When were you diagnosed with Type 1 Diabetes?
I was diagnosed in January 1991 at the age of 16. My father had been a type one diabetic for 4 years, having been diagnosed at the age of 40. I had probably noticed that I had displayed some of the symptoms of diabetes now that I think about it. I just either didn’t do anything about it or didn’t put the two together. At the age of 40 that is now 24, nearly 25 years ago.
I had a part time job at the weekend and after school at a ten pin bowling alley and my father noticed that I was taking a 2 litre bottle of pop to work whenever I did a shift and drinking all of it. I had the other symptoms of urinating a lot and feeling tired. We did a blood test at home with my father’s test strips and it was about 9 I think. Not terrible but clearly not normal. We didn’t have meters back then! So I went off to see the nurses at the hospital.
I must be a bit weird as it was quite a novelty at first!! The hospital suggested that I try and control it with diet for a week or so. Then we tried tablets for another week or so and finally on to injections after that. It didn’t come on in a mad rush. So there was no hospital admission. The main concern at the time was that it was my seventeenth birthday in September. I didn’t want anything to stop me being able to drive.
I think it became more of a big deal for me once I was on injections. All of a sudden there is the possibility of hypos and the impact of carrying glucose, blood tests and it being such a huge part of your life. However, I am very pragmatic in life and there was little I could do about it, so I just got on with things.
My parents were very supportive. They understood the things I would need to do from their experience when my father was diagnosed not that long before. I liked playing golf at the time and they even bought me a new bag and trolley so that it wouldn’t be as heavy and might make it less of an effort for me!
Why did you choose an Animas insulin pump?
I was on injections when I was first diagnosed. Hypurin protamine zinc and I can’t remember the other one. Pork and beef they were back then though. I had a problem with losing warning signs not long after diagnosis and the hospital felt it might have been due to the human insulin that I was on in the first few weeks, so I went on to the old version. One or two incidents at first like stabbing my thumb with the syringe. A few hypos here and there, but not too bad.
When a new consultant started she suggested that we try the human insulin again and I am always game for something new. Lantus had just come out, so I tried that as well. This meant that I could use a pen again too. It went well and I had a few years on those.
My main issues with control were when I worked unusual hours. I am an electrician and at the time was working some late nights and into the early hours. Missing meals or moving meal times messed up my control sometimes. I had also started to do more exercise too.
I realised how important blood pressure is rather than just the HBa1C and so had started to do some running. So far, a couple of half marathons and a few 10k runs. I had heard about insulin pumps through odd articles in the Diabetes UK magazine and the name itself conjured up images of a machine pumping uncontrollable amounts of insulin into me. Not something I fancied.
However, when I went to an appointment one day, my doctor, the specialist nurse and the dietician were all there. It looked like something of an ambush! They suggested a pump to help with the areas I struggled with an after explaining it to me, it didn’t sound too bad. So, off we went again, time to try something new.
Having been a bit of a cyclist previously and I stress a bit, I thought that I could combine this with running and maybe try a triathlon. Having had a fear of deep water I had made efforts to overcome this so that I didn’t pass it on to my two daughters. Swimming, cycling and running meant it had to be a triathlon. Given that I was so weak on swimming, I needed to do some swim training. If that was the case, it had to be the Animas® Vibe® Insulin Pump & CGM System. I could swim with it on and this meant my control was much better.
The other big thing for me with an Animas insulin pump is the Continuous Glucose Monitoring (CGM) and that it works with the pump. Using a CGM sensor means that I can attempt longer distances and events and know what my blood sugar is at any point. I can look at my normal day to day routines and get real data to make decisions myself to make changes.
I don’t wear a sensor all of the time. I can wear one for a specific reason to look at my basal rates or what happens after exercise. I can wear one for training times or when doing an event such as Ironman. Or sometimes I wear one for longer periods because it’s great to see how things are going. I just love the fact that it works with my pump and I can see the blood glucose level on the pump without needing any extra equipment.
How did your Animas insulin pump change your life?
First major pump change? Shaving off my hairy chest! I am never one for doing things by halves and when the nurse said that I was quite hairy and the cannula might not stick well, I went home and shaved off all the chest hair! Maybe a little over the top, but they stuck well after that.
Otherwise the pump was a revelation. I could be so much more flexible now. I had been increasing my food intake at different times of the day to prevent hypos. Now I could just adjust my basal insulin. I don’t have to have mid-morning and mid-afternoon snacks now. If I wanted to miss a meal or have it later, I could do that too. This was great. Funny work shifts were much easier. I could simply adjust my basal rates and eat later rather than “going low” because I had moved from my normal routine.
On MDI I had my regime to fit a standard day. If I was working at a time when I would normally have been at home, I always seemed to end up low unless I remembered to eat. Now I could make adjustments.
