Thirty years to the day after being diagnosed with Type 1 diabetes, Chris; a GP, father of two, and the runner behind @chrisrunswitht1d, crossed the finish line of the Montane Spine Challenger South having smashed the course record by more than an hour.
It’s the latest milestone in a journey that’s already included victory at the full Spine Race in 2024, and it stands as proof that diabetes doesn’t have to be a barrier to elite endurance performance, it just adds, as Chris puts it, “an extra dimension.”
We caught up with him to talk through the race, the relentless behind-the-scenes work of managing blood sugar, and how nutrition from VOOM has become a non-negotiable part of his racing.
Chris, you’ve just won the Summer Spine Challenger South and smashed the overall course record by more than an hour, what was going through your mind as you crossed the finish line and how was your experience?
Photo credit: Spine Race / Sam Pratt
I honestly enjoyed it from start to finish. We had driving rain on Jacob’s Ladder and Kinder. We had headwinds to Stoodley Pike and then blue skies around Hebden. There was a beautiful sunset at Malham and then even Cam Road had a pretty special sunrise. Half of me was gutted it was over (but the other half was ready for a full English breakfast!)
Breaking a course record by that kind of margin is awesome. Were you aware during the race that you were on record pace, and did that change how you ran it?
Photo credit: Chris Cope
After the disappointment of dropping out of the Winter Spine following a bad fall when I was in first place and also not finishing the UTS 100 due to an ankle issue I needed this race to go well. I’ve worked out that my best performance was probably going to be around 21 hours.
I know the course well so it came down to managing my pace and nutrition as well as possible whist keeping the diabetes on track. I use two of VOOM’s Pocket Rocket bars every hour. Easy on the stomach and no sticky mess. (Raspberry bars plus a caffeine Berry bar every 2 hours).
It’s been a game changer splitting my hydration and energy; it means I’m better about to balance my nutrition and hydration needs feeding on the weather and time of day. It all worked well and my pace stayed consistent right to the end so I knew I was on course for a good CR.
You’ve now got the Summer Spine Race win in 2024 and this Challenger South record under your belt. How do you reflect on your journey across these Spine events, and where does this latest achievement sit for you personally?
Photo credit: Spine Race
I think this is the race I have felt most relaxed about beforehand. The full Spine in 2024 was a voyage into the total unknown in terms of distance and I did not know the route. I had just got a 2:29 PB at London 8 weeks before so my engine was firing well but it’s a totally different fitness to jog-waking 268 miles though bogs, and 2024 was definitely the worst I’ve known the Pennine Way. I was on antibiotics for my feet afterwards and I know people who were admitted to hospital with trench foot. I think I was broken for 6 weeks after the Full.
The Sprint South in 2025 was fun. Sean Merryweather and myself were pushing each other hard despite it being so ridiculously hot and dry. I was so dehydrated at the end that every muscle was going into cramp as I ran the hill down into Hebden but I knew I was on course for a good CR so just kept pushing. I was recovered within 5-6 days.
The Challenger South was the maybe one I enjoyed the most as I didn’t get the awful pre-race nerves. I was calm and knew my plan and believe I could execute it. Having the right knowledge, preparation, experience, kit and nutrition is key to getting to the start line in a relaxed state. I believe this is key to then letting everything else flow smoothly.
You’ve been living with type 1 diabetes since you were 14, how did that diagnosis shape the runner you’ve become, and did it ever make you question whether events like the Spine were within reach?
The morning of the Montane Spine Challenger South was 30th anniversary of being diagnosed with Type1. It’s not a club any of us want to be us, but it’s a pretty supportive community once you’re in!
When I was first diagnosed sport was considered possible but only in small, controlled amounts with regular blood sugar testing. I ran a lot of cross country and I remember the consultant being quite concerned so an event like the Spine would be absolutely out of the question.
Fast forward 30 years and we’ve got Type1s at the very top of many sports. This is in part to the huge advances in technology that help us control our blood sugars but I think there is more to it than that. Type1 makes you more in tune with your body.
We listen more to how we’re feeling and react quicker to address problems. We have to maintain nutrition; there were times later on in the Spine Challenger where I did not want to eat but it is a non-negotiable as my blood sugar would crash without a regular Pocket Rocket and so the life discipline of Type1 keeps it going in regularly.
