Triathlon and Type 1 Diabetes: an Athlete’s Perspective

Emma Kleck has been participating in triathlon since August 2022, and joined TCM in June 2023. While a member of the squad, she has reached a PR on the 70.3 distance and sprint distance triathlons, and finished first in the 30-34 AG at the 2023 Bearathlon. She also enjoys other endurance sports, and trains for a 50K trail run once a year. Emma works as a Nurse Practitioner at a local healthcare organization.

If you ever hang out around triathletes, I’ll bet that you’ve heard a conversation about fueling. There are so many ways to get energy during an endurance sport, and it usually takes a painstakingly detailed approach to find the right blend of electrolytes and carbs via liquid nutrition, gels, and solid foods. The options are endless, and usually overwhelming. It’s not just about taste - if you find an electrolyte drink mix that tastes good, will it sit well in your stomach? Provide enough energy? Cause nausea or diarrhea? Will it still taste good after being jostled in a warm water bottle for hours on a bike? 

Fueling is overwhelming, to say the least. It’s something that every athlete will struggle with, at one time or another. At the very root, good fueling means that an athlete’s body is getting enough energy. Let’s revisit high school biology (Krebs cycle, anybody?). When you take in, say, an electrolyte drink, it’s digested into salts and glucose. The salts go do their thing, and the glucose enters the bloodstream and is eventually taken up into cells to be used as energy. If you’re not fueling, you’re not giving your body glucose and energy. 

Fueling gets a lot more complicated when you throw a chronic disease into the mix. I live with type 1 diabetes, and have lived with it since age 7. My body doesn’t produce any insulin, the hormone responsible for bringing glucose from the bloodstream into the cells. Insulin is necessary for life, so I take it through an insulin pump. It’s unfortunately not as easy as taking a pill or a fixed dose once a day. My insulin needs are always changing - just as your body adjusts its own insulin production by the second, based on the level and change of blood glucose. It’s been estimated that people with type 1 diabetes make an average of 180 health-related decisions per day. I’d say that number doubles when I’m doing a triathlon or endurance sport. 

I can take in fuel just as good as the rest of them - I just don’t always process it in the same way. If my blood sugar is in the target range (for me, for exercise, this is between 120mg/dL and 150mg/dL), then I can pretty safely take some sips of electrolyte drinks throughout my sport and not suffer too badly. If my blood sugar is low (anywhere below 100mg/dL during exercise, or below 70mg/dL on a normal day), then my body doesn’t have enough glucose in the bloodstream, and my poor muscle cells are starved for energy. I can feel shaky, weak, fatigued, and dizzy if my sugar goes too low. This usually results in me pounding some gels or electrolyte fluids to the point of nausea. If my blood sugar is high (anywhere above 180mg/dL), then I have enough glucose in my bloodstream, but no way of getting the glucose into the cells. Again, my muscles are starved for energy! This time, though, I’ll feel nauseous, lethargic, and a big hangover. The farther from target range, the worse I’ll feel. 

But wait, there’s more! Adrenaline, exercise, stress, food, and so many other things affect blood sugar, as does insulin. If my blood sugar is high I’ll take insulin, but not too much because exercise makes insulin work better! If I get nervous or excited before an event, my blood sugar tends to spike up rapidly. The intensity needed for sprint triathlons is along the same lines of adrenaline and tends to cause high blood sugar levels, whereas the endurance needed for an olympic or 70.3 is more of a slow burn and tends to lower my blood sugar levels gradually. This is why I enjoy long endurance sports like 70.3s, or even ultraruns - they’re easier to manage on a diabetes front. 

When I train and race, part of my brain is focused on the task at hand, but the other part is focused on how I’m feeling. Did I eat enough fast-acting carbs? Did I take too much insulin? Is my tummy feeling off because of something I ate, or because my blood sugar is going up? It’s a fine balance of pretending to be an organ. I need to pay close attention to what my body is doing so that I can keep myself safe. Too much insulin will make my sugars drop quickly, and could end in an emergency situation. Too little insulin will make my sugars rise and cause some nasty symptoms. Both compromise my ability to perform at my best. 

The good thing that comes with type 1 diabetes is that I am usually very in tune with my body. I’m always paying attention to what it’s telling me, and that goes beyond the blood sugars. The best part? Even if I finish dead-last in an event, I am still flooded with a huge sense of accomplishment. Not only did I do a triathlon, but I managed to keep myself alive at the same time!