Type 1 Challenge – We Did It!

It is difficult to put into words how good the Type 1 Challenge was, it was a spectacular success! After months of hard work organising the event and training for the ride, the results for everyone involved could not have been better. In summary:

  • We raised close to $140,000 for JDRF (thank you to all our sponsors and supporter who made this possible!)
  • The JDRF One Ride event raised $1.1M (second highest in the events history)
  • We featured on TV news, Radio and in the Newspaper, raising awareness for Type 1 Diabetes
  • We meet with families in Bendigo and Sea Lake (which was really inspiring for us T1D’s)
  • We had amazing feedback through social media on @JDRFAus, @Type1_Challenge and @Type1Athletic
  • All 15 cyclists and 8 support people made the full journey (some supporters even cycling a bit) from Melbourne to the Barossa Valley (910km)
  • All 15 cyclists participated in the 160km JDRF One Ride in the Barrosa Valley, two leading the way in the leading bunch and also taking out the KOM for the day (I’ll congratulate my self for that one)
  • Received so much interest from people about participating in the Type 1 Challenge next year that it can’t not go ahead again
  • I received a special thank you award from JDRF for founding this ride and pushing it to achieve the successes that it did
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Smiling as we charge out of Melbourne and into the hills on day 1 (the smile last the whole week)

 

When we arrived in the Barossa Valley on Friday afternoon I have never been so proud and I had a real moment of reflection on the amazing things that we had all achieved (fundraising, awareness and cycling). When I spoke to the JDRF One Ride group at the Friday night briefing I noted that as a cyclist, a T1D and as a JDRF Ambassador, this ride had truly been a life changing experience.

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Meeting Blair (T1D) in Sea Lake. What an inspiration this kid was, doing so much for T1D in his isolated regional community! What a champion!

The ride itself could not have gone better. We had no incidents or mechanicals (only 3 punctures), the weather was perfect (no rain) even having a tail wind most of the way, and our organisation/logistics ran so smoothly (100% professional).

The people on the ride really contributed to the great time we all had. You couldn’t have asked for a better group, everyone had a fantastic attitude and we had a lot of fun together. I think that we have made some life long friendships and cycling mates out of the trip. The support crew was absolutely fantastic and the ride wouldn’t have run as smoothly without them. Managing 15 cyclists for 5 days is not easy job and to keep everyone happy and well feed (always on time) was just spectacular. Several of the support crew even jumped on their bikes and rode in the peloton each day and we were happy to sit them at the front and enjoy the ride. A special thank you to my wife who supported me from the beginning and has made a massive contribution to the success of this event (a often stressed cyclist and type 1 diabetic is not easy to live with).

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Type 1 Challenge cyclists, support crew and JDRF representatives at the send-off 

 

The ride was all about type 1 diabetes and having three type 1’s riding really had an impact on everyone and the event overall. Myself, Trevor and David nearly all cycled the entire way and has no major diabetes issues. Riding, eating, recovering everyday whilst managing our type 1 was not only great for ourselves but also gave everyone else in the group an insight in to what we have to deal with everyday. Feedback from other was that this was really powerful and contributed to the swell of support for JDRF.

 

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Great cycling roads, fantastic people, perfect weather and country bakeries made for big smiles

This was really a inspiring and I think life changing event for me. I have a real passion for everything about this event (cycling, T1D and awareness) and I am already thinking about what we can do next year to build on what we have achieved. Already excited!!

Thank you for all of your support and donations.

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That’s who we’re representing – JDRF and type 1 diabetes

 

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Type 1 Challenge – 1,000km Melbourne to the Barossa Valley

The time is finally upon us! After many months training, organising and fundraising we are one week from starting our ride 1,000km ride from Melbourne to the Barossa Valley in support of JDRF One Ride and type 1 diabetes research. The training has been long and hard, we have fund raised tirelessly and the planning/logistics meetings are finally complete. There has been fatigue, frustration and stress, but over the last week the realisation that this amazing event is about to happen has really energised me and I couldn’t be more excited to get started on Monday 1st of May.

The ride has been named “Type 1 Challenge” which aims to reflect the association with type 1 diabetes and also the challenge of the event along with the challenge of living with type 1 diabetes. The way the idea has flourished has led me to commit to running a “Type 1 Challenge” annually in conjunction with JDRF to build on the amazing base of support I  and the concept have received this year. The more I reflect on what we have achieved, and the more I speak with people about what we are doing, the more I am motivated to make this bigger and better. But know we have the 1,000km of cycling to get through before we can really celebrate!

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The Type 1 Challenge: Ride to the Barossa cycling kit full of our wonderful sponsors logo’s

The Type 1 Challenge is now 15 cyclists and 8 supporters who have raised over $160,000 for JDRF. This is a significant contribution which will allow 1yrs further research to be funded. This not only includes the money raised by the 15 cyclists but also direct corporate support for the Type 1 Challenge from; Mastercard, Cuscal, Telstra, Bendigo Bank, Placard, Nokia, Prosegur, Art Series Hotel Group, Sterling Products, U-Haul Australia, NCR, Transaction Network Services and Wilson Plumbing & Drainage. I a truly thankful for all of the support given by these companies (as the founder of the Type 1 Challenge and also as a type 1 diabetic).

Our ride will take us 5 days cycling an average 200km per day. We will be stopping in Bendigo, Sea Lake, Pinnaroo and Murray Bridge before making a triumphant (yet very tired) entrance to the JDRF One Ride event in the Barossa Valley on Friday afternoon. As a group we have ridden nearly 50,000km cumulatively in 2017 (so far) to train for this ride and after out last group training ride on the weekend I am confident that we will all enjoy a safe and highly successful journey to the Barossa Valley.

