In our last installment of Timesulin Does a Triathlon, we talked about why it’s important to stay physically fit with Type 1 diabetes. We talked about training regimens and health. Most importantly, we talked about not letting Type 1 diabetes stop you from going out and doing something incredible. In fact, going out and challenging yourself do the impossible can make living with Type 1 diabetes much better, and can give you the kind of satisfaction with life that most people only dream of.
Of course, I’m speaking from experience here. I’ve been participating in endurance races for the last 10 years and running triathlons for the last 3 years, as a way to both stay in shape and personally challenge myself. They’ve been my go-to to prove to myself and the world that diabetes hasn’t managed to control my life. Plus they’re tons of fun. So that’s what I wanted to talk to all of you about today. A couple of months ago I ran a triathlon in Stockholm, Sweden and wanted to recount my experience. By sharing it, I hope to convince and motivate more people in the T1D community to go out there and do something great, and prove to the world that nothing is impossible when you set your mind to it.
This wasn’t my first triathlon, but it was one of the hardest ones I’ve ever run. Everything seemed to go wrong. Problems started the night before with a frustration that many people with Type 1 Diabetes face – I just could not get my blood glucose level under control. Nothing seemed to work, and I went to bed frustrated. Things didn’t get much better, and I was up and down at least six times throughout the night. This is a common enough frustration for most of us with diabetes. It’s a lot more frustrating when you have to be up at 6am the next day to do race prep. It didn’t help that the Dexcom 7 CGM I was wearing kept buzzing to tell me my blood sugar was low. Thank you, I know!
The morning of the race is always difficult. Managing blood glucose and liver glycogen for the race is a tough challenge for even well-conditioned triathletes in prime health. For triathletes with Type 1 diabetes, getting glucose levels high enough while still being in a safe range can be an incredible challenge. My breakfast of choice is oats, with some almonds and applesauce. I’ve found in the past this is the best way to get me the energy I need without causing an unsafe situation. Luckily, the Dexcom 7 is great for keeping up with blood glucose levels minute to minute.
With breakfast out of the way, I was off to set up my transition area. For those that don’t run triathlons, transitioning is one of the keys to getting a good triathlon time. Since standard triathlons are made up of three very different events – first swimming, then biking, and then running. Going from one stage to the next requires changing into the gear for that next stage. This is called transitioning, and setting up your gear properly to shave seconds off your time is critical. As usual, I set my bike up on a rack for quick transition, and my running shoes and socks (yes, I wear socks!) laid out for ease of putting on.
The swimming portion started well enough. I wore the CGM sensor under my wetsuit, and it felt comfortable and unobtrusive. It remained fully functional, too! Take note, athletes with diabetes! The swim portion of an Olympic triathlon is 1.5k, which I did in 32 minutes this time. When I got out of the water, however, I felt very low. A lot of triathletes report that getting out of the water is the hardest transition, physiologically. Laying down on your stomach while swimming for 30 minutes and then going into a standing run can be pretty unpleasant. It’s even worse when your blood sugar starts dropping. Testing my blood sugar gave me a reading of 52 mg/dl (or 2.9 mmol/l). Typical blood glucose is 4 – 6 mmol/l. Just goes to show you – if you’re feeling low, check if you can, but trust your gut if you can’t. I ended up having to eat an energy gel to get my blood sugar up, which added almost 2 minutes to my usual transition time (that’s HUGE for a triathlon).
Getting on my bike and taking off was great because I could keep my CGM monitor on me tucked into my racing jersey. This let me keep an eye on my blood glucose level in real time as I biked and adjust as needed, which I did with more gels and sports drinks. Finally at the turnaround of the first lap (of three), my blood sugar is stabilized at a normal level and I can concentrate on the race 100%. I finish the 40 km race in an hour and 20 minutes. Not too bad.
Getting back to transition and throwing on my running shoes, I felt great – ready to power through and finish strong. Things were great…up until they suddenly weren’t. Half-way through lap one, I felt a shooting pain coming up through my knee. Trying to push through just kept making it worse, and I had to stop three or four times on the way to the finish line. I ended up finishing the 10 km in 57 minutes, a whole 15 minutes off my time. Which was a shame, because I was so close to setting my best time for a triathlon. I ended up finishing the whole thing in 2:57.
The experience was wonderful, even with the knee pain and the hypo problems. I had a blast, and there were some important lessons in this experience. First of all, the CGM worked great. I cannot stress how helpful this little gadget was. By giving me my blood glucose at a glance, it freed me up from worrying about my blood glucose and let me concentrate on the race at hand. Better yet, it kept me from having to front-load on carbs and run a high blood glucose level to avoid a hypo situation. Next, I learned that PowerGels are amazing. If you play sports, look into them. If you DON’T play sports, look into them anyway. They’re great at getting your glucose back into a good range. Finally, I learned that conquering Type 1 diabetes doesn’t mean I’m immune from knee problems.
Thanks for sticking with us and reading this whole long account! And look for more pieces about people with diabetes going for great. In fact, if you have any stories of triumph in the face of T1D, send it over to us and we’ll put it up! After I get my knee checked out, that is!