You’ve said diabetes adds “an extra dimension” to ultra running rather than making it impossible. Can you walk us through what that extra dimension actually looks like on a typical training week, especially as a GP and a dad of two?
On race day, ultrarunners have lots of ‘data’ to make sense of, whether it’s from our watches or feelings from different parts of our body. Some ‘data’ can be ignored but others can be race ending if not addressed. ‘Be bothered’ is the Spine saying.
With Type1 the extra dimension is the objective data from our continuous glucose monitor (CGM – a sensor in my arm that measures glucose every 5 minutes) and the subjective data about how it body feels. Low blood sugar often causes us to feel shakey, sweaty lightened or confused.
High sugars can cause nausea, a dry mouth, fatigue and blurry vision. These symptoms are very common in anyone doing a 268 mile race so correlating these sensations with our blood sugar readings is vital.
Investing 15-20 hours a week in training whilst working as a GP and being a husband and father is a tricky balance. I hugely appreciate the support I get from friends and family! Putting that amount of time into training means I want to optimise every aspect of my life to let me reap the gains of that training and the recovery. I drink less alcohol, I optimise my sleep hygiene and, most importantly, eat a really healthy diet. This is great for the control of my Type 1 although, in contrast, after races I am a lot less dedicated to avoiding beers and processed foods!
As a GP I believe everyone should exercise regularly. Training for and competing in these events is my type of fun. I fit training sessions into my daily life: running to and from work, heading out whilst the kids attend piano lessons, or grabbing an hour at lunchtime. Sometimes, I run through the night; great for training navigation in the dark, finding new routes and understanding the effects of sleep deprivation on my pace, diabetes and decision making.
I sometimes run straight after a big meal to train the stomach to better tolerate food and exercise which is important after aid stations during ultras. Every session requires planning around about what my insulin and carb needs are in the two hours before training, during and afterwards. This can be mentally fatiguing and a bit frustrating at times!
Your Instagram handle is @chrisrunswitht1d, how important is it to you to be visible as a diabetic athlete, and what kind of messages do you receive from the T1D community?
I don’t think Type1 defines me, but it’s a big part of my life and has brought some positives and negatives. I’ve had lovely messages from Type1s and parents of Type1s from around the world after I’ve completed different races and challenges. Inspiring patients is brilliant, but it’s just as great to hear that I’m reassuring parents that their child can have a happy and full life.
As a GP I see patients with lots of medical problems. Nobody wants a condition but how we view it and adapt to them is a key part of how well they are controlled and our mental wellbeing. It’s really important to me that I demonstrate that hard work and care can allow our bodies to do great things whatever the challenge and that we should not set limits on ourselves but gradually and sensibly push the boundaries.
Equally, I don’t want to come across as saying that having Type1 or any medical condition is easy and rosy. It isn’t. In 2024 someone commented on social media that I was ‘a beacon of positivity’ out there on the Spine course. As much as I appreciated the comment, my family laughed! I sometimes throw my toys out of the pram just like anyone else and it is okay to be frustrated and grumpy at times, just don’t let the feeling persist. Control the Type 1, don’t let Type 1 control you.
Blood sugar management across a long distance/multi day event is incredibly complex. What does your pre-race diabetes planning look like, and how far in advance does that preparation start?
That’s a big question! We know steady blood sugars breed steady blood sugars and equally if you have a hypo (low blood sugar) you are much more likely to have one in the next 24 hours. Avoiding hypos before a race is therefore essential. This was often easier said than done as my blood sugars used to fluctuate massively before a race as I carb-loaded and would then have higher sugars requiring more insulin which could then make me go low.
This is less of a problem now as I don’t carb load much. It used to make me feel sluggish and cause blood sugar issues. With modern day race nutrition I can take on 90-120g of carb every hour consistently, so being carb loaded is no longer important to me.
I have VOOM Rocket Beet for 4 days before a race and on race morning. The powder will mix into anything and it is one of the few supplements with really good scientific evidence behind it. I definitely get a boost. I try to reduce fibre and FODMAP foods in the 24 hours before a race to empty the gut as much as possible. I will have a simple breakfast such as banana, yoghurt and muesli 3 hours before the race with my normal amount of insulin. This means that by the start of the race most of the insulin has been used.
