1) What type of Diabetic are you?
A: I have Insulin Dependent Diabetes Mellitus (IDDM), or Type 1 for short. In hebrew it is Suceret Neurim (children's diabetes).
2) Why don't you stop eating junk food and do some exercise then you will be fine?
A: You are confusing me with someone with Type 2 diabetes and you should probably do some research before opening your mouth next time.
3) Why are you boring me with listing your sugars and what you ate? If I wanted to see what people ate I would go to Instagram.
A: It is important for Type 1 diabetics to understand that what they eat, how much insulin they take and how much activity they do affects their blood sugar. Better understanding of how our bodies behave will lead to better control and less complications in the future.
4) Are you a medical professional?
A) No. But I am a doctor.
A) I have a PhD in computer science.
6) So! How does that give you the right to talk about long distance cycling and diabetes?
A) I am not telling anybody how to do anything, or live their life in anyway. I am building a repository of information based on my own experience with endurance training and living with diabetes in the hope that some people might benefit from my experience or possibly get in touch and help me. I have been cycling a lot longer than I have been diabetic, never in competition, but I have done track cycling, road cycling and some time trials. I have watched cycling on TV not just the Tour de France but many other races that Eurosport show throughout the year. So I know stuff. I know a bit about cycling, not much about endurance training but I am learning and a lot about diabetes.
7) How do you know so much about diabetes?
A) When my brother was diagnosed with diabetes 20 years ago I learned about it then. I even spent a week following a doctor around a hospital who was an expert in diabetic complications. That was a real eye opener. When I was diagnosed there wasn't much more to learn in theory just the day to day living with a disease that you just cannot get away from.
8) What is the difference between long term and short term insulin?
A) The long term insulin is my basal dose. I take it once a day (in the evening). It lasts in my body for around 24 hours and helps to keep my blood sugar in check so that if I eat something small I usually don't need to add any insulin. It also helps manage the sugar created from breaking down glycogen and fat. The short term insulin is my bolus dose, which is used to counterbalance large intakes of carbohydrate. It means that I will not be too high after a big meal, as long as I get the dosage correct.
9) Why are you doing a sport that could be dangerous for your diabetic condition?
A) Since I was diagnosed I decided that it wasn't going to hold me back. There are many professional and amateur athletes with Type 1 diabetes and I take inspiration from them. There is even a team of professional cyclists (Team Type 1) made up of predominantly Type 1 diabetics. I love cycling, I always have, since I was very young. I know its doable with my condition so the question is just getting it right. I have regular meetings with medical professionals who help me manage my condition so that should keep me safe from harm.
10) Why stay fit?
A) Controlling ones diabetes is much easier if you are healthy. Fitness, exercise and healthy eating make managing diabetes easier. Not easy, but easier. Also keeps reduces the chance of heart disease and vascular disease which diabetics are in a high risk group.
11) What exactly is the problem with doing all this exercise when you are diabetic?
A) The problem is that if I do not eat enough (sugar/carbohydrate) I will have hypoglycemia (low blood sugar). It does not feel very nice and if left untreated (treatment is eat sugar and quickly) then I will pass out and eventually (matter of minutes/hour or two) die!
12) Thats insane are you sure you want to risk that?
A) Yes, I am quite careful and check regularly so I know if its about to happen.
13) So why not just eat shit loads of sweets and bread then you will never be low?
A) Actually if I ate loads of sugary foods and still took more insulin I could still have low blood sugar (and probably be very fat). But I don't think that is what you are getting at. I cannot simply just eat and not take insulin as I will end up with very high blood sugar. This is very bad long term and if not dealt with I could end up in a coma (easily resolved with an insulin drip) or ketoacidosis which is very unpleasant. Assuming those do not happen having high blood sugar that doesn't cause these problems causes diabetic complications later in life. These can be peripheral vascular and nerve degradation (which can lead to gangrene and amputation), loss of eyesight, loss of kidney function.
14) Thats pretty bad, you should look after yourself.
A) Thats the point. I get a urine test once a year to check kidney function. I have an eyetest once a year where they check my retina to make sure its ok. I have a sensitivity test once a year to check my feet. I have a blood test 3 or 4 times a year to check my long term blood sugar control and as I said I regularly meet with doctors, nurses and dieticians to help keep everything in check. I check my blood sugar at least 5 times a day and make sure to adjust my insulin according to what I am eating and what kind of activity I am doing.