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Completing a Marathon in All 50 States with Diabetes

Updated: 8/14/21 6:00 amPublished: 11/16/15

By Alexander Wolf and Ava Runge

When North Carolina native Ross Baker, 42, was diagnosed with type 1 diabetes in 1992 at the age of 19, he couldn’t have expected that one day he would be working to finish a marathon in all 50 states. But with 46 states down (plus the District of Columbia), he’s only four away from a goal that seems daunting for anyone – diabetes or not.

How did Ross Baker get to where he is today? We sat down and discussed his running journey and how he approaches this grueling task, all while managing his diabetes. From his personal food strategy (no carb loading), use of technology (pump + CGM), and focus on the present (“I just try to get the next state done.”), Ross has found a strategy that works for him.

Ross’ extreme humility is striking – he hopes to inspire others with diabetes to do what they love. We are in awe of his passion and dedication, and invite everyone to cheer him on in his final races!

Thank you so much for speaking with us Ross. This is such an amazing story. How did you get started running marathons?

ROSS BAKER: When I graduated from college, I still had an athletic mindset, and I wanted a challenge. The father of a church friend ran marathons, and he challenged me to enter my name in the lottery and see if I could get a spot in the New York marathon.

I got in to the event, and then felt like I was committed. I had been running three to four miles a few times a week, basically just to stay in shape. The idea of a marathon obviously was a whole other animal to tackle. At the time in 2000, I hadn’t run across many people with diabetes that were competing in marathons. So, I basically became a guinea pig with myself, trying to learn how to handle it all.

When did you start thinking you wanted to take on the challenge of running a marathon in all 50 states?

ROSS: After the New York marathon, I ran a couple more races: one in North Carolina and one South Carolina. And then, before I knew it I had done a handful of states. When I was growing up, I had never traveled. We had a very modest standard of living, and my Mom’s work meant we didn’t go many places. I thought running marathons would be a really cool way to see the country and meet different people. It became a challenge and a great experience.

As time goes on, 10 becomes 20 becomes 30, and then you realize you don’t have that many left. Back in May, I finished the 46th marathon out of the 51 [the 51st being Washington D.C.]. That’s when it started to feel like something I could actually do.

People say, “Well, how do you run 26 miles?” I just tell them I run one mile 26 times, and that’s kind of the way I’ve always looked at the races. I don’t worry about getting 50 states done, I just try to get the next state done.

What are the diabetes challenges of training and running the marathon?

ROSS: Everything with diabetes for me is predicated on scheduling, with food being the main thing and then just balancing that with insulin intake. For me, it was developing a schedule and anticipating just how my body was going to feel at a certain point during the course – at 12 miles, 16 miles, things like that – and just being very aware. I had to find out what foods worked well for me that I could eat while I was running, that I could digest well, that wouldn’t cause digestive issues, and that provide a reasonable amount of sugar without an overdose of it at one time. In terms of running, one of the things I like to eat are Clif bars. They are really easy, they don’t melt, and they provide a good stable base of glucose.

And in the case of the marathon, because you’re going to new places, you need to figure out how to map everything out and what you need to carry. In these courses, you can’t be sure that if you’re at mile 18 or 19 and you need something to eat, there’s going to be a 7-Eleven right across the street where you can run in and grab something. A lot of times the courses have break stations, and some of them are really good with food. And a lot of times, you’ll find that there’s really nothing there.

So much of diabetes management feels like it’s about knowing your limits. And yet, a marathon seems like pushing yourself beyond your limits. How do you navigate that?

ROSS:  Marathon running, and any kind of endurance stuff in general, is just about managed discomfort. And whether it’s the pain you feel, the cramping, and whatever else, it’s about how you can push yourself while at the same time knowing when you need to dial it down or ramp it up.

Each race is unique. When I ran the Disney World marathon about 12 years ago, my blood sugar was fairly high that particular morning. So, I chose not to eat anything before the race and I felt great the whole race. Never had an issue with fatigue, hunger, nothing.

And then, I’ve had races where I literally feel like I need to eat something every couple of miles, even when I had a decent breakfast that morning, because nothing feels sufficient. Whatever it is, the sugar doesn’t stay up for any length of time. They’re always unique, and I never take it for granted.

What is your meal plan leading up to a marathon like?

