The Outdoor Type: Svati Narula
Welcome to “The Outdoor Type” — a series of interviews with diabadasses who love spending time outside. We talk about the realities of outdoor adventuring with diabetes, tips and tricks for diabetes management, and most importantly, our love for the outdoors.
“If he could climb Mount Everest with type one, I could certainly keep running cross-country with type one.”
-Svati Narula
I want to thank Svati so much for being our very first interviewee. Svati is a journalist, dedicated runner (we’re talking ultra marathons), and 29-year old type one diabetic who resides in New Hampshire with her dog, Cabot (yes, like the cheese). In our interview, Svati dives into the significant role diabetes and the diabetes community have played in her life as a runner and outdoor adventurer.
Please note that any information shared by our interviewees should not be taken as medical advice. You should always consult your doctor before making any changes to your management plan.
Svati Narula
Journalist, Ultra Marathon Runner
Years with T1D: 20
Technology: Tandem T-slim with Control-IQ, Dexcom G6
Favorite outdoor activities: Running, Backpacking
Favorite trail treat: GU energy gels, Untapped Vermont maple syrup packets
Svati’s Top Tips and Takeaways:
Running in the morning when there’s no insulin on board is the best way to have nice even blood sugars on a run
When traveling or adventuring in remote areas, store supplies in different areas (different jackets, bags, etc.) in case of, in Svati’s case, an avalanche
You can have this disease under control, but that doesn’t mean that it’s not sometimes going to get the best of you. Take it from Olympian Kris Freeman.
It’s totally valid to be nervous and scared of going outdoors, especially if you don’t have as much experience, but you’ll get better with experience and learn that bad things can happen, but you’ll be okay as long as you’re prepared
How do you like to spend time outdoors?
I’m primarily a runner. I really like trail running and ran my first 50k Ultra Marathon back in 2018. I really want to do another one, and have done a couple of regular road marathons as well.
How has diabetes played a role in your experience running and spending time outside?
It’s funny, I don’t think I would’ve become a runner in the first place if it wasn’t for my diabetes. It all started with the middle school fun run (a timed mile in P.E. class):
The teachers always sprung it on us as a surprise because kids hated it so much and they didn’t want people to cut class. But all the P.E. teachers knew that I had diabetes, and they didn’t want me to be caught off guard, so someone would always come and knock on my classroom door at second period to be like “Hey Svati, fun run today.” And the P.E. teachers were so worried about me going low during the run that they always had a can of coke waiting for me at the finish line. So I was the special kid in P.E. who got coke at the end of the mile run. And rather than feeling ostracized or weird about it, I really embraced it and was like, yes, I’m special, I love it. All of the other kids were jealous of me. So I loved the mile run. And it turned out I was pretty good at it. I got a lot of positive feedback from the P.E. teachers who were so impressed with how I ran it, and they told me I should try out for the cross country team in high school, which I did. And I made the varsity team my freshman year, which was a big confidence booster for me since I had never really been good at sports before.
All of a sudden running became a big part of my identity. I was doing cross country, indoor track, outdoor track, and it was really, really hard with my diabetes. I would say my diabetes made me want to quit the team quite a few times. My blood sugars were just really high all the time since I was so afraid of going low during practice, so my hemoglobin a1c wasn’t great.
At the same time in high school I was involved with JDRF and a couple of other diabetes organizations…
At one point I was attending the Children with Diabetes conference, and it was there that I learned about this organization that doesn’t exist anymore called Insulindependence. It had been started by these guys who wanted to help people with diabetes who wanted to do Ironman Triathlons. And the organization really changed my life by introducing me to a lot of other active diabetics who I wanted to model myself after and be like.
Before I met these guys, I also met this guy named Sebastien Sasseville who had climbed Everest with diabetes. And I interviewed him because I had a blog for teens with diabetes. I interviewed Sebastien, realized that he had climbed frickin’ Mount Everest with type one, and thought, if he could climb Mount Everest with type one, I can certainly keep running cross country with type one.
Can you tell me more about Insulindependence and your experience being around a community of diabetic outdoor enthusiasts?
Insulindependence’s philosophy was that by pushing yourself to do an Ironman Triathlon or do a backpacking trip with diabetes, you’re actually going to get to know your body better, and your diabetes is going to be better controlled. That was a new twist on it for me. I had thought that I was running despite my diabetes, but these people were running and exercising because of their diabetes. This philosophy really helped shift something in my brain.
They were also just really great role models for me. I met all of these people through Insulindependence that did Ironmans, went on backpacking trips, and ran marathons, and being able to talk to them online throughout my training was really inspirational for me.
While the organization is no longer around, a lot of people who were involved with them are now involved with Connected in Motion, an organization based in Canada that does retreats in the U.S. as well. It’s basically like a diabetes summer camp for adults.
You mentioned that your diabetes made you want to quit running, which of course you never did, and today you’re a very accomplished runner. What has kept you going?
Diabetes takes a big toll on your mental health. And knowing that there is scientific proof that the time you spend outdoors and the time you spend being active helps your mental health...I feel like I do it to relieve the stress that my diabetes brings on.
Another big reason, and probably the most compelling I have, is knowing that the more active I am, the less insulin I need overall. Even if a super hard workout or one at an inconvenient time of the day ends up sending me on a rollercoaster blood sugar ride, I know that over the longer term, the fact that I’m being active means that my body will have an easier time processing the carbs I have that week.
Seeing that effect on my body when it comes to insulin sensitivity and overall even-keeledness with blood sugars keeps me motivated.
