Editor's Note: Have you tried cross-country skiing? It ain't for the faint-of-heart, even if you don't have a chronic disease...
Kris Freeman, 26, is the number one cross-country skier in America and the only 2006 Winter Olympian to compete with Type 1 diabetes. He's currently training for the 2010 Games in Vancouver, where he's poised to be the first American since 1976 to earn a medal in cross-country skiing — a sport typically dominated by Scandinavian and Central European athletes.
I was lucky enough to meet him recently at Eli Lilly and Co, the insulin-producing company that sponsors him. He kindly agreed to talk with me and my DiabetesMine.com readers about what it's like competing at the Olympic level with diabetes. Here's what Kris had to say:
KF) When I was first diagnosed the doctor I saw did indeed tell me my career was over. I wouldn't accept that. I researched the treatments available to diabetics. I found that fast-acting insulins such as humalog had only been on the market for four years and were having a huge impact on diabetic care. I decided that since the insulins had only been on the market for such a short time that doctors probably didnt really know what was possible for a patient using them.
DM) How often do you interact with your doctor or CDE? Do you always have one of them by your side when you train and/or compete?
KF) I use my doctor as a resource not a life line. I see the Nordic US Ski team doctor for advice and prescriptions. I get my A1C tested at a local clinic or by the US SKi Team. I only interact with my doctor when I have a problem or read about new medications that I am curious about. As long as my A1C is under 6 (last 3 A1C tests averaged 5.7) I choose to stay independent in my treatment. This is my body and my disease and I trust myself to make the right decisons.
At races, my coaches carry a glucagon kit, which they have never needed to use, as well as a glucose monitor and Humalog for use immediatly after the race.
DM) What's your basic strategy for avoiding hypoglycemia? Do you have a particular "starting sugar"? Do you eat glucose tabs? Drink Gatorade during ski races?
KF) I like to start my races with a glucose level between 100-120. For the first mile of a race my glucose actually rises due to adrenaline that releases sugar into my blood stream. After an initial rise it begins to gradually decrease. In longer races (15-25 miles) I will take "feeds" at the top of downhills. "Feeds" are bottles of sports drink that are handed to me at the top of descents. I drink from the bottle while gliding downhill so as not to lose any time. Most XC athletes utilize this technique, so it's not unique to me.
DM) Have you had any particular hypo incidents or "close calls" that taught you some important lessons about cross-country skiing with diabetes?
KF) On two occasions over the past six seasons I have had low blood sugar while racing. They both happened in longer races when I dropped my feed while taking it from my coach. I now have back-up feeds in case a hand-off is botched.
DM) What are some other things you learned about competitive sports and diabetes by trial and error?
KF) I have learned that staying as relaxed as possible in all situations is key to good glucose control. Stress and nerves make controlling glucoses much more difficult. I have used our team psychologist to come up with strategies and techniques to stay relaxed in any race situation. Whether I am at a National-level race in Utah or the Olympic Games in Italy, I approach every race the same.
DM) You've been acting as Eli Lilly and Co's "Ambassador" since 2001. What does that position entail? And why did you choose to do it?
KF) I chose to be an ambassador for Eli Lilly's "Lilly For Life Program." The program honors people with diabetes who live outstanding lives despite their disease. No one should let diabetes stop them from accomplishing their goals. My role is to promote the program while traveling around the country. I think it's important to show other diabetics the stories of people who do not allow their diabetes to get in the way of their dreams.
DM) You didn't get the medal you wanted this year in Italy, so now you've stated that you're "going for gold" in 2010 in Vancouver. What will you do new or differently to prepare?
KF) Leading up to the last Olympics I was sucked into a training program that I did not believe in. I was constantly assured that I was training properly to be the best in the world by my coaches but I felt something was wrong. I ended up racing below my potential so I am now training more independently. I am training longer hours than anyone else in the country, and I feel great. I should be in top form at the World Championships in Japan this February.
DM) What about the diabetes in your personal life? How knowledgeable or involved is your (yes, sorry ladies) girlfriend on that front?
KF) I don't like to depend on anyone to treat my disease. I stay as independent as possible. That said, my family and girlfriend have learned a lot about the disease just from being around me. They know how to administer glucagon, give an insulin shot, and to test blood sugar.
DM) Finally, if you had just one "sound bite" to share with the diabetes community, what would you say to them?
KF) I would say that this is the best time in history to be a diabetic. The treatments available are light years better than they were even 10 years ago. With this medicine at your side there is absolutely no reason that you shouldn't go after your dreams, whatever they may be.
Thank you, Kris. We are humbled.