I’m back now for my next exclusive check with Kris Freeman, world-class skier competing at the Winter Olympics this week. He is the only athlete there with diabetes. And on Saturday, it caught up with him. A blood sugar wreck killed his odds for taking a medal at the men’s 30K occasion, where he was a favorite (he dropped to 45th place after needing to lie at the snow mid-race to get a little). Naturally, he’s disappointed, but pushing his limitations.
Via phone from Vancouver Sunday afternoon:
DM) Kris, you have had two disappointing races in these Olympics so far, but you’re still breaking ground for diabetics at endurance sports. How are you feeling right now?
I’m discouraged, but I’m definitely not giving up.
I’m likely to go for a different Olympics. I like to ski, and I have skied with the best in world. I have defeated every skier on earth if you count all the race times — but just not all at once.
As much as it will stink to have a very bad Olympics, people have a tendency to think that is the only focus. We actually have a huge racing circuit, with the world championships every 2 years. I do not live my own life in academic blocks.
Additionally, there are many dominant skiers, but no one contender who wins everything… there are so many factors in this game and lots of things can fail. The blood sugar is definitely another factor that complicates matters.
I sort of wish that I could be more of a function model (for athletes with diabetes). I’m not really feeling like you right now, but I’m doing my best.
You have been so meticulous exercising your dosing strategies — can you inform us what went wrong in the 30k occasion Saturday?
Obviously the rate I chose was too significant. I’m sort of stratching my head since this event was like the race in Alaska, where I used the exact same dosing. But this is not the first time I’ve seen disagreements in my demands just based on venue and conditions. It was remarkably hot Saturday, so that was different, and elevation consistently makes a difference, although the altitude’s not that high here…
I used the exact same basal rate as in Alaska, and fed the exact same amount going in: 3 beverages in the very first 12k of the race. I was comfortable in the lead group, feeling rested, but then I got a ‘twinged sense’ that something was wrong…
The problem is that the feeling of low blood sugar and the feeling of the pace being too large is similar. Within three minutes I got to a stage where I couldn’t make forward progress. I pulled to the side of the course. People today fall out of races all the time, so that did not look unusual, therefore nobody was really coming to my aid. I yelled into the audience “Does anyone have any sugar?” Subsequently one of the German coaches came and gave me Gatorade and a few goo.
I considered just staying there. But then I thought, ‘It’s the Olympics, I’m going to complete the race’ At that stage, I’d dropped over 3 minutes already, which is a lifetime.
Can your adventure be helpful as a learning stage for additional Type 1s working to conquer endurance sports?
It’s definitely a science trying to figure this all out. I have been doing so for 10 years now, and I figure I could race two manners: I could be conservative with my dosing and receive respectable results, and that is OK. But to really shoot for the Olympic podium I need nearly perfect BG controller. The thinner the window I shoot for, the easier it is to overlook, so I haveta determine how narrow I want to go.
This was only the fourth 30k I have done since I changed into the Omnipod. I have definitely had success at the 15k with the bunny, so I’m going to continue working at it until I get it appropriate for different events.
I’ll have a meeting with my doctor today (Sunday) having to work out my best strategy for the 50k. Basically, we put out each of the factors, then guess at what went wrong… Maybe I could have been 25th spot when I hadn’t shot for this a tight window, but I would not be happy with that. I have been there before.
Are you working with a few famous endocrinologist then?
No. I’m working with a cardiologist at Vail, a very wise man who is constantly on the mobile phone with me, constantly talking through these items, figuring out it, and that all helps tremendously. If I’m stressed, by way of example, it has enormous impact on my BG levels along with my needs.
You can have the most brilliant doctor in the world, but when he’s distant, it is not that helpful.
What would you say to people who might say certain forms of game are just not possible for Type 1 diabetics?
I would say that they are wrong. Anyone saying it can not be done is not worth listening to. This is only the third time I will recall a blood sugar low with bad impact on a race, and it really sucks that it happened. But I think it’s because I’m not just hoping to maintain the race, but to be at the front part of the race.
I’m the first man who’s attempted to do it in this level, and I’ll continue to test. I might make more mistakes, but somebody’s gonna come along after me and do it better than I am.
I attempt to make the most of every innovation that appears. The Omnipod has helped me in the 15k, and I’m sure I will use it better in the 30k as well.
For sure CGM (constant glucose monitoring) is another innovation I’ll benefit from. I’ll spend too much energy as possible trying to get ahold of a single which will help me.
Speaking of CGM, what about OmniPod’s planned integration with the Dexcom? Won’t you one of the first patients to receive their hands on that device?
I’m sure I will. It’s nice to be in the forefront of the. New technology innovations will make it much easier to dial in dosing, etc., but there will continue to be sudden crashes and items in extreme sports. To a certain extent, it’ll still be a guessing game.
Grrrr, life with diabetes! By a previous dialogue with Kris on life as a world class athlete participates with Type 1:
What about drug testing for athletes that are competitive? Isn’t insulin considered a performance-enhancing substance?
Insulin is on the prohibited list to the international Olympic competition, but you can find a health waver if you’re able to prove that you require it. Obviously, I obtained the waiver.