I rarely start a race or training run with more than 2 units of ‘insulin on board’ otherwise I will go hypo. I have 45g of carb in a VOOM Pocket Rocket on the start line and then a half a bar every 15 minutes. I’ll have a Pocket Rocket with caffeine in every 2 hours. After a few hours I might add in a cereal protein bar or Pow’r bar instead, for a bit more beetroot and variety as well as whatever is available at aid stations.
Pushing hard enough to break a course record adds a whole other layer to managing blood sugar, higher intensity changes everything. How did you balance going for the record with keeping your levels safe?
Photo credit: Spine Race
You have to put the energy in to keep getting the energy out. I’m taking on 90-120g of carb an hour which makes controlling blood glucose a challenge. 10 years ago I would be checking my blood sugar with a finger prick test every hour and then injecting insulin if needed.
A lot has changed in the management of Type 1 diabetes since then. Instead of injecting, I now have an insulin pump on my arm to steadily infuse insulin, this is replaced every three days. Instead of testing my blood sugar by pricking my finger (or weeing on a test strip when I was diagnosed 30 years ago!) I now have a continuous glucose monitor (CGM) – a sensor in my arm that measures glucose every 5 minutes. The pump and sensor are connected to my phone by Bluetooth. The real magic happens on my phone with the AndroidAPS app (this software is called a loop and several are available).
It’s transformed my life. If my glucose rises, the app makes my pump inject more insulin. If it falls, it stops injecting. I can tell the app that I am going to exercise so it will inject less insulin; keeping me safer whilst running. I can tell it what I am about to eat, so it will inject an amount of insulin appropriate for the grams of carbohydrate.
This 5 minute computer control allows far tighter glucose control when exercising but I have to tell the loop that I am exercising. This means it has a slightly higher blood glucose target (for safety) and will inject much smaller amounts at a time to ensure I do not go hypo.
But sometimes technology fails! I always listen to my body. Do I feel low? Do I feel high? I always carry the manual glucose meter so that I can check if I think the glucose sensor in my arm is giving accurate readings and I will always carry an insulin pen so that I can inject insulin if the pump fails. Be prepared, be safe.
Sleep deprivation is a huge factor in ultra running, you’ve even trained through the night specifically to understand its effects. How does lack of sleep interact with your blood sugar, and how do you account for that?
Sleep is massively important for day-to-day life; from the physical recovery from training to helping our mental wellbeing. During races we are balancing the need for recovery of brain and body against the loss of time moving when we do try to sleep. It’s a fine balance.
Type 1 adds an extra dynamic because sleep deprivation causes an increase in the release of stress hormones such as adrenaline and cortisol. These both cause rises in blood sugar, making it harder to manage levels.
When you are exercising you normally need very little extra insulin as the muscles will keep absorbing the glucose whilst they exercise and need only tiny amounts of insulin. During the 268 mile Spine race in 2024 I needed very little insulin for the first 40 hours but after that my loop was having to put out progressively more insulin to keep the sugars controlled. I was eating the same. I was still moving fairly well, but the sleep deprivation (I only had three 20 minute trail naps and an hour at Bellingham) along with the body breakdown was causing huge amounts of stress hormone release. These have the opposite effect to insulin. Without the loop making 5 minute decisions and working very hard to keep the blood sugar under control, I think it would have been impossible to finish that race in 79 hours.
Fuelling for an ultra is hard enough without diabetes in the mix, how did you approach your nutrition strategy for this race, and where did VOOM products fit in?
Firstly, I don’t carb load much now despite being a lover of all food. It used to make me bloated and sluggish as well as causing blood sugar issues. With modern day race nutrition I can take on 90-120g of carb and hour consistently so being carb loaded at the start is no longer important to me as.
I have VOOM Rocket Beet for 4-5 days before a race and on race morning. The powder will mix into anything and it is one of the few supplements with really good scientific evidence behind it. I definitely get a boost. I also try to reduce fibre and FODMAP foods in the 24 hours before a race to empty the gut as much as possible.