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The Type 1 Challenge Team post final training ride enjoying the prospect of 1,000km to come!

We will be leaving Melbourne on Monday 1st May and arriving in the Barossa Valley on Friday 5th May. The best way to follow our progress will be through instagram via @type1athletic, @type1_challenge and @jdrfaus. Looking forward to a great ride, a great JDRF One Ride event and continuing to raising awareness of type 1 diabetes and inspire people!

You can still donate to JDRF through this link: Donate to JDRF/Type1Athletic

Cycling for T1D. What we have achieved so far!

When I was first introduced to the JDRF One Ride in the middle of 2016 I immediately started hatching a plan to ride from Melbourne to Adelaide. A fundraising event was the perfect excuse to take on a seriously challenging ride and I was certain that being for JDRF, my family would support me (with their usual worry for my well-being). A type 1 diabetic taking on an extra challenge for a fundraising event for type 1 diabetes, it was a perfect match and the immediate support from JDRF was enough motivation for me to commit 100% (by writing a blog about it!). Apart from the cycling, I was also aiming to raise $10,000 for JDRF, a nice figure I thought but one which I had no idea how I would achieve.

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The Type1Athletic kit was popular with the locals in Tasmania recently, and always raised awareness and discussion about Type 1 Diabetes!

Fast forward to today and we are only 7 weeks away from 23 people making the 1,000km journey from Melbourne to the Barossa Valley in support of the JDRF One Ride. 15 cyclists, including 3 type 1 diabetics, and 8 supporters will travel from Melbourne to the Barossa Valley over 5 days, cycling nearly 200kms per day and participating in two JDRF Diabetes Community events in Bendigo and Murray Bridge. It’s hard to believe how much this little idea of mine has grown, now being a major part of the JDRF One Ride event! The enthusiasm from everyone involved in this ride has been truly amazing, not only from the cyclists taking on this mammoth ride, but the commitment from the supporters and the behind the scenes work that is going into organising the logistics for the ride. The support of individuals and their companies, both through their time and through their donations has been truly amazing and as a type 1 diabetic, I am truly humbled and thankful for the support everyone has given to this cause.

There is a small group of around 25 people directly associated with the ride to the Barossa who are do that extra little bit for JDRF. When we arrive at the One Ride Event this group will have collectively raised over $125,000 through their individual event fundraising along with the extra funds raised through direct sponsorship of the Melbourne to Barossa ride. The group of companies supporting this extra ride cannot be thanked enough for their generosity with many also supporting other parts of the One Ride event including their own company teams.

Special thank you to Telstra, CusCal, Bendigo Bank, Placard, Nokia, Mastercard, U-Haul, Art Series Hotels, Wilsons Plumbing, NCR, TNS, Prosegur and Sterling Projects for directly supporting out ride to the Barossa Valley and JDRF. You can see our team jersey below which we will all be wearing very proudly as we ride!

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Melbourne to Barossa Ride team jersey; thank you to our amazing sponsors!

Another fantastic by-product of our ride to the Barossa has been the broader effect on the One Ride Event itself with an added sense of excitement and energy being generated for the event. Feedback from JDRF is that both the fundraising and participation budgets will be significantly exceeded in 2017 and that there are new riders registering every day, and major donations being made to individuals and corporate teams. Some of the high-profile participants are even increasing their fundraising goals to match and further boost the great work that so many individuals are doing. If the fundraising budgets are exceeded, the funds raised would provide for at least two years of cutting edge, innovative T1d research which can be supported by JDRF directly.

Personally, I have thoroughly enjoyed meeting the fantastic people involved with this ride, some with T1D, some with a connection to T1D, and others with very little knowledge of T1D. Firstly, having an excuse to go on long rides with like-minded cyclist is brilliant! Being able to talk to everyone about T1D, how it impacts my life and how the work that JDRF does has a real-life benefit to me has been enjoyable for me and then beneficial for everyone I think. Having now made many new friends, we are all looking forward to the challenge of riding to the Barossa Valley!

Having now spent time with JDRF staff, the Melbourne to Barossa ride team and many other One Ride participants, I am looking forward to arriving at the One Ride Event on the Friday night and seeing all the other participants, supporters and JDRF staff that will make the event fantastic. This excitement is even before tackling the 160km One Ride course which I have given little thought to, but know from the route profile will be seriously challenging.

Seven weeks of cycling, fundraising and organising to go. It’s going to get busy and hectic but I am looking forward to the challenge and I know that everyone is 100% committed to this cause and event! There is still plenty of time to donate to JDRF and this event, please support anyone who is participating in the event! You can donate through this link: PLEASE DONATE

Multi-day Cycling in Tasmania & My Diabetes

I recently spent 8 days cycling in Tasmania from Launceston to Hobart experiencing the amazing landscapes, the great cycling routes, and also the impact of 8 days cycling on my diabetes. This was my first time to Tasmania and it was truly a great experience, I will be back to experience more!

This was an organised cycling trip with my father and our partners which had been in the planning for some time. It aligned perfectly with my JDRF One Ride training and I was looking forward to cycling heaps of kilometres while is Tasmania. The trip including 8 days of cycling from Launceston to Hobart around the east coast, with one rest day and covering between 50km and 100km per day. This was going to be a great challenge for my partner (she rode he first 100km ride during the trip) and with the extra time I was planning on clocking up over 1,000km for the trip (which I did).

