Type 1 Diabetes Training

Training For IRONMAN Kona with Type 1 Diabetes

BY Ben Griffin

Training for an IRONMAN is complex without having to deal with Type 1 Diabetes. But that hasn't slowed down Patrick Devlin, who will be competing this year at IRONMAN world championships in Kona. Find out how he and his team are showing the world that Type 1 Diabetes doesn't have to limit any athlete.

Patrick Devlin is a 32 year-old triathlete planning to undertake the IRONMAN World Championships in Kona later this year. It might seem like there’s nothing especially remarkable about that, until you realize he was diagnosed as a Type 1 diabetic 8 years ago. Patrick is a proud champion of Diabetes Sports Project, which aims to educate and inspire diabetics to live healthy, responsible and active lives. He will be racing the 2018 Ironman World Championship on behalf of Ironman Foundation, to show the struggles of life with diabetes, but also that it is possible to overcome it and achieve your dreams.

Ben Griffin: How did you get into long-course triathlons?

Patrick Devlin: Growing up I played basketball and ran track, specifically the sprint events like 4×100 and long jump. Ask me to run a mile (let alone race an IRONMAN) and I would laugh in your face. After high school I did not really get involved with sports except for the occasional pickup basketball game.

It wasn’t until after I was diagnosed as Type 1 Diabetic in 2010 that I got into endurance sports. I started out with a 10k fun run and enjoyed the training process and the feeling of crossing the finish line… It just snowballed from there. Next was a sprint triathlon and at the time, finishing that event felt like I had finished an IRONMAN and ultra marathon on the same day!

I was hooked and began signing up for more races and longer distances. The closer I got to the sport, the more people I saw finishing the long course races, which made me think, can I do that? After spectating the 2013 IRONMAN Texas I knew that I had to give that distance a shot. I registered and began training. I was always thinking that if I were to finish that race, that I would not do another. And just like many before me, as soon as I crossed the finish line I was itching to sign up for another, and another… pretty soon I had 4 long-course finishes under my belt.

BG: How did you find out that you are a type 1 Diabetic?

PD: I had just returned home from a work rotation in Malaysia and my wife noticed that I had lost some weight. It wasn’t surprising to me because at the time I really didn’t enjoy Asian food. We didn’t think much of it but as a few months passed of being back home, the weight continued to come off.

We made an appointment with our family doctor and the first thing we noticed was that I had lost about 30 pounds. Normally I was about 150 pounds but I was down to about 120. The warning signs for Type 1 diabetes are excessive thirst, exhaustion, dramatic weight loss over a short period of time, and frequent urination (and others). I could check every one of those boxes.

Sure enough, my initial blood sugar reading was over 1000 with normal being 80-120. It was quite a shock to the system to have been a tremendously healthy man for my entire life and to be told that I had an autoimmune disease that will stay with me forever. I began taking insulin, adjusting my lifestyle, and within a few weeks I began to feel healthier and return to a healthy weight.

BG: How does being a type I diabetic affect your ability to train for an IRONMAN?

PD: IRONMAN training for anyone is a huge challenge. And as a Type 1, I have to constantly monitor my blood sugar to ensure that it stays in a normal range. If it goes too high (hyperglcemia), then my body goes into overdrive to attempt to right itself. The potential to go into Diabetic ketoacidosis is the main concern. This means that my body tries to break down fat too fast, causing my blood to become acidic. On the other side of the spectrum, if I take too much insulin and my blood sugar falls, I run the risk of losing consciousness.

A normal person training for an IRONMAN has to take in enough carbohydrates and calories per hour to maintain energy levels. I have to do the same thing but also ensure that I take enough insulin that my body can process all of those same carbs and calories without shutting down.

Things like the weather, stress, altitude, and effort levels all play into how much insulin per each gram of carb I need to take. Over the 12-17 hours of a full IRONMAN, I am constantly monitoring my blood sugar relative to all of my surroundings, both internal and external.

BG: Obviously monitoring your blood sugar levels is very important. How and when do you check these?

PD: Thankfully technology since my diagnosis has increased exponentially—I use three devices to maintain my blood sugar. First I do fingerprick tests 2x-3x per day, which give me a measurement of my blood sugar at a single point in time. Then I take that measurement and input it into my insulin pump. I use a tubeless pump called Omnipod. It mounts directly to my body and provides a constant stream of insulin, 24/7. The pump will take my measurement and tell me if I need to take additional insulin or eat a small amount of carbs.

The third device is called a continuous glucose monitor. (It’s called the Dexcom G5.) It’s also mounted to my body and constantly measuring the sugar levels of my interstitial fluid. This means that it’s not a 100% accurate blood sugar reading, but it’s usually within 10%. Throughout a race, I can look at my receiver and see an estimate of my sugar, along with a trend line that gives me an idea if I am falling or rising. These three devices are critical to me in my everyday life, and crucial during endurance events like IRONMAN.

BG: Have you encountered any ‘bad’ situations due to your blood sugar dropping too low to too fast?

PD: Typically when sugars start to rise or fall quickly, I am able to stop my workout and address it without issues arising. That being said, during everyday life I have had instances where my sugar has been extremely low (27 is my lowest reading so far) where I have become disoriented. Thankfully, the people around me on a daily basis know what I have to deal with and can assist me when needed.

When my blood sugar is low, I will look for fast-acting carbohydrates like orange juice or Coke. Usually within 10-15 minutes my blood sugar has risen to the point of safety and I can return to what I was doing. If this happens during a workout, it is very difficult to resume the workout until my body has recovered and my sugar is stable.

BG: How are feeling about that racing Kona this year?

PD: The opportunity to race IRONMAN World Championships as a part of the IRONMAN Foundation is a tremendous one. It is a great opportunity for myself personally as well as for my team, Diabetes Sports Project. We’re continuing to show the world that people like me, young and old, can thrive with diabetes.

My training is coming along well. Right now I am getting back into good habits and starting to see results, specifically with my recovery between workouts. Sansego coaching has been the key here by loading workouts specific to my level and slowly building the intensity. We still have months to go but I am very excited thus far.

BG: Any specific goals for the race?

PD: I want to set a new personal best. Currently my best is 13:44, and that was self-coached. My expectation is to improve that number significantly.

BG: What motivates you during training and racing?

PD: My family. I have an eighteen-month old son who obviously won’t remember any of this, but he inspires me to constantly improve myself. My wife has always been a huge supporter, so I want to make this opportunity worth it for her. Ideally by putting in the work and finishing early enough in the day to go out for a victory dinner!

Lastly, the Type 1 diabetic community motivates me. There are people diagnosed every day and I feel obligated to ensure that they know their diagnosis, while incredibly serious and lifelong, does not have to limit their capabilities.

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The Ultimate Full-Distance Training Guide

Training Guide

This guide is designed to be used as you train for a full-distance triathlon, with in-depth information on every part of the process. Each chapter is packed with tips, workouts, and insights from triathlon coaches, to give you all the tools you need to succeed.

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About Ben Griffin

Ben Griffin, AEP is an exercise physiologist and coach with Craig Alexander’s Sansego Coaching Team. He is a 14-time IRONMAN finisher (PB of 9:15) and enjoys helping both age-group and professional athletes reach their goals.