While doctors once steered people with type 1 diabetes away from vigorous exercise, the development of new monitoring and insulin delivery technology has prompted them to change their tune. "The sky is the limit. From an athletic perspective, there's no type of exercise a person shouldn't do, as long as they're willing to monitor and manage their diabetes," say Larry Deeb, past president of medicine and science for the American Diabetes Association. Previously, doctors warned that sudden uncontrolled dips in blood sugar levels that often accompany intense exercise could cause fainting, seizures, and even comas.
A manifestation of the new attitude: Team Triabetes. It's a group of diabetic athletes, mostly men, who are committed to pushing their bodies to the limit. Many members of the group plan to compete in Ironman races, grueling contests that feature a 112-mile bike ride, a 2.4-mile swim, and a 26.2-mile run. It may seem like insanity for a diabetic to do this, says Peter Nerothin, one of Triabetic's directors. But he claims the intense training demands such a thorough and intimate understanding of his body—and how blood sugar and insulin levels react to physical stress—that he's also better at controlling his blood sugar levels when he's not training.
Deeb, an endocrinologist, isn't surprised. "Guys training at that level pay incredibly close attention to their body," he says. Nerothin describes diabetes as a bit like doing a complex multifactorial equation: To control it well, you have to have a precise understanding of how certain foods, sleeping habits, or stresses, for example, come together to impact blood sugar levels.
But is such rigorous exercise really safe? I asked Deeb. "Absolutely," he says, as long as athletes monitor themselves closely during training and races. Some doctors might still discourage type 1 diabetics from intense exercise, he says, but that's probably just because they don't have much experience working with people with diabetes. His advice: "Find another doctor."
Team Triabetes isn't just for hard-core, elite athletes. While the "captains" participate in an annual Iron Man race, as well as clinical studies that will help researchers understand in greater detail how exercise affects diabetics, other members of the group can organize more modest outings, such as marathons and mountain climbs. At the moment, in fact, the group is looking for new recruits. If you're interested in signing up, click here. And if you want to see what you might be getting yourself into first, here's the blog of one current member who transformed himself from a self-described couch potato into a triathlete.