ROSS: A lot of people will go the night before a race and eat pasta dinners and other carb-heavy meals. I actually don’t. I would rather have a muffin in the morning for breakfast and eat a fairly normal meal the night before. For me, a lot of times that sugar jump in the morning from the pasta and everything can be too much to handle. I’m very fortunate that I can eat and start running 30 minutes later and I don’t have any issues with cramping. It’s better for me to just eat something like a muffin 30 to 60 minutes beforehand as opposed to building all that carb loading up through the night and then being out of sorts when I wake up first thing in the morning.

You’ve been running marathons for about 15 years now. What has been the biggest change in your management leading up to and during marathons from your first one in New York City to your most recent?

ROSS: It’s kind of funny. I’m from the South, and the way we eat down here is not always the healthiest in the world. When I did my first marathon in New York, I was so worried about having low sugar that I actually filled two bottles up with sweet tea, which is not really the healthiest thing in the world to try to drink in the middle of the race. And it’s not really the most pleasing to the palette.

Since that time I’ve learned you don’t have to go those lengths to avoid hypoglycemia. And obviously, I’ve been able to improve my diet and understand what works for me without jumping the sugar up.

For me, too, wearing the OmniPod about two and a half years ago helped a lot because I was able to manage the insulin better – even through a race if I had to suspend my insulin and turn it back on. I also wear a Dexcom CGM. Now, I don’t have to deal with constantly checking my blood sugar, carrying everything with me, having to worry about carrying needles or insulin bottles, etc. 

What is the one thing that you wish that people who don’t have diabetes knew about living with diabetes, especially when it comes to athletics?

ROSS: In terms of the athletic side of things with diabetes, it’s hard for people to understand how one day I can go out and run a marathon, and other times it might be difficult for me to go get the mail. And that’s obviously an extreme, but when my blood sugar gets really low I literally feel like I can’t get up. That part doesn’t always equate with folks.

The thing that I don’t think anybody can understand is that when you have diabetes, it can become your identity. It’s not that you necessarily go around wearing shirts, but it’s part of every thought you have in the course of the day. When I wake up, the first thing I think is, “What’s my blood sugar? What am I doing today? What am I going to eat? What do I need to have on me?”  I think like that throughout the whole day.

I’ve gotten sort of used to it, but I know for a lot of people with diabetes it becomes a real grind. And for people that really struggle with maintaining healthy blood sugars, it can really overwhelm them. They don’t want to go to the endocrinologist to just wait to hear how bad their A1c is and feel like, “Okay, so when am I going to get my leg amputated?”

It’s hard for somebody without diabetes to understand how much it just becomes who you are. And I don’t think there is any way to adequately explain that to anybody until they experience it.

What piece of advice would you give to someone who is newly diagnosed with diabetes?

ROSS:  In a very weird sort of way, diabetes can be a blessing. You’re never going to feel that way when you find it out. But for me, I probably never would have run marathons had I not been diagnosed. It gave me an extra challenge.

For anybody who’s diagnosed, it’s really important to realize this is not a death sentence. You can live a normal life, and it doesn’t have to involve marathon running. It can be a lot of other different things, but it doesn’t mean everything in your life is going to be limited and you can’t do a lot of the things you want to do. 

When I was diagnosed, my doctor sat down with me and said, “What do you eat? What’s your diet?” I was a typical college kid, so I went out eating pizza and drinking and everything.

She said, “Well, you might be able to eat one piece of pizza.” At the time I thought well, how am I going to survive? I mean, I was in college – this is what we ate. She sort of prepared me for worst-case scenario. And she made it sound like “you just can’t do that or you just can’t do this,” and I don’t think her message was conveyed very effectively. But ultimately, she was just trying to push moderation. You can live a very normal, healthy, productive life and accomplish a lot of goals, but you’ve got to do it with responsibility.

I would much rather embrace my diabetes early on than try to handle the shock of potential consequences 20 or 30 years down the road. I can survive and thrive with diabetes.  

Do you have any big plans for when you finish the last marathon?

ROSS: I plan on sitting on the couch and eating a lot of snack cakes [Laughs]! But seriously, I don’t have any grand plan. I just want to enjoy that race and then, maybe consider an Iron Man triathlon. If I’m able to finish all 51 marathons, I’ll be stunned that I was able to actually accomplish it. 

What do you think?