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Training with type 1 diabetic athletes has taught coach Rick Crawford about metabolism — and life.

By Rick Crawford
Published: Mar. 6, 2009

I got involved with Diabetes Training Camps about three years ago. I’ve been to seven camps since then. I just wrapped up a camp in Tucson with the Triabetes group, which was a departure from the other camps I’ve done in that all the diabetic campers were training for the same goal, an ambitious one, to complete the Ironman in Phoenix in November ’09. All the campers have type one diabetes.

Every time I do one of these camps with diabetic athletes, I learn so much about metabolism, among other things. Diabetic athletes are beginning to emerge now, with monitoring, pharmacological, and delivery technologies advancing to the point where what was once seen as a debilitating handicap is now a manageable situation. Certainly, it is very apparent that athletes with diabetes are realizing that diagnosis of diabetes is no longer a life sentence to sedentary life.

Type one diabetes is characterized by a reduction or complete shutdown of the pancreas’ ability to produce insulin. Insulin is the primary transporter of blood sugar to the muscles and tissues. In a person with a normally functioning pancreas, blood sugar is regulated to tight tolerances. In the type 1 diabetic, in the absence of insulin, blood sugar can get too high or too low, both of which can lead to fatal consequences. If blood sugar goes too low, the big fear is hypoglycemia induced coma; too high and a ketoacidotic coma results. Type 1 diabetes that goes untreated is fatal.

For people without diabetes, like myself, we ride and don’t usually think about eating from a life and death point of view. If we don’t eat, we might bonk, but we’re not going to slip into a coma. For athletes with type 1 diabetes, if they fail to fuel adequately, it could literally be a fatal mistake. If they fuel too much without enough insulin on board, their blood sugars rocket skyward and again they are screwed. So the type 1 diabetic that decides to take on cycling or triathlon has to have a very keen understanding of the metabolic trends upon which the delicate balance of life itself depends.

After having hung out with “type unos” for a few years now, I’ve gotten used to them whipping out their glucose testing kits, where they plunge a lancet into one of their fingers to draw a small drop of blood and put it on a test strip and slip the test strip into a glucose meter where they instantly get a reading. Based on that reading they take action to either inject a bolus of insulin to lower blood sugar, or eat some carb to raise it, or make no adjustment if blood sugar is at a good level. Coordinating that drill with training and workouts is a tough trick, but a trick that they must get really good at. While non-diabetics can afford to take their metabolism for granted, diabetics must not. There’s a very complex system of glucose monitors, insulin pumps, slow-acting basal insulin, fast acting insulin for boluses … a lot of gear and managing the numbers.

You wanna see a diabetic panic? Take away their gear, and watch them scramble. They can often feel when they are going low or high, as there are progressive symptoms that accompany extreme blood sugar levels. They realize all too well what the consequences are for losing their kits. Diabetics always know where their gear is. It’s life or death.

I’ve come to a huge appreciation of the dedication of these type one diabetic athletes. They have decided not to let diabetes stand in the way of their goals. I have learned a ton about metabolism and the learning curve is still steep. I have also learned a ton about the boundless potential of human character. My perspective of what is hard has been redefined. Cycling and triathlon are sports that are defined by tough people hardened by their experiences, looking for ever bigger challenges. Diabetes is hard, and an experience unsolicited by those who have it. These diabetic athletes have been made hard, and seeking bigger challenges, they have decided to take on big athletic goals, swimming upstream against the mainstream logic that diabetics can’t lead normal active lives.

The Triabetes bunch is the most vibrant, vigorous, healthy, and generally well-adjusted group of people I’ve had the privilege to work with. Diabetes is a tough thing to get stuck with, but these fine folks do not begrudge the fact that they have diabetes. Diabetes has made them pay attention to every detail of their bodies and they are blazing a trail that non-diabetics can learn from. The coolest thing is they don’t take anything for granted. They don’t take their metabolism for granted for sure. We should all have the academic exercise of being our own pancreas for awhile to learn the intricacies our metabolic activity, and to learn to appreciate the gifts that we have.

I have learned many valuable things working with the Diabetic Training Camp. The best thing by far I have learned is not to take a single thing for granted. Every breath of life is precious. Every day is a gift. Our body is our temple. In my long history of pursuing continuing education, the lessons of life that I’ve learned from the diabetic camp experience are the most fundamental and the best training advice I’ve ever gotten.

Editor's note: Rick Crawford is C.O.O. and Premier Level Coach with Colorado Premier Trainingand coaches many top professional cyclists and triathletes.