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Tasmania is a great place to cycling being easy to find quite and spectacular roads

Big days in the saddle are not foreign to me and I cope with these pretty well. Cycling back to back days though introduces new challenges being physical, mental and with managing my diabetes. I learnt a lot on this trip and this is especially important as I will be riding 6 days straight and nearly 200km per day when I ride to Adelaide for the JDRF One Ride at the start of May. So what were these new challenges I experienced over the 8 days:

  1. Physical toll: an obvious one but every day’s effort has a cumulative effect and without spending 4-6hrs in the saddle regularly this will be a very new experience for your body. Physical condition, recovery and diabetes plays a big role in how you feel each day.
  2. Mental condition: just cycling day after day, keeping your mind occupied trying not to think about the aches and pains, and trying not to think about the kilometres ahead becomes strangely more difficult each day. The joy of cycling can be lost quite easily over many days.
  3. Getting recovery each day: without being able to take a day off it only takes a bit of dehydration, poor nutrition or minor niggle to turn your next day into a disaster. It’s easy to miss one of these for any number of reasons but as soon as you get on the bike the next day you’ll realise the issue and once behind the eight ball, it’s difficult to get your body back in check.
  4. Changing responses to insulin (insulin requirements): specifically relating to type 1 diabetes, I experience a significant drop in my insulin requirements from day 1 to day 8. As an example, my morning insulin went from 2 bolus units and a basal rate of 0.600 on day 1 to zero bolus units and a basal rate of 0.400 on day 4. Impossible to predict these changes which then required constant BGL checking, eating and insulin adjusting along the way. There is then the reverse problem when the riding stops.
  5. BGL instability: with the cycling, the changing insulin requirements and the variable carbohydrate consumption is can be expected that your BGLs might be more unstable than normal (more of a roller coaster pattern). This instability has a big impact on how you feel, how you recover, what you can eat and how you sleep. Coupled with the other challenges this can take a pretty significant toll on you.
  6. Variable days, meal times and activities: I am a big advocate for consistency for good diabetes management and a group cycling trip doesn’t provide the most consistent environment with activities, times, meals, etc. changing every day. This is a real challenge for a type 1 diabetic.
  7. Food and drink: on a normal long training ride, you can consume just about any food and drink you like and your body will be able to cope with it (within reason) and then you can go back to your normal meals after the ride. When you are out on the bike for 8hrs each day to can’t just east anything and it is tempting to do so as you would on a normal training ride. Energy bars, coffee and high carb foods eventually wreak havoc with your stomach and then your overall feeling of well-being.

So having experienced the above to varying degrees on the trip, what will I be doing on future multi-day cycling trips to avoid them happening again. My biggest challenge was balancing my food and recovery with the changes and instability of my BGLs. With each day that passed my fatigue built and the challenge to eat the right foods and get a good night’s sleep (both impacted by up and down BGLs) took its toll. By the last day of the tip, day 8, I was tired and struggling. Next time I will be working on the following:

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The final climb of the trip to the top of Mount Wellington in Hobart. A tough climb especially with 1,000km in the bank, the weeks fatigue, and my BGL up & downs 

  1. Plan: goes without saying, plan for everything as a cyclist, a traveller and most importantly as a type 1 diabetic. This is both preparation and execution during the trip. I would highlight insulin requirements, food and hydration, and your means of achieving daily recovery as the most important.
  2. Regular checking BGLs: no excuses here, check your levels every 30 minutes to make sure that you know where your BGLs are. You can then adjust before they rise or fall too much. There was nothing worse than thinking about how good lunch was going to be for the last hour only to arrive and find my BGLs had gone through the roof and then I wasn’t able to eat!
  3. Conservative approach to insulin doses: it’s better to be a little high than a little low so I will reduce my insulin doses from what I learnt on this trip and also use a combo bolus (staggered bolus) if I need to make adjustments whilst riding. Avoiding big bolus doses and high carb intakes will help avoid big BGL spikes and falls.
  4. Try to maintain regular meals: that is breakfast, lunch and dinner, and make these meals similar to the healthy diet that you normal eat (low GI carbs, protein, fats and fibre). This consistency will help with BGL stability, stomach health and recovery which will all overall benefit you. My days’ meals would include: porridge, salad sandwiches and then a larger dinner, all meals having the carbs, protein, fats and fibres I need.
  5. Eat real food: don’t get stuck eating muesli and sports bars, gels and snacks from the bakery along with coffees as your daily ride nutrition. This will not only be detrimental to your recovery but also cause stomach issues after a couple of days. Sticking with a balanced breakfast, lunch and dinner, along with snacks like fruit, nuts and anything unprocessed which will generally have a higher nutritional value and be better for your stomach. For my snacks I like bananas, trail mix, dried fruits, vegemite/peanut butter/jam sandwiches or homemade bars/biscuits/cakes.
  6. Ensure you are well hydrated: it’s easy to not drink enough on the bike and then drink too much coffee at the café, making sure that you are drinking around 500mls an hour whilst riding is important and has a big effect on your performance and recovery. A recovery hydration formula is also beneficial for a little top up at the end of each day (I use Endura no-carb, NUUN and hydralyte).
  7. Communication: as a type 1 diabetic there is a good chance that you’re not going to be feeling 100% at some point on the ride, there’s no need to worry about this (you can still be the strongest cyclist and have a T1D issue) and it’s best to let others know how you are feeling so that they can help you out, even if this is just moral support.

There’s clearly a lot to plan and think about for a multi day cycling trip and being a type 1 diabetic just adds to the important items which you must stay on top of. Things don’t have to go perfectly to plan and as we know they generally don’t, but being well prepared and sticking to some of this simple steps will mean that you’ll go a long way to minimise the physical, mental and diabetes stresses from a multi-day cycling trip.

Training Variations & T1D Management

For the last couple of years my training has been very focused on Ironman and 70.3 triathlons with a couple of cycling and marathon events thrown in for something different. In training for these events I have learnt how to manage my diabetes and keep my BGLs very stable. Basal rates, when and what to eat and how my BGLs fluctuate depending on the intensity and duration of the session have all been figured out. My training sessions have generally been specific to a program including swimming, cycling, running, strength and recovery. In most cases the longest of these session was a 3hr cycling session but each different session, duration/intensity requires a specific plan for my diabetes. Although everyone manages their type 1 diabetes differently, I think that it is beneficial to look at the variations we all experience.

Below I have noted the way in which I have to manage me diabetes, nutrition and hydration for various cycling sessions. I have reviewed this recently as my training focus has changed to building endurance for my JDRF One Ride cycling fundraising and 1,000km ride from Melbourne to Adelaide coming up in May 2017.

Recovery (Zone 1)

  • Low heart rate, low power and high cadence
  • Aerobic nature of this exercise has a strong pull down on my BGLs
  • Require a lower basal rate to avoid a hypo (-20% for a morning session and -60% for an afternoon session
  • I use a drink with carbohydrates in it to assist maintaining BGLs and also good hydration, approx 30gr of carb for a 1 hour session

Aerobic (Zone 2-3)

  • Medium heart rate and power (as determined by FTP) and smooth pedal stroke/cadence with medium-long intervals
  • Aerobic nature of this exercise does pull down my BGLs but this does not occur until about 1.5hrs into the session
  • For morning session my basal rate remains the same as normal, but for afternoon sessions I need to reduce this rate by -60%
  • During these session I need to eat at the 1-1.5hr point of the session and then every 30 minutes after that. Depending on the session I need about 25gr of carb each time I eat and I eat a low-GI food for its slow release
  • I use a zero carb hydration formula for these session and try to consume 500ml per hour. I use a zero carb formula so that I can also drink without working about any carb intake.

Anaerobic (Zone 4-5)

  • High heart rate, high power and maintaining smooth pedal stroke with short-medium intervals
  • During these more “effort”session I need to increase my basal rate as the effort forces my body to release glycogen as I am pushing my threshold. I only do these sessions in the morning as I have been unable to maintain stable BGLs in the afternoon with this type of exercise
  • These sessions are usually around 1hr and with the rise in my BGLs I do not consume any carbs during the session. A post session meal is very important for recovery from these efforts.
  • I again use a zero sugar hydration formula and consume closer to 1L of fluid for the hour session

Like with anything to do with type 1 diabetes there are variations within variations which need to be managed as they occur. Always carrying high and low GI carbohydrates is critically important along with being willing to change your session if things don’t go to plan. If thing do run smoothly then my insulin and carb requirements run as per the chart below with insulin requirements dropping linearly and carb requirements increasing more exponentially as the length of the session increases. Being fat adapted I generally require lower carb intake early on in the session and then increase this intake as the time goes on. My basal rate drops to around 50% of normal around the 4hr mark but to maintain stable BGLs I do need to consume about 75gr carbs per hour, at this point through my body needs this to continue training.

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Chart shown the decrease in insulin requirements and increase in carbohydrates required over training session duration (note: active basal is 1.5-2hrs post the basal rate setting/time)

So the important things that I now work on (for my diabetes) to get through my cycling training sessions are:

Short Rides (1-3hrs)

  • Set adjusted basal rates 2hrs before starting including switching back to normal rate somewhere in the last 30 minutes of the ride
  • Carry  1 x gel (high GI) and 1-3 x bars (75-100gr of low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Know the turn-around points where I can assess how I am feeling and turn-around if things aren’t tracking well

Long Rides (3-6hrs)

  • Set adjusted basal rates 2hrs before starting and maintaining a lower basal rate for a couple of hours after the ride to avoid a delayed hypo
  • Carry  2 x gels (high GI) and 3-4 x bars (low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Have a route planned out and stick to it
  • Know stopping points where food and water will be available including at around 3 hours when some more solid food will be good to consume (bakery is a favourite for this stop)
  • Have a plan in place is things do not go to plan, this can include turn-around points, someone to come pick me up or public transport to get back home
  • These rides are safer to do with other people

Day Rides (6hrs+)

  • Set adjusted basal rates 2hrs before starting; it is very important to understand how long I will be riding for and lowering my basal rate accordingly
  • Carry  4 x gels (high GI) and 4-6 x bars (low GI carbs)
  • Adequate hydration and mixed formula (carry sachets to refill bottles)
  • Depending on the ride I sometimes use a small backpack to carry all of the supplies which may be required for a long day in the saddle
  • Have the route planned out which you’ve checked thoroughly and let someone know where you are going
  • Maintain communication with someone during the day so that they know you are alright
  • Know stopping points where food and water will be available which should include places to get more substantial food (service stations don’t count)
  • Have a plan in place is things do not go to plan, this can include turn-around points, someone to come pick me up or public transport to get back home
  • These rides should be done with other people
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Long days in the saddle are much easier and safer with a group

There are a lot of things noted above and they certainly don’t cover all of the ways that diabetes and BGLs can vary. Overall I find that longer rides are easier for my diabetes management as any fluctuations in my BGLs can be adjusted  more smoothly over the longer time. I also take the opportunity to consume a few extra calories (and treats) which on a normal day I wouldn’t be able to for fear of wild BGL swings. Most importantly, preparation/planning is key, regularly checking your BGLs is critical and then making adjustments (insulin, crabs, route, etc.) well before you get into trouble will ensure the safest and most enjoyable time on the road!