Exercise was a huge change for me. When I had increased running distances before, I had been taking on more carbs to fuel them. On my first half marathon I had drunk so much orange juice beforehand I felt sick for 8 miles. I virtually sprinted the last five miles as I felt so much better. Now I could reduce my basal rates. Swimming was always a worrying one, taking on enough carbs to stop a hypo and then sticking your head under water is not pleasant. Now I didn’t need to do that. It was a little scary at first.
When you have always eaten or drunk something before exercising for 21 years, to try a few adjustments on a pump and then not do this, seemed very odd. It was something I had to do in steps and keep trying it a little more and a little more. As my confidence increased, I was able to try more experimentation with the advice I had been given. It has reduced the impact that diabetes has on me during everyday life and sports.
What sport do you practice, and how has the Animas® Vibe® Insulin Pump had an impact on exercise for you?
The first year on a pump was a huge change for me. HUGE! I then went to the Animas Sports and Exercise Weekend and it was a bigger change still. Here there were people with real experience and real life advice. I had completed some sprint triathlons already and had toyed with the idea of doing an Ironman event. When I got here, it seemed anything was possible.
There were people who had achieved all sorts of things. So, what could I do next? I was doing more and more cycling already, so when I heard about the possibility of riding from Brussels to Barcelona with a group of type 1 diabetics I thought I fancied that. So I used the advice from the event and made some more changes. I did more training and put the Ironman on hold for a year. 2013 was the year for a 1300 mile ride, 22,000 metres of climbing over 13 days.
It was fantastic. I loved every minute of it. I made some great friends and confirmed to myself that I could attempt anything.
So 2014 was Ironman year. A 2.4 mile swim, followed by a 112 mile bike ride and then a marathon to finish it off. On 27th September 2014 I completed Ironman Mallorca in 15 hours five minutes. Not an elite time, but it was a massive achievement for me. From a kid that was terrible at all sports at school and then got diabetes, this proved that I could achieve anything. I have been better at sports with diabetes than I ever was without it. It’s just something I live with.
There are clearly lots of things to think about when you are diabetic and training so much. I adjust my basal rates during exercise and afterwards, I have to allow for how many carbs I need an hour and monitor my blood glucose levels. Preparation is a big thing. But then if you speak to anybody doing an Ironman, they are considering some of these too. Certainly the need for carbs over such a long event is there for them as well.
What are your main day-to-day challenges with living with Type 1 diabetes and how do you cope with them?
Living with diabetes is a constant thing. It’s there every minute of every day. I have very rarely let it get me down, but then I am normal. We all have our bad days. Overall, I try not to let it affect me too much and aim to do whatever I want and just work out how to make the diabetes fit around me. I make mistakes like everybody. I have hypos, I have days when I am high. I fancy eating something and forget to bolus or don’t bolus enough.
On the big bike ride, halfway across France I didn’t bother washing my hands at lunchtime as I was in a hurry and did a blood test and was 19. So I had a bolus to bring it down and went hypo at the bottom of a huge climb! There had been an energy gel on my hands and I was nowhere near that high. But I got through it.
Being on a pump has made a normal life so much easier to achieve. It makes life much more flexible and that means I can do whatever I want without as much planning. I like to think that I have tried anything I have fancied doing and have not let diabetes get in the way.
That has been good for me in many ways. I have had a fear of heights and jumped off the sky tower in New Zealand and a fear of deep water and completed a 2.4 mile Ironman swim in the sea. I tend to think now that anything is possible and have met many other people that have proved that is the case.
What would you say to someone who has heard your story, also lives with Type 1 diabetes and now wants a challenge of their own?
I would say that anybody who fancies doing a challenge should get on with it and do it. There are many people to give you help and advice on whatever you need to know to control your diabetes while you complete your challenge. Just see it as part of the planning. You would plan your bike ride, your run, your expedition. It’s just a little part of that process.
If I can ride 1300 miles across Europe or complete an Ironman event, then anybody can achieve their goals. I’m not an athlete. I was last in every cross country run at school and rubbish at every sport I tried. But I have turned that around after I was diagnosed. So to go from where I was to where I am now proves that the diabetes has not been a factor. It’s just something to bear in mind. My only other comment would be to tell me what the challenge is please? I might fancy doing it with you!
What advice would you give someone who has just been diagnosed with Type 1 Diabetes?
Find out how to manage your diabetes so that you can still do everything you did before. Anything that you had planned before can still be achieved. There is so much more knowledge available now to help. The methods of treatment have come on such a long way. There are many ways to talk to other people. I have met and talk to other diabetics from all over the world. You can get all of the information you need to live a normal and challenging life. But challenges set by you. Not by your diabetes.