I will have a simple breakfast such as banana, yoghurt and muesli 3 hours before the race with my normal amount of insulin. This means that by the start of the race most of the insulin has been used. I rarely start with more than 2 units of ‘insulin on board’ at the start of a race or any training run otherwise I will go hypo.
I have 45g of carb VOOM Pocket Rocket on the start line and a half a bar every 15 minutes from then on. I’ll have a Pocket Rocket with caffeine in every 2 hours. After a few hours I will switch I will start to add a cereal protein bar or Pow’r bar instead, for a bit more beetroot and variety.
Predictable, fast-acting carbohydrates are critical for managing blood sugar on the move. What specifically do you look for in a sports nutrition product, and what made VOOM stand out?
I started using VOOM’s Pocket Rocket bars as I was fed up of gels that are awkward, sticky and only contain half the sugar for the same weight. Before this I was having powders in drinks. This also never really worked for me as in cool races I will hardly need anything to drink and in hot races I can lose 2 litres of sweat an hour and this needs to be replaced. Separating fluids and energy was essential for me whilst making sure whatever I took was quickly absorbed and sat well on my stomach.
Three months ago I was doing a recce of the BGR route and met a young runner who was halfway round on his attempt. He said he’d not eaten for 2 hours and was being sick after each gel. I offered him a Pocket Rocket and he got it straight down. Within 10 minutes he was like a new man and powered to the finish at Moot Hall under 24 hours. It’s a great story for a great product.
When you’re pushing hard enough to break records, you’re eating on the move in tough conditions. How practical and reliable did you find VOOM products when you were deep in the race?
They were essential. They go down better than anything I’ve had before and so when Voom offered to support me as a runner I was delight.
They are small and energy dense with a texture and flavour that always works for me no matter how I’m feeling. Knowing you can trust your stomach to keep accepting something despite sleep deprivation, dehydration, heat exhaustion or fatigue is essential. If athletes stop eating our race is over 90 minutes later.
Having the different flavours help further to reduce palate fatigue and knowing I can have a bar with caffeine in every 2 hours means that I’m not messing about with caffeine pills either.
After winning the Spine Race in 2024 you said “diabetes shouldn’t stop you doing anything” and encouraged people to “start with a parkrun.” With this latest record to add to that, what would you say to someone newly diagnosed who feels like sport is no longer for them?
Exercise is one of the best things that everyone should do to maintain their long-term health. There are many Type1 diabetics doing incredible things across sporting disciplines. Alexander Zverev is a Type 1 tennis player who has just won the French Open! Nacho Fernández played football for Real Madrid and won many trophies. The Novo Nordisk international cycling team only has riders with Type 1.
We should never dare to dream. No limits. However, we should do it safely and sensibly, especially when starting a new form of exercise. Do it with someone else who knows you have diabetes and knows what to do if you have a hypo. Always carry your insulin, a glucose meter and some sugar (a Pocket Rocket is perfect!) Let someone know where you are going and if you are heading out on your own set up a tracker on your phone so someone can trace you if you are late back.
What is my number one piece of advice for exercise? Do something you love.
What’s next on the race calendar this year?
It’s not really a race but a personal challenge. The recovery is going well from the Spine Challenger which is good news because I only have three weeks from finishing that to standing on the steps of the Moot Hall in Kendal ready to attempt a double Bob Graham Round. I will be doing the clockwise then anti-clockwise routes taking in all 42 peak twice. 206km with over 15000m of elevation, an awesome band of supporters plus a bag full of Pocket Rockets and a couple of pork pies.
If you could give three pieces of advice to a T1D runner just starting out, about nutrition, planning, or mindset, what would it be?
- Be ready to make mistakes, learn and adapt. Exercise with Type 1 does get easier and it will help your overall diabetes control in time. Keep positive!
- I never start a run with much active insulin on board, this will make you go hypo very quickly if you do. Always take some sugar to treat hypos, a VOOM bar would be perfect.
- Exercise should be fun. Sometimes I run with friends, other times I’m on my own. If I’m on my own I tell my family where I’m going and when I’ll be back. Use a GPS beacon on your phone so someone knows where you are. Be safe; keep it fun.
