Eric Tozer, co-founder of the Diabetes Sport Project (DSP) shares his story and gives us a glimpse into the lives of athletes with Type 1 Diabetes.
What’s Type 1 Diabetes and when did you realize you had it?
Type 1 diabetes is an auto-immune disorder where the pancreas no longer produces insulin. Insulin is a hormone that connects blood sugar (think glucose, carbs, sugar, etc.) into your cells so it can be used for energy. Without insulin, sugar is unable to get into the cells and therefore builds up in the bloodstream. High blood sugar (not having enough insulin in the body) is extremely dangerous and damages the body. The immediate effect of high blood sugar is feeling flat out awful, lethargic, headaches, tired, the list goes on. Over time, high blood sugar causes complications that can lead to blindness, kidney failure, nerve damage (resulting in infections and potentially even amputations) and much more.
On the flip side, if too much insulin enters the body, it can result in low blood sugar, which is equally dangerous. For non T1Ds, this can feel like a “crash” where you simply need to refuel to bring your blood sugar back up. For us T1Ds, the danger is exponentially worse.
13 years ago, I had a seizure in the middle of the night because my blood sugar went so low. I had injected a little too much insulin, as I had yet to fully understand the effect that exercise can have on the body as it relates to my insulin needs and absorption.
Essentially, insulin needs are an incredibly complex and potentially life-threatening balancing act which we deal with 24/7. We need to inject the right amount of insulin to account for the carbs/sugar/glucose that we are eating and drinking. Too much insulin and we go low. Not enough insulin, and we have high blood sugar.
There are hundreds of factors that can change the algorithm of how much insulin is needed; and that algorithm is unique and different for every person. Time of day? Did I already exercise? Am I going to exercise? What type of exercise? Am I stressed? Am I at altitude? Is it hot/cold? Am I traveling? Did I get enough sleep? What type of food am I eating? The list goes on.
So that’s what type 1 is, but a day-in-the-life is so much more... We need to check our blood sugar multiple times throughout the day; either by taking a sample of blood via a finger prick or through a Continuous Glucose Monitor (CGM - i.e. Dexcom). We wake up at all hours of the night if our blood sugar is too high or low, to eat/drink sugar or inject insulin. We need to calculate every gram of carbohydrate we consume; along with fat/protein/fiber and more, to help calculate how much insulin to inject. We deal with scar tissue build up from the injections. We wear various devices on our bodies; imagine being in middle or high school with that dynamic. We deal with medical device technology failures, which can throw our plans out the window as we need to stop whatever we are doing and replace or fix the issue which can mean going back home if we don’t have enough supplies.
How did the diagnosis change your life?
Being diagnosed with T1D changes everything, not just for me, but my family, friends, co-workers and more. Period. I was 22 years old, coming off my college soccer career, and while traveling abroad, I lost 20 lbs in two weeks. I was having to urinate frequently, drink tons of water and felt terrible.
I remember getting back home and hearing the diagnosis over the phone from my doctor. In that moment, I made the decision that I wasn’t going to let this thing, this “type 1 diabetes,” which I didn’t know really anything about, stop me from achieving whatever I wanted to pursue in life. There were countless trials and errors to continuously learn and improve my management. My competitiveness drove that initial mindset, which was great, but it also caused me to become frustrated when things went bad because of my T1D. Then, I shifted my mindset and saw those “failures” as opportunities to learn and grow. Now, just as in training for a sport, I have countless opportunities to improve my management to the point where I now have confidence and comfort to head out the door for a ride or a run and worry (less) about my T1D. 
Tell us a bit about the Diabetes Sports Project: the idea for its creation, its mission/goals/what it means to you.
DSP was founded with the mission to inspire, educate, and empower those impacted by diabetes. We are 150+ T1D athletes who utilize sports as a platform to have a positive impact the community. 100% of our funds go directly to various diabetes community events; we speak at children's hospitals, podcasts, diabetes conferences, support groups, diabetes camps and more. I'm incredibly proud of our organization as everyone involved works on a volunteer basis, so we can use our funds to host sporting events where we can bring the community together. We help coach fellow T1Ds to prepare for different races and then come together to accomplish our goals as one. As cool and exciting as our accomplishments are, our outlook is that if we don’t use them to help others, then we’re missing the big picture and the huge opportunity to change lives.
Image: Diabetes Sports Project
What unique challenges do T1D athletes face?
We need to know the exact carb counts for everything we eat and drink before, during and after exercise. Since we manually inject insulin, if we miscalculate our individual, complex, ever-changing algorithm (which I talked about above), it will result in either high or low blood sugar, which can immediately put us on the sideline. High blood sugar, which happens if we don't inject enough insulin, can result in feeling super lethargic, dizzy, cramping, blurred vision, headaches and more. Low blood sugar, which can hit us significantly faster than a non-T1D if/when we inject too much insulin, causes us to feel dizzy, hungry, weak, thirsty, excessive sweating, nervous, cloudy-headed and more. Every T1D adjusts insulin requirements differently for each