My 5th discipline is called Type One Diabetes (T1D) and without careful attention to this domain, completing a triathlon would be a pipedream. T1D is an autoimmune disease that manifests after the body self-destructs its own insulin-producing cells of the pancreas, resulting in the complete loss of carbohydrate metabolism. Talk about self-sabotage. There is no cure and I play full time pancreas- balancing administering insulin injections and carbohydrate counting.
Managing T1D for the last 4 years has taken endless planning and experimenting, it has brought tears, challenges and failures but it has also made me acutely aware of not only the capabilities of our bodies and their intricate, varied response to nutrition and exercise, but ultimately the confounding power of the mind.
A diabetic’s aim is to maintain blood glucose readings between 4-8 mmol/l, which is achievable, thanks to carefully calculated insulin injections and sugar monitoring. However, insulin comes with its complications. Too much insulin will bring your blood sugar too low, leaving you confused, weak, disorientated, shaky and if severe will manifest in seizures, result in brain damage and death.
Insufficient insulin results in high blood sugar, severe dehydration and electrolyte abnormalities, irritation, fatigue and if prolonged can result in diabetic ketoacidosis, coma and death.
As severe outcomes lie on either side of the scale, managing diabetes is a constant pursuit for this fine balance between high and low, this delicious 4-8 mmol/l sweet zone. This is challenging on your average day, now add in three forms of exercise, a dash of adrenaline and your glucose requirements are completely altered. To help, I use a special device called Dexcom which is continuous glucose monitoring (CGM) system which reads my blood sugars every 5 minutes.
Breakfast was a smoothie comprising of a carefully measured 20g of carbohydrates. I injected 4 units of insulin, a higher dose than normal, but I expected my nerves and adrenaline to shoot my sugar high.
I arrived at transition with the perfect blood glucose reading, celebrating with little inside victory dance and a few childish, internal cheers “Nailed it, Trace you da bomb, Diabetes you lose, I win.” To which diabetes casually smirked, “Oh really?” Within 15 minutes of arrival the nerves took residence, adrenaline and cortisol pumped around my body and my sugars shot to 14mmol/l and continued rising.
Diabetes: 1 Tracy: 0
With limited time until the start, I prayed to the Diabetes Gods, had 3 units of insulin, popped my CGM and insulin injections on the “medical” table that stands at the front of transition, suited up and headed to the beach.
The most potent moment of 70.3 was running into that dynamic, golden ocean. The sun breaking on the horizon, the frothing waves illuminated silver and yellow. Every single concern was forgotten and I could not contain a giggle and smile as the true beauty of the morning unfolded. Yet so magical was the sun that it had to remind me of its glaring, blinding presence for 840m as I am a dominant right-sided breather. Nevertheless, the water was phenomenal, my wetsuit the ideal floatation device and the buoys perfectly visible.
After slogging up thick sand to transition, I grabbed my CGM off the table and in the pure breathless panic of sand and wetsuit, did a finger prick and manually tested my sugar which was a pretty good-looking 8mmol/l. I injected 2 units of insulin in order to be able to eat along the bike course and then proceeded to run 5 thousand metres with my bike, thanks to the world’s longest bike transition, before heading off excitedly on my noble steed.
Diabetes: 1 Tracy: 1. The playing ground was levelled.
Diabetes can be an overwhelming mental game. An abnormal blood sugar is a great mimicker of normal sports related feelings such as fatigue and weakness. You can be plagued with constant doubt, “Am I buggered because I pushed too hard or is my blood sugar high or low?” Additionally, I could be feeling like a million bucks, only to discover a terrible blood glucose reading that automatically prompts my mind to decide that my body is broken. Throughout the bike course I looked at my CGM every 15 minutes ensuring that I was in range and ate accordingly. Thankfully, I didn’t have to stop to inject insulin along the bike route, and my sugars stayed tightly between 7 and 8mmol/l.
Diabetes: 1 Tracy: 2
Diabetes, I won this one bro.