TORONTO – Dustin McGowan is determined to get to the bottom of the fatigue which plagues him during his starts.
In-between outings, he'll become better acquainted with a treadmill.
"Actually I'm going to start running a lot more, just see if that helps with endurance," McGowan told TSN.ca on Friday afternoon.
If only it was that simple. McGowan is a type 1 diabetic.
"I think a lot of it, for me, I'm starting to figure out it's got something to do with my blood sugar," he said. "It's so high."
To put it into context, according to the National Institute of Health, the normal blood glucose level for a non-diabetic should be less than 125 milligrams per deciliter. Once McGowan takes the mound, his readings skyrocket to disconcerting levels.
"I get so anxious and stressful and nervous leading up to the game," said McGowan. "Before I go out, I'll be fine, it'll be 140, 150 and, without drinking anything or eating anything after I come out of the game, it's over 300."
In the ongoing effort to find a solution, he's going to take in insulin while he's pitching.
"I may start wearing my pump during the game just to see if (the blood sugar) levels out a little bit," he said.
McGowan's injury history is well documented. He was a mainstay in the Blue Jays' starting rotation in 2007, winning 12 games in a breakout season, and appeared poised to live up to the promise his status as a top prospect suggested.
After remaining healthy through the first half of the 2008 season, he was forced from a July start with shoulder pain. Three weeks later, McGowan's season was over when it was announced he would need surgery to repair his labrum.
He had knee surgery in 2009 and a second shoulder procedure in 2010, this time to fix a torn rotator cuff.
After returning to the rotation in September 2011 and making five starts at the end of the season, he experienced more shoulder problems in 2012, which led to another surgery.
McGowan doesn't blame diabetes for his injuries but he believes the condition has hampered his ability to make hastened returns.
"Recovery has been a pain because even when I get a blister or a cut, it takes forever to heal," said McGowan. "I can only imagine after getting my arm sewn back together what it was like. In that way, it's been brutal but I don't think it's done anything to cause me to get hurt. It's just the healing process takes a little longer."
Finally last season, McGowan rejoined the club in June and settled into a relief role in which he posted a 2.45 ERA in 25 appearances.
His return to the rotation this year is a testament to his perseverance but also a reflection of the Blue Jays' desperation. There were no other immediate options after Ervin Santana spurned the club for the greener pastures of the National League and a contract with the Atlanta Braves.
McGowan would like his blood sugar level to be between 150 and 160 milligrams per deciliter while he's pitching. He's as concerned with the reading dropping too low as he is with disturbing spikes and so he's okay with a slightly higher count than what a non-diabetic would expect.
"When you're doing exercises, it's supposed to go down," said McGowan. "I think just because of the stressful situations pitching and stuff like that, it just causes it to boot up a little bit."
Manager John Gibbons is openly musing about using a six-man starting rotation with the schedule about to get busier. The Jays have one off-day between the start of the next road trip, Tuesday in Kansas City, and Sunday, June 1. There are only four off-days remaining between now and the All-Star Break in mid-July.
After admitting he'd wondered to himself if a return to the bullpen makes the most sense, McGowan wants to clarify: he wishes to remain in the starting rotation.
"It's something I'm not going to shy away from," said McGowan. "I'm going to do it until they take it out of my hand."