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Jef’s Journey: The Road to the Boston Marathon with Type 1 Diabetes

Jef Malpass running a marathon

In 2010, Jef Malpass cheered from the sidelines of the Seattle Marathon and watched his friends become part of the 1% of the population who complete a marathon.1 For Jef, who has been living with type 1 diabetes since 2004, this was the motivation he needed to hit the pavement.

Running a marathon is a daunting task for any person. For Jef, it took focus and commitment beyond what the average runner musters to train for and complete the 26.2 mile race.

Jef has lived with type 1 diabetes for 18 years. Marathon training means he must also overcome the difficulties of his blood sugar levels. Heart-pumping workouts can lead to hypoglycemia, in which blood sugar can drop dangerously low.

While some who live with diabetes might cut back on exercise, Jef is about to conquer his 19th marathon in April 2022. And it is not just any marathon. Jef will run the Boston Marathon and this feat will conclude his amazing accomplishment of running six of the largest marathons in the world, also known as the World Marathon Majors.

We were honored to speak with Jef about his family, his marathon journey and his current role at Hillrom, where he uses his experience as a person living with diabetes to educate others on the importance of taking care of our eyes.

Jef Malpass and Family

Hi Jef! Please tell us about yourself and your family.

I am from Seattle. During the pandemic, I moved to Cle Elum/Roslyn, about 80 miles east of Seattle, to be in the Cascade Mountains in Central Washington. I have been married to my wife, Angie, for 15 years and we have two boys — Miles (10) and Parker (7).

What type of diabetes are you living with?
Type one. I am insulin dependent.

How long have you been living with diabetes?
I have been living with diabetes for 18 years. My younger brother also has type 1 diabetes. He was diagnosed in 2003, a year before me, so I was aware of all the symptoms before getting a diagnosis of diabetic ketoacidosis (DKA).

My mom was a critical care nurse (retired after 40 years at the bedside), so I checked my blood sugar on her unit. My blood sugar levels were 240 mg/dl, and I knew right then I had diabetes. Normal blood sugar levels are 100 mg/dl.

How did you get into running? Tell us about your marathon journey and why the Boston Marathon has always been a goal of yours.
I grew up playing hockey. After my first son was born, I could not do the late-night ice time anymore, plus I kept getting injured — knocked out my teeth and broke my hand and several ribs. So, I started running and fell in love with it. I watched some friends run the Seattle Marathon and knew instantly I wanted to run a marathon.

I was remarkably close to qualifying for the Boston Marathon after my first marathon in Seattle and just kept going for it while running the other World Marathon Majors — New York (2012/2013), Tokyo (2015), Chicago (2015), London (2017) and Berlin (2018).

I have done them ALL, except Boston. I have come excruciatingly close to qualifying several times and first qualified in 2017. However, by only 18 seconds (3:14:42). There were so many runners who wanted to run Boston in 2018 that, unfortunately, it still was not fast enough to get in.

On July 24th, 2021, I ran my fastest marathon (3:12:50) and gave myself a 7 minute and 10-second buffer. Thankfully, I also moved up in the age bracket and was graced with five extra minutes.

I WILL be going to Boston and running in 2022! I have run 18 marathons now, along with a 50-kilometer and a 50-mile ultra-marathon. The Boston Marathon is so special, and I cannot wait to experience it.

Only 5% of runners can qualify and it was something I knew I could do. Plus, I just love running — it helps me stay fit and sane by reducing stress. And, setting running goals helps me stay motivated to keep pushing.

Can you share what patients living with diabetes should know about their eyesight and the effects of diabetic retinopathy?
Despite having great glucose control, people with diabetes can still develop diabetic retinopathy and they may not even know it before it is too late. That is why it is so important to have an annual diabetic retinal exam (DRE). If you catch it early, 95% of vision loss is preventable.

According to the American Diabetes Association, only 50% of people with diabetes are hitting their A1C targets (less than 7%) — it is even more important for these people to have an annual DRE. There is nothing scarier (for me at least) than the possibility of going blind.

How is the RetinaVue® care delivery model helping providers treat patients living with diabetes?
Having a diabetic retinal exam during your annual primary care or endocrinology/diabetes center visit is a huge value add for patients. A patient with diabetes on Medicare must go to the endocrinologist four times a year. The amount of doctor visits can be overwhelming. Not to mention that after a dilated diabetic retinal eye with an ophthalmologist, patients cannot see (their vision is blurry) for a few hours — it is a big inconvenience and many people just do not do it.

The RetinaVue care delivery model has the power to help prevent patients from falling through the cracks, damaging their vision and possibly going blind. The RetinaVue care delivery model also allows providers to hit their HEDIS® measures and close care gaps, which in turn creates a great financial return for the provider, clinic and health system.

What would you tell someone who has just been diagnosed with diabetes?
Get a continuous glucose monitor (CGM). Learn as much as you can about diabetes, nutrition and exercise. Be an advocate for yourself and stand up for what you need to be healthy. As a person living with diabetes, there is not anything you cannot do — you just plan more carefully.

How is training for the Boston Marathon going? What is your anticipated finish time?
I will probably start training in February of next year. I recently ran a 100-mile (with 30,000 ft of elevation gain) trail run on September 11th and have focused on running farther but slower. I will be happy with anything under 3 hours and 30 minutes in Boston.

What is something people may not know about you?
I was ranked 7th in the United States in the under 18 division for pairs figure skating. I try not to tell too many people because it ruins my credibility as a tough ultra-runner.

Author photo of Kaitlin Lyons

By Kaitlin Lyons, Manager, Marketing, Vision Screening & Diagnostics

  1. Galic, Bojana. Livestrong. 126 Running Statistics You Need to Know. Accessed: September 24, 2021.