Can you share something specific that you’ve learned about yourself and your diabetes as a result of spending time being active outdoors?
One lesson that really took me a long time to learn, but is very important, is that it’s all about the insulin on board. I’ve gotten to a place in my life where I can go on a run first thing in the morning starting with my blood sugar at 90 and still end the run at 90 because of having no insulin on board, and it’s wonderful that that’s a thing I can do now.
A couple of years ago, even though I had had diabetes for 18 years and had been running for 13, I never ever ever would have gone on a run when my blood sugar was 90. I was always trying to start my runs above 200 because I would drop so much. I also used to think I couldn’t run without eating, but now I know that’s not true and it’s just taken some practice to get used to it.
Running in the morning has been a game changer for me. It’s the best way I know to have nice even blood sugars during a run.
Do you have any tips or tricks on how to make preparing for outdoor excursions easier for diabetics?
I have a med kit that’s red. It looks like a first aid kit, but it has supplies in it and I always have to check it before I go anywhere that’s really off the grid, but it always has a glucagon kit, ketone strips, glucometer, back up pump, and at least one of each type of pump supply. I keep my insulin in it too, and when it’s time to go I put my insulin in a frio pack that’s also red and put that in my red kit. My glucagon is also red. So it’s all red.
I also always make sure I bring double of what I think I’ll need, and try to store the supplies in different places. This goes for travel especially, like keeping things in different jackets and bags, in case something happens. I actually learned this from Sebastien, and it turned out to be really good advice for me. I had this one experience where I got to go to Everest Base Camp, and while I was there a major earthquake hit Nepal and caused a large avalanche where I was. When the avalanche hit Base Camp I lost some diabetes supplies, but not all of them because I had them in different places. So that was a really good thing that kept me from stressing in a really scary situation.
(Read more about Svati’s Everest experience here).
Do you have any favorite glucose or protein sources that you like to have on the trail?
I love good old fashioned GU packets. I guess they don’t actually raise my blood sugar as fast as some other things could, but one thing that works really well is from this company called Untapped, which is based in Vermont, and they make maple syrup packets—which can also be great for stirring in your coffee or oatmeal while on the trail, so it serves as both a food item and a low blood sugar item. The packets are designed for athletes so they’re really hardy and I’ve never had one burst on me.
How do you educate your friends and new people you adventure with about your diabetes?
My one habit is to teach them about my glucagon the way you would teach someone about an epi pen. I don’t think I’d ever go on a backpacking trip or be on a hiking trip with people who don’t know I have diabetes. It’s something I’m very upfront about. Like, it usually comes up on a first date! People know I have diabetes. My pump’s always beeping, I’m always doing things. So when it comes time to go on an outdoor trip with people, I will at some point early on say, “by the way, while we’re out here, I have this red kit. And in the red kit is my glucagon. And here’s what you need to know about it.”
I think having that talk with them and telling them “hey, this is a piece of equipment that I carry in my pack that I want you to know where it is,” primes them for also thinking about my blood sugar on the trip, and they’re more likely to be comfortable asking me after a long day of hiking, “how are you feeling?” “how’s your blood sugar?” They know that the stakes are a little different for me, and that there’s a risk for me so they’re more cognizant of that.
What advice do you have for anyone who might be new to outdoor recreation and a little hesitant or worried about diabetes management outside?
The first thing I would say is that it’s totally valid to be nervous and totally valid to be scared. I think one thing that shouldn’t get lost—no matter how many people with diabetes are doing really cool things like climbing Everest or running marathons—is that this disease can be scary and can actually hinder us and knock us down, and it’s totally valid to be worried, especially if you don’t have a lot of experience and don’t know that you can trust your body. Of course you’re going to worry, so don’t think that you shouldn’t worry about it.
The other thing I would say is that you get better with practice. So it’s really important to go out and take those risks and to fall on your face if you need to. If you have a bad low blood sugar when you’re halfway up the side of some mountain it might suck but you’re going to learn from it and you’ll learn how to avoid it next time, and as long as you’re prepared for something like that to happen, you’ll survive it. It’s a great learning experience for the people who are with you but mostly for yourself: to know that bad things can happen and you’ll be okay.
And they’re going to happen, but they’ll happen fewer and fewer times, the more practice you get, and you can’t get practice without just doing it.
I think one thing that helped me was hearing that Kris Freeman, an olympic cross country skier with diabetes, had a really visibly bad race once—like, he went from being in 2nd place to 45th place—because his blood sugar crashed and he had to stop and drink Gatorade. I was like okay, even Olympians mess up sometimes. Kris Freeman has his diabetes dialed in, and I’ve always thought that he’s so good at diabetes in a way that I could never be, because he’s in the frickin’ Olympics, but he still had an off day, and got low and nearly had to drop out of a race. This was during the 2010 Olympics in Vancouver.
You can have this disease under control, but that doesn’t mean that it’s not sometimes going to get the best of you.
What’s next on your list of adventures?
I would really like to do another 50k trail race. That’ll be my next adventure when this pandemic is over and we’re allowed to have races again.
Follow or chat with Svati on Instagram or Twitter!
Living with T1 Diabetes
Aya Tsuruta
Aya is a marketer, environmental steward, outdoorswoman, and member of T1D nation (since '97). Through life's ups and downs she's found joy, solace, and strength in the outdoors—on the trails, at the crag, and under the stars—and is passionate about helping other diabetics feel safe and confident outside.