Howdy

Thank you. One good thing is I learned a good lesson about being careful with exercise exuberance back in 2006 when I took up running for the first time and in a 7 week period managed to run myself into a fracture of the tibia. But I came back from that and ran a half-marathon in November 2007. Haven't really run much since 2010, but I'm definitely mindful of the idea of building things slowly and carefully. Getting sidelined by an injury sucks, and I'm very much of a mind now that exercise should be fun and should be done as much as possible to build health and avoid injury.

But when I feel ready for it, I hope to start some barefoot running training and I'm aiming to do a half-marathon barefoot in the fall of 2014.

I suppose that I likely check my feet more often or as often as a normal person out walking barefoot -- that is, any time I feel something is off, I check. So far as times that doctors have checked my feet, they have full sensitivity and good circulation. I take that to mean just because I'm diabetic it doesn't mean that my feet are going to explode or have rapid-onset gangrene, it just means that I'm a diabetic and that so long as I do my best to keep my blood sugars in a good range, I can enjoy a fully human range of life.

I've also come to think that it has not only been diabetes which is responsible for some of the difficulties that have been observed in the feet of diabetics, but it has also been the standard medical advice to diabetics to keep their feet shod as much as possible. But I think most of us would agree that if you want to promote healthy circulation to body parts, those body parts need activity and their muscles need to be used. But when we stick feet inside of shoes, the muscles atrophy some. Isn't one of the arguments made by barefooters is that it's more healthy for feet to be bare because the muscles of the feet get more use when used barefoot? So maybe doctors should actually advise diabetics to walk around barefoot, to develop as fully as possible the muscles of the feet so the feet get good circulation.

I feel fairly confident that my thinking is right on that. At least I hope it is and I hope to enjoy many years of barefootedness to come.

And we need you to recruit a friend to run with you named "Sniff."

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I hadn't ever thought of that. Can I request that Sniff be a member of the world famous Swedish Bikini Team?

That's very interesting that you've had to do some study on the subject of diabetes and exercise. It's very true what you say about variations in people and about how that means you can't put all individuals inside the same box. One thing I've sometimes talked about with other diabetics I've met or on message boards for diabetics, it's how for all of us, being well-controlled means conducting a sort of experimental study upon our bodies daily. Every day I collect new data and new experiences and based upon those slowly or sometimes more substantially alter the understanding of my own body's metabolism.

The great thing about science is that it is a great tool for slowly figuring out things work. When I first became a type 1 diabetic, the method of control was to sort of frontload the daily insulin with injections of NPH and then eat meals and snacks at scheduled intervals. But as the monitoring tools like glucometers improved and as the insulins improved, that paradigm has been largely discarded in favor of the basal/bolus method which gives a type 1 diabetic the chance to eat and live a more normal existence -- I adjust the amount of rapid-acting insulin I take for the meals I eat and how much carbohydrate they contain (there are other confounding factors, but that's the basic one) and use an injection of Lantus to roughly match the amount of glucose my liver releases as a trickle throughout the day.

One sort of difficulty right now in interacting with the medical field is that much of the knowledge about diabetics is sort of burdened by the historical data when it was much more difficult for any diabetic to maintain good blood sugar control. So I think there is sometimes a skewed vision of what diabetics are doomed to -- kidney failure, blindness, foot pathologies, etc. We really don't have good longterm data of what happens with diabetics who maintain good control, there is more than there used to be, but it's still incomplete. But the medical field is used to the idea of having to fix or treat problems from diabetes and perhaps is still working out more comprehensively how to prevent those problems, such as foot pathologies.

But I hope my reasoning is sound and I believe my doctor will be persuadable that I've not gone off my rocker when the next foot exam is performed and I'll likely have to explain the soft leathery pads on the balls of my feet.