of how complicated fueling yourself while managing insulin levels during this event is, PT. Power to you and your team!