Pump it up - Adventures of a type 1 triathlete with insulin pump
Pump it up - Adventures of a type 1 triathlete with insulin pump
Please visit my new blog here: Pump it up - Adventures of a type 1 triathlete with insulin pump

Diagnosed at the age of 5, I have been a type 1 Diabetic for over 29 years; being on an insulin pump for 11 years now. I took up triathlon in 2011 and am hooked ever since! Being diabetic doesn't stop me from doing what I love - swimming, cycling and running!

Intricacies of racing with Diabetes

Eva29by Eva29Apr 24th 2013
Planning the next four weeks of my training with my coach Andy, it suddenly dawned on me that my first triathlon race of the 2013 season is exactly 4 weeks away! It also occurs to me that for the first time ever I won┬'t need to worry about the logistics of racing with an insulin pump that isn┬'t water proof!

Every diabetic triathlete out there can tell you a thing or two about the intricacies of racing with Diabetes. The question I get asked the most is ┬"What do you do with your insulin pump when you race, in particular during the swim?┬".
For those that haven┬'t seen an insulin pump, here is a picture of mine:
Intricacies of racing with Diabetes
I have been fortunate enough to have been given a new insulin pump earlier this year which is totally waterproof but my previous pump wasn┬'t waterproof; not even for a quick dip in the water. This of course meant that I had to take the pump off before putting the wetsuit on which for me as a diabetic isn┬'t as easy as that:

At most races there is an mandatory race briefing close to the start of the race which means you have to be ready, fully zipped up to go shortly after that. Transition is also usually closed. Now, for most people that┬'s not an issue. You do a last check on everything, toilet stop, get zipped up and off you go. I have seen people ready and zipped up an hour before the start but unfortunately I can┬'t do that. Although I reduce the amount of insulin going into my body before and for the major part of the race (to avoid going into a hypo =low blood sugar due to the intense exercise) I need to ensure that I still get enough insulin, even if a little less than normal, to avoid a shortage of insulin in my body which can in some severe cases be fatal to your health. This means I can┬'t just take off my insulin pump an hour or 30 minutes before race start. You might think that insulin not going through my body for 30 min wouldn┬'t be an issue? It isn┬'t in most cases but if you add up the time when you┬'re in the water without the pump, this can easily mean I don┬'t get insulin for an hour or so. And to me personally it tends to be very noticeable if I don┬'t get insulin for more than 30min.
I usually check if there are several race briefings and go to an earlier one so that I can get myself ready closer to the start. If that isn┬'t possible, I tend to get into my wetsuit up to my hips and wait for as long as possible to take the pump off and zip myself up.

When I say I take the pump off this is what I do:
There is an insulin cartridge in the pump to which the tube connects. This tube is part of the infusion set and connects to a little unit on my stomach with a 5mm needle under my skin. I can simply disconnect this end without having to remove the needle.

So far so good, pump is off, I am zipped up and ready to go┬.... But now, what to do with the pump that I have just taken off? In an ideal world, the transition area is right next by the swim start and not closed off so that I can attend the race briefing, go back into transition, take my pump off, zip myself up and head to the start. In most cases, however, transition is a little way away. Luckily, I have previously been able to hand the pump to someone for them to hold it for the duration of the swim and to hand it back to me when I get out of the water. In some cases, where I was on my own, I had to ask some very surprised but very helpful volunteers or marshals to take care of it. I have never come across anyone who wasn┬'t willing to take care of it. The disadvantage of having anyone looking after it during the swim is that you don┬'t quite know if they really do ┬- it might sound crazy but an insulin pump cost around GBP3000 and although they are fairly robust, a damaged pump is quite a hassle! Also, when my pump gets handed back to me, I am wet and out of breath and trying to run with an insulin pump in my hand as well as goggles and race cap, isn┬'t easy. I simply haven┬'t got hands enough to then also unzip my wetsuit whilst running so I wouldn┬'t say my transitions are the fastest...but still reasonably ok considering that I also tend to check glucose levels in T1.

I guess for the bike and run it is much more straight forward as I just tend to wear the pump clipped on to the back of my tri shorts allowing me to access it quickly if I need to. However, I learnt a useful lesson there too:
In longer distance races I tend to wear a race belt with a small pouch for gels etc. on the run. During the run of my half Ironman last year, the race belt somehow got totally tangled up with the tubing of the pump. Trying to untangle this whilst on the run, even a slow one, was a real nightmare and with hindsight I should have just stopped, untangled it and continued to run. In now tend to clip the pump on to my sports top underneath my arm to the side instead of having it clipped to the back of my tri shorts during the run.

As for testing my glucose levels (which the pump doesn┬'t do), I have learnt to be quite skilful and am able to test my blood sugar on the bike when on aero bars. Obviously, I have to slow down and can┬'t do it in full speed but at least it allows me to continue riding instead of having to stop (I happily admit that I am competitive and want to save precious minutes). I also tend to use several glucose meters during a race: On longer races, I tend to check my glucose levels in T1 after the swim, on shorter ones I wait until I am on the bike if possible which is where I have a second meter in my bento box. I will also have a spare in the transition area, in case one fails. During my half Ironman I did most of the testing on the bike, one in T1 and one in T2 and then right after I crossed the finish line. Needless to say that I have pretty much spares and extras of every possible diabetic utensil with me or in transition. I am really pleased that I never had to terminate a race early because of a problem with my insulin pump or Diabetes in general so keep fingers crossed.

It might look to the ┬"normal┬" triathlete as if being a diabetic triathlete is a lot of hassle and ┬"faffing┬" but actually it┬'s just about being organised and knowing as much as possible about the race and the race courses etc.

For my first triathlon race of the season in May, I will no longer need to worry about having to take the pump off for the swim due to it being fully waterproof. I will simply wear it under my wetsuit, but I will tell you more about this in my next blog so tune in again. I would be interested to find out what other Diabetics do with their pumps or any tips and tricks in general? Has anyone got any ideas how I best fix a glucose meter on my bike?
smartiepeteby member: smartiepete, Apr 24th 2013 22:01
I guess there are some things we take for granted, having to race and cope with all this must be difficult at the best of times. Many of us struggle to manage races/transition/nutrition without forgetting something. It must be hard.
sarahleonardby member: sarahleonard, Apr 25th 2013 09:46
Great blog, very interesting. Think I could lean something about being more organised ;-)
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