It appears you’re the parasitic rival in these Winter Olympics. How do other athletes or coaches react to your diabetes?
Basically I so rarely have problems with it that the other athletes and trainers frequently forget that I have it. I have been diabetic for a decade, and I have never lost consciousness; I have only gone low in a couple of, but I knew something wasn’t right.
Otherwise I’m always incredibly ready. I’ve at least two trainers out on the course prepared with sports beverages — and have had this in every race over the previous four years. In that sense, the coaches are sort of questioning, “What is all this prep for?” I have to remind them that if I’m not entirely prepared, there can be severe consequences.
So that you don’t carry sugar yourself?
Carrying the extra weight would be a drawback, so I depend on the coaches’ help. It has worked well so far.
Last March, you ended up needing surgery for “compartment syndrome” on your thighs — how did that proceed with the diabetes? Did the physicians allow you to keep your pump on while hospitalized?
They wanted to understand what my everyday insulin regimen was, and I explained that I utilize a floating scale depending on my activity level. They did not really like that very much. But I had my main physician. He was by my side, therefore if (the surgeons) wanted to mess with me, they needed to get through him. I was quite aware that when my BG was out of whack, it would take much longer to cure.
Inform us about your diet.
It’s strictly controlled. I take in about 4,000 to 5,000 calories per day during heavy racing and training, then cut down to 2,000 calories when I’m not moving so much. Then I’m fairly low-carb. When activity picks up, I need more fuel.
How much carbohydrate do you say is the ideal amount?
If you’re not moving far, the answer is not really much! I really consider food as fuel. That’s the biggest key to maintaining my BG in control. My last A1C was at the mid-5s. I have had no A1C over 6 at the previous seven years.
Basically, I keep away from processed foods, foods which are high glycemic. I eat foods in their natural shape. As an example, I get much less of a BG spike from eating an orange than from drinking a glass of orange juice.
I like to understand where my food came out. If can not consider reason why I need that food, I do not eat it. I know that’s hard for many people, but that is just the way I do it.
As an athlete, you must be testing your BG daily long…?
Whenever I have a repeatable routine, it is so much simpler to handle my BG levels — such as when I’m at home and my activity level is more even, then I only maybe check my BG twice every day.
On the street and training? I check as many times as I have to. If I’m not in range, then I keep at it until I am. If my BG is too large, I just won’t go to sleep. I have been known to do 200 jumping jacks in my bedroom for BG back. I won’t break while my BG is large. Since I know my own body is not really resting… it is under stress. The human body is not supposed to be over 120.
You take a good deal of ‘correction’ doses then?
I do not have a corrective bolus if I’m at 180 or lower. My doctor and I think that the enemy of superior control can be great control… meaning if you’re at 170 and correct, then you frequently drop down to 70, then cure and bounce back up. It becomes a yo-yo effect.
So was there a special methodology that would let you accomplish extreme sports with a ‘bad pancreas’?
I just handled it like a science challenge. I started working with a doctor from Vail and the coaches. We devised custom insulin regimens. We actually hooked me up to pressure tests and heart monitors, etc., to test how different basal rates effect my body under different exertion states.
The most striking correlation is that when my BG gets over 200-250, the lactate level moves up. That makes your muscles go thick and tired and feel dead. I think that is a significant portion of it for individuals whose sugars run large alot. But if you’re really out of shape, what’s an anaerobic attempt, which in turn causes your BG rise.
Obviously you’re an exceptional athlete and guy. Are there any lessons to get us ‘routine’ diabetics?
Someone once said that I do not like hardship. My reaction is: who enjoys adversity? But I’m also quite driven. If I encounter hardship, I just face it. I struck blocks in the street, but I go around them and I don’t stop.
The surgery was a significant block, the diabetes has been just another… There are ways around them.
When anyone tells me I can not do something, it infuriates me. Even when I’m offered piece of cake at a party and I say no thank you, and somebody says “Oh, you’re diabetic so you can not have that,” it gets me angry. Do not say I can not have that. I CAN. I just don’t want to have a significant bolus and handle the consequences.
The very first message I received from my initial physicians was that my athletic career was which I couldn’t do it. Now it is 10 years later and look where I am.
I’m likely to compete for another four years, and do a different Olympics after this one. After that I’ll likely call it a career, and pack up and go to college…
Meanwhile, you’re doing a whole lot for a role model for children with diabetes, right?
I am hoping so. I visit eight camps for children with diabetes. I go and attempt to send the message that as long as you remain in good control, you are able to do anything. These children get told over and over again that they can not do something because they have diabetes. That’s just wrong.
Were there any diabetic athletes who served as role models for you?
Few. There was Gary Hall Jr.. (Olympic swimmer), but his occasion only takes a couple of seconds. My game is a totally different thing. I couldn’t find a lead-level endurance diabetic athlete. So maybe I’m the first.
Btw, why are you nicknamed “Bird”?
Growing up I was a Bind skier. I got the nickname FreeBird from leaping. When I got into cross-country, apparently 3 syllables was too much (chuckles)
Well, this diabetic bird may not be soaring in the moment, but you’re doing us proud, Kris. Thank you!
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