I am cycling to raise money for JDRF and type 1 diabetes research. I am riding 1,000’s of kilometres every month and will be riding from Melbourne to Adelaide in May 2017 to raise awareness of type 1 diabetes and show people that although living with type 1 diabetes is challenging, anything is achievable! Please donate to make a difference Donate Here!

All information provided in this piece is from the authors own experience and does not represent medical advice. See Disclaimer

My JDRF Fundraising Story

To kick start my fundraising for my JDRF One Ride participation I wrote an email which I planned to distribute to all of my contacts. I was aiming to connect my personal diabetes story with the JDRF cause and positive outcomes to get as many people to support me as possible. As I wrote the email though I became quite emotional as I realised how challenging living with type 1 diabetes is and how significant and life threatening the complications can be. It actually brought me to tears when I read it out to my fiance. Below is an adapted version.

As you may be aware I am a type 1 diabetic, I was diagnosed when I was 11 years old and I have been living with the condition for over 22 years now. Type 1 diabetes affects the body’s ability to produce insulin which is what allows the body to process sugar to create energy. Without insulin, the body literally starves as it cannot process food and the sugars which remain in the blood stream then cause other complications. To manage type 1 diabetes, I must keep my blood sugar levels as close to the normal range as possible by dosing insulin, something that is very complicated and difficult to maintain.

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You would have seen me testing my blood sugar levels (nearly 50,000 finger pricks) and giving myself insulin (over 30,000 injections) and from the outside I would appear to be a very healthy young man; at the moment I thankfully am. The longer I have type 1 diabetes though, the risk increases that the disease will ravage many of my organs and bodily systems leading to health complications including kidney failure, blindness, nerve damage, amputation, heart attack and stroke. The potential complications though are secondary to the daily challenges of keeping my blood sugar levels within a safe range whilst being active and living a normal life, all while trying not to stress about the condition. Type 1 diabetes requires constant management 24 hours a day, 7 days a week, 365 days a year. I have had type 1 diabetes for nearly 8,000 days, and counting.

Type 1 diabetes is one of the only conditions where the patient determines their own doses of medication (insulin), and that this medication both keeps them alive and can also kill them. Insulin is required constantly or at minimum with every meal every day of a diabetics life.

Type 1 diabetes has not stopped me living an active life, nor achieving my goals. Through school and university, my working life, completing many endurance events including an Ironman, and most recently getting engaged and starting to plan for a family. Along the way I have overcome the daily challenges of having type 1 diabetes which have included hypoglycaemic events (which can be fatal), always planning ahead and carrying my diabetes supplies and food, and trying to fit the strict nature of diabetes around the spontaneous nature of life. Although I have managed my diabetes well there have been plenty of scary incidents; being resuscitated by paramedics due to severe hypoglycaemia, breaking my hand during another hypoglycaemic event and various times where things just didn’t go to plan and I really didn’t know what was going to happen. I can’t imagine my parents stress when I was a teenager and now what my fiancé feels when I head out on a solo adventure with all of that to worry about.

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So I am fundraising for JDRF through the One Ride Event  because I understand how challenging living with type 1 diabetes is and it scares me that even with good control there are high risks of potentially fatal complications. I have also received the benefits of recent technological developments which have made living with type 1 diabetes so much easier; I am on an insulin pump and I use a CGM to monitor my BGLs. I am cycling 1,000’s of kilometres to inspire all type 1 diabetics that this disease should not stop them from doing anything their heart desires and that achieving their wildest goals is within their grasp. My plans for my fundraising activities can be found here JDRF One Ride 2017

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I am currently preparing for the Ballarat 70.3 Ironman on December 8th, my only triathlon for this coming summer and one which I really want to do well at. After that I will be focusing on cycling as many kilometres as I can to raise funds for JDRF, raising awareness about type 1 diabetes, inspiring other type 1 diabetics to join me, and also prepare for my ride from Melbourne to Adelaide in May 2017. There’s also an engagement party and a wedding in there which will be a lot of fun!

I have not previously done much fundraising and before starting to work with JDRF I didn’t really understand how important it is. JDRF has invested nearly $2 billion since its inception and has delivered a pipeline of innovative therapies and technology to people living with diabetes including my insulin pump and continue blood glucose monitoring which I have found absolutely life changing. By making a contribution you will have a direct and significant impact on the lives of all diabetics, making it easier to live a healthy and complication free life.

If you would like to donate and support me on my JDRF cycling journey please donate through this link Alex JDRF One Ride

I can honestly say that your donation will contribute to making a significant difference to my life and I will forever be grateful.

My 2yrs on CGM and Insulin Pump

In October 2014 I was formally introduced to the insulin pump and CGM. Up until that point my 18 years with type 1 diabetes was based around 1,000’s of finger pricks and injections. There was no real reason why I hadn’t investigated these amazing technologies earlier but I guess up until that point I was managing OK and just thought that managing diabetes was meant to be challenging. In saying that, my insulin pump and CGM technology has had an amazing positive impact on my life and I now find it hard to believe that I ever lived without them.

My journey onto an insulin pump and CGM started with my utter frustration that I was unable to target my insulin levels and BGLs around my increasing triathlon training loads and this difficulty and subsequent variability in  my BGLs meant that I was unable to get the most out of my training sessions. Trying to get BGLs right over night for morning sessions, for recovery after sessions and then for evening session was really difficult when I was using injections at meals and before bed only. The daily variations in training, recovery and food needed a much more flexible approach. I was very lucky to be put in touch with another diabetic triathlete who also worked for a diabetes tech company. She put me in touch with a fantastic diabetes educator whose passion and knowledge for sport and exercise gave me great confidence in her advice. Having managed my diabetes on my own for so many years, thinking that I knew everything that I needed to, it was humbling and fantastic to get advice which nearly instantly changed my diabetes life.

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Finishing 2015 Ironman Melbourne, one of my proudest achievements and one which may not have been achieved without my pump and CGM

Over the past two year I have achieved many things that I am really proud of as an athlete but especially as a type 1 diabetic. Some of my proudest achievements on my insulin pump and CGM have been:

  • First Ironman Triathlon in 2015 at Ironman Melbourne (Asian Pacific Championships) in a time of 9hrs 28mins
  • 600km unsupported ride through the Victorian high-country (one week after starting on the pump)
  • Multiple Ironman 70.3 triathlons and personal best times
  • Several open water swims
  • Cycling Gran Fondo’s including L’Étape du Tour (Stage 16 of the 2015 Tour de France)
  • First road marathon at the 2016 Melbourne Marathon in a time of 3hrs 1min.

Although I may have still achieved all of this if I was not on a pump or using CGM, using these devices has allowed me to train and races more closely like a non-diabetic athlete and have a far greater understanding of my physiology and why things happen (hypos, fatigue, poor performance, etc.).

For all of these great achievements there have been plenty of difficult and challenging times which have taught me a lot about managing my type 1 diabetes. Starting on the pump has also been the catalyst for me starting Type1Athletic and blogging about my experiences. Some of the great things which I have learnt from since starting on my insulin pump have been:

  • Able to maintain very stable BGLs overnight including accounting for a BGL rise when I fall asleep and the dawn effect
  • Achieve stable BGLs before, during and after training sessions including morning, afternoon and longer weekend sessions; all require different basal insulin rates and carbohydrate consumption
  • Allowed for finer insulin adjustments at any time to account for meals and activities; the change from single unit pens to 0.05 unit adjustments on the pump has been significant
  • No longer needing to carry around injections or pens
  • With the need to understand carbohydrates (carb counting) I have learnt more about what I eat and what is actually in my food; I believe that my diet is now healthier
  • With the need to adjust basal and bolus setups in my pump I have learnt a lot about how insulin works with my body and with the food that I eat
BGBC Image

So much information from my pump and CGM; this day in particular was great but having this information has allowed me to learn from every experience.

In terms of managing my day to day diabetes I believe that the development of CGM technology has had the greatest impact on my diabetes control. Prior to CGM I was testing my BGLs up to 30 times per day to provide me with the understanding that I needed to keep my BGLs stable throughout the day, especially when training. I started on the Dexcom CGM and have since started using the Freestyle Libre Flash Sensor, both sensors have provided me fantastic insight into my BGLs and made my day to day diabetes management a lot easier. Some of the benefits which I have found from using a CGM are:

  • No need to finger prick test!
  • Easier to check levels with the bonus of history and trends
  • Provide far greater understanding of BGL variations including from physiological processes, psychological states, high and low GI carbohydrates and exercise
  • No need to carry around a bulky blood testing kit any more
  • Improved athletic performance by making testing and tracking BGLs far easier (finger prick testing on the bike is certainly a challenge)
  • Some CGMs provide real time feedback which allow for trends and warnings to be setup; I see this especially being beneficial for young children who rely on their parents to check their levels, and people whose BGL awareness is not effective

Apart from a couple of years at University I believe that I have always had pretty good control of my diabetes. Before my insulin pump and CGM I thought that I had everything under control and I was satisfied with how I managed my diabetes day to day. Since starting on my pump and using CGM devices I now have better control and BGL stability, my understanding of how insulin, food and exercise effects my BGLs and physiological processes is far great, and I am far more educated about type 1 diabetes and exercise in general.

An insulin pump may not be for everyone but the development of CGM’s has been game changing for diabetics. Easier testing, BGL history and trends, along with warnings provide the best possible information for a diabetic to manage their BGLs. They can be expensive and this can certainly be a turn-off, but even using a CGM sporadically will provide you with a greater understanding of your diabetes. It is fantastic that technology is advancing so quickly now and I am excited to see what the future holds including advanced trails of a CGM closed loop system which is due to occur in 2017!

#All the information provided in this post is from the authors experience only and the opinions expressed are the authors only. See Disclaimer.

Melbourne Marathon Report

Race Summary

  • Time: 3hrs 1min (goal time was 3hrs)
  • BGL Checks: 10 (from 6:30am started warming up to 10am end of race)
  • BGL Range: 10.0 to 18.0mmol/L (much higher than I wanted)
  • Bolus adjustment doses required: 2 x 0.25 units during the race (somewhat ineffective but taking a very cautious approach)
  • Carbs Consumed: approx. 50gr during the race (much less than planned due to high BGLs)

On Sunday 16th October I completed my first road marathon at the Melbourne Marathon and crossed the line in a time of 3hrs and 1 minute. Although I have always been fit, I have never been a runner and many years ago the thought of doing a marathon was terrifying. I went into the race with the goal of running under 3hrs and I only missed this by a minute; I am really happy and proud of my performance. Marathons are really hard and I’d rate this as one of the hardest events which I have completed, as I write this several days later my legs are still screaming at me.

The lessons that I’ll take away from this event and implement for the coming triathlon season are important for me and for bettering my performance in the future:

  • Try not to get sick before a race; nothing I could really do about this and in the end I think that I managed it pretty well
  • Increase insulin doses pre-race to cover the BGL rise from my nerves and adrenaline, this will be more important for new events where it’s more difficult to relax
  • Stay hydrated during the race and not get dehydrated; this will involve managing my own hydration and not relying on the ‘aid stations’
  • Adjust insulin plan during the race if BGLs are running high, it is important to get fuel in during a race and get the carb/insulin balance better
melb-marathon-2016-13

Not sure how I look strong and happy at this point, just past 40km!

My training leading in the event was really good and a month before the event I decided on a goal time of 3hrs. I believed that if everything went smoothly I would be able to achieve this (though I wrongly calculated the per kilometre pace which made for some funny conversations in my head during the first 5kms of the race at 4 minute pace).

Two days before the event I came down with cold/fly symptoms which put me in bed from Friday morning. Feeling terrible with body aches and a blocked up head the only thing which I could do was rest, drink lots of water and hope that I would be feeling OK on Sunday. After months of training this was terribly depressing but I was determined to complete the marathon. With illness come higher and more irregular BGLs and I had to work really hard to keeps these within good levels for these couple of days.

With a start time of 7am I was up at 5:30am on race day and arrived in the city at 6am to get ready. My BGLs had tracked OK overnight and they were stable around 6.5mmol/L at this stage and I ate a small low carb protein bar to get some calories in before the race. My plan was to consume carbs during the race from about the 30-minute mark where my basal rate and the exercise would keep my levels reasonable stable. At 6:30am I jogged to the start line which was about 2km away, I used this as my warm-up. Just before 7am my BGLs had risen to 9.5mmol/L, I was not overly concerned about this as I expected them to plateau once the race started.

BANG! We were underway. I had decided to run with the 3hr pacer and just try to hold on to the finish line. The pace started at 4min/km and I pretty quickly realised that this was going to be a tough race and the pace for a 3hr marathon was 4:15/km pace! In my head this was scary, so I just focused on the runners around me and started ticking off the kilometres. In training I generally check my levels every 30 minutes to being with and then every 15-20mins after the first hour. I checked my levels at the 7km mark and they had risen to 16.0mmol/L, not what I had planned! I decided to give myself a small bolus dose of 0.25 units which I expected would bring them down. It was nice a this point when another runner asked me about my diabetes and said that his son had just been diagnosed. My Type1Athletic top must have been easily spotted and it felt great that I was able to tell him that type 1 diabetes had not stopped me from doing anything, including running this marathon.

Kilometres 10 to 30 passed without too many issues. I focused on having a good cadence and light ground contact and the kilometres just ticked over. I checked my BGLs every 20 minutes and they continued to be around 15mmol/L. I was nervous about giving a bolus dose and having a hypo. As I was feeling pretty good I continued with only another small 0.25 unit dose. I ate a low card protein bar at around the 1 hour mark and then a gel at around the 2hr mark when my BGLs started to trend down (but then up again after the gel). I was conscious of keeping hydrated and was taking water at every aid station. In hindsight a small cup of water every couple of kilometres really wasn’t enough and as the race progressed so did my dehydration. Sticking with the 3hr group until 35km, ticking over at 4:10 pace, not fuelled or hydrated, I then hit the proverbial wall!

finish

Winner are grinners; finishing with a lap of the MCG.

Although I had felt pretty comfortable up to this point the head cold, my high BGLs, lack of fuel and fluid during the race eventually caught up with me. Drained of energy and with my legs really hurting my pace dropped to 4:45 kilometres. Jogging, running, jogging, running, walking, jogging, the next 5 kilometres were a real battle. Never wanting to stop and with the MCG (the finish) visible, I just pushed as hard as I could. Walking through the two remaining aid stations I took down as much water as I could. As I got closer to and passed the 40km mark my pace quickened with a little boost of finish line adrenaline and I ran through the last kilometres feeling amazing that I was going to finish my first marathon and go oh so close that that magical 3hr mark. Crossing the line with barely the energy to raise my arms above my head, my whole body aching, my stomach churning and knowing that I was really going to suffer when I stopped, I could not have been happier. Best off all my family was in the stands of the MCG cheering me around that final lap and my best mate finished the half marathon only 10 minutes earlier, was also there to celebrate with me!

So a really challenging race both physically and mentally that I am super proud of. Starting with a head cold, running in 35km/hr winds, dealing with high BGLs due to being sick, not being able to fuel properly and then getting dehydrated all made this really really challenging. I always review my races and I will learn a lot from this event and hopefully not have to experience these challenges again (the ones which I can control).

From a diabetes point of view, the reasons for my higher BGLs during the race were (plenty to learn from here):

  • Illness; I had been suffering from a cold/flu for a couple of days leading into the race
  • Nerves/Adrenaline: Due to running my first road marathon with a challenging goal time
  • Dehydration: Dehydration can cause BGLs to rise at a more rapid rate
  • Carbs/Insulin: Trying to balance eating a small amount of carbs during the race but also dosing a small amount of insulin trying to avoid a sharp spike in BGLS
  • Exercising in the anaerobic zone; higher effort and heart rate sucking all the glycogen into my system for fuel

After going so close to 3hrs I’ll have to do another marathon to get under this magical mark. I’m also super proud of the other type 1 diabetics I saw out on course and also the people who I spoke to during the race about diabetes. I hope that we’ve inspired a few people to give something like this ago and not let type 1 diabetes hold them back.

Diabetes No Limits

Just another example that type 1 diabetes shouldn’t stop you achieving your goals, an article by type 1 diabetic and ex. professional cyclist Justin Morris on his experience completing the Simpson Desert Challenge. Posted on the Cycling Tips website it’s great inspiration for me knowing that we can push our limits under extreme conditions just like everybody else.

Image: Euan Pennington

Image: Euan Pennington

“As a cyclist who lives with type 1 diabetes I had a few extra challenges to overcome to ensure I could manage to race in such remote conditions. I was lucky to have an amazing support crew around me to ensure I was a-ok. To even be able to attempt such an event as a T1 diabetic is something that would have been considered impossible 10 years ago. I hope by giving this race a good go I will help open the eyes of my diabetes brothers and sisters.

