A big problem here is that every diabetic is their own individual case. Having no knowledge of how this diabetic is testing his sugars and dosing his insulin, I can only give some general thoughts and even those might not be applicable to his specific case.

Personally, I avoid eating any sort of snack or meal 2 hours prior to running. The reason I do that is because I want to only have basal insulin in effect if I can. It is generally observed that physical activity decreases insulin resistance, and if I were to have extra bolus insulin active, it increases the chances that my blood sugar will drop too low.

His being too low prior to those races -- was it because he had eaten earlier, bolused for that, but ended up low? If that's the case, that's another reason why it's my general practice to avoid eating and bolusing 4 hours or less prior to a time I plan to run. If the basal insulin is working properly and you have your blood sugars at a good level then, it is easier to keep them at a good level by not introducing carbohydrates into the system and then having more insulin being put into the body. Assuming this runner is using one of the modern fast acting insulins with approximately 4 hours of activity, you can see why I'm trying to keep the use of extra insulin out of the equation of running.

Before a race, I monitor closely what's going on. I will start checking maybe every 45 minutes to an hour, that keeps me on top of what's going on, especially if I have bolus insulin that is still winding down. If I find I'm dropping too much, I can compensate with carbohydrate in the form of glucose tablets and I know that for myself that 8g of carbohydrate will raise me about 30 mg/dL.

But just because 8g raises me 30 mg/dL, it doesn't mean that it's the same for him. This is the kind of stuff diabetics have to figure out with practice and experimentation. It takes some time and diligence, but it can be worked out.

Hi Mitchell,

Good for you for wanting to learn more!  You have already received great advice from Scratch and Kenny.  As they pointed out, we are all "an experiment of one" in many ways, but there are some concepts that can help narrow down the experiment.  

I think most people who don't live with Type 1 have the perception that it's all about food.  That is certainly part of the equation, but it is really the combination of insulin, carbohydrates, and exercise (and other factors beyond our control or prediction at times).  

I utilize an insulin pump and have done it both ways for short runs (3ish miles) eating before, and not eating.  Either way, I tend to follow a 50% rule of sorts.  If I'm not going to eat, and my blood sugar is in a good range, I will cut my basal rate in half about and hour and a half before a run.  If I choose to eat, I eat about an hour before the run, only bolus about half the normal amount of insulin that I otherwise would for the carbs I'm consuming, and leave the basal rate alone.  That works a lot of time....for me.  The best and simplest explanation of this type of thing I have found is a concept called ex-carbs:

  http://www.diabetesnet.com/diabetes_control_tips/excarbs.php#axzz11PaqTB00

A 3:1 carb to protein ratio is good, and I'd suggest if he/she chooses to eat that the fat content of the food be kept pretty low (since it tends to slow absorption of the carbs....sometimes for several hous). 

The young person on your team is fortunate to have a coach who cares enough to learn.  In my opinion, the biggest gift you can provide is supporting him or her through the "do not starts", and ecouraging learning from those and making adjustments to run another day, rather than feeling like it is a failure.