The Simpson Desert Bike Challenge is more than just a race; it’s a race with a purpose. The Royal Flying Doctor Service (RFDS) provides life-saving medical attention to Australians living, working and travelling in remote areas. This organisation has saved countless lives over the years and is a lifeline to many outback cattle stations and townships which are otherwise many days’ drive from any medical centre or hospital bed.”

Click through to read more at Cycling Tips.

TFM Around the Bay in a Day

This past Sunday I rode with the Freedom Machine team in their annual Around the Bay ride supporting Zagame Motors. The Zagame group was huge (over 200 people) and the weather conditions were terrible (50km/hr+ winds) but the ride was a great success.

tfm

The TFM crew at the mid-ride stop, still smiling before the headwind return!

Details of the Ride

  • Distance: 150km including getting to the start
  • Time: 5:30am to 12pm including waiting at the start and mid-ride stop
  • BGL Checks: 20
  • BGL Range: 4.5 to 12.5mmol/L
  • Bolus doses required: none, adjusted basal program provided enough insulin
  • Carbs Consumed: approx. 150gr during ride (7am to 12pm) based on my BGLs and how I was feeling energy wise
  • Issues: ‘pump not primed’ warning which require a stop and re-prime

The evening before an event is very important, apart from organising all of my cycling kit I also figure out my diabetes plan which includes insulin (basal rate) and the food I’ll consume. For a ride like this I’ll usually take enough real food, sports bars and gels to provide up to 50gr of carbs for the first couple of hours after which I would restock. For hydration I prefer a no-carb mix as I can then always consume it no matter where my BGL’s are at (a carb loaded drink could not be consumed if BGL’s run high). With my basal rate I need to consider that although I was getting up at 5am to get to the start, the event wouldn’t actually start until 6:45am. I needed to increase basal a little for when I got up and then a little more for when the ride started. I obviously wanted to avoid a high or low whilst I was waiting for the event to start. In the end I set my basal to increase at 3am and 5am and then reduce at 8am and 10am to cover the ride duration. All in all, it’s a good hour to get things organised the night before an event.

On Sunday my alarm went off at 5am and I immediately checked my BGL’s which were running at 6.5mmol/l. A good start to the day! I usually try to get up and be training within 30 minutes so having to ride to the start of the event and then wait for around 1hr meant that I have to take extra care to maintain stable BGLs. Due to this I consumed a low carb protein bar whilst waiting at the start and I checked my BGLs every 15 minutes to ensure things remained stable, which they did. Setting off for the ride my BGLs were at 8.5mmol/L which was a good level with my increased basal rate and the cycling soon to kick in.

When cycling I usually check my levels every 30mins over the first hour, then every 20 minutes for the next couple of hours and for longer rides like this one I end up checking every 15 minutes as the risk of rapid BGL changes increases the longer I am riding for. With a strong tail wind, the first half of the ride was really fast and we were at the breakfast turn-around within 2hrs. I had consumed a muesli bar on the way down and my BGLs were dropping when we arrive. This was actually planned and I didn’t eat any carbs as we got close to the midway point know that there was food available there. I had a coffee, ate a banana and half a vegetable wrap at the stop which equated around 50gr of carb. For the 20 minute stop I would have checked my levels 4 times so that I ensure I did not go too high or low. The stop was only for 20 minutes so I did not give myself a bolus dose with any BGL increase to be limited when I started riding again. We ended up stopping for over 30 mins which meant that my BGL rose more than I would have liked to 12.5mmol/L. I decided not to give myself a bolus dose and after we started the ride back (into a 50km/hr+ headwind) I check my BGL every 15 minutes to make sure that this re-stabilised.

Riding back into such a strong and gusty headwind was really challenging. Obviously I was getting blown all over the road, the effort was high and the speed was slow, and in situations like this you can forget to check your BGLs and it’s easy to forget to eat. We were also responsible for getting the group to the finish line safely which meant constantly checking on how the group was going (not an easy task given the conditions). I was checking my BGLs consistently on the way back ate a sports bar and snickers bar (my treat on long rides) as well as mixing some Gatorade in my drink bottle for some extra carbs. I was able to keep my BGL’s stable on the way back and finished with a reading of 6.5mmol/L. After a quick shower I was able to have a good lunch with carbs (50gr), protein (omelette with extra egg white) and plenty of salad.

8-oct

Not perfect but very manageable, two spikes before the start and at the mid-way stop.

Overall the ride was not overly tough even though the wind made the return journey twice as long. From a diabetes point of view, it was a challenging ride having to manage a delayed start, riding with a group, at their pace, and generally not being in control of my own ride. Also having to monitor the group, provide assistance and battle the weather added to extra things to think about. I was able to manage my diabetes without an issue and to achieve this I made a point of doing what I needed to do, when I needed to do it (check BGL, eat and even re-prime my pump).

So some important things which helped me get through this ride:

  • Good organisation the night before the ride including setting insulin plan (basal) and laying out all the food I needed including calculating the nutrition/carb content and having some low carb options
  • Regularly checking BGLs throughout the event including every 15 minutes during critical times and later in the ride when insulin sensitivity increases
  • Making sure that I ate when I needed to which was not necessarily when the group stopped and eating only what I could best estimate the carb content of (no egg, bacon and relish rolls)
  • Letting people know when I needed to stop to re-prime my pump, confirming things were alright and then chasing back on to the group

Even with type 1 diabetes every event is achievable and all that is required is a little extra planning and following the process to maintain stable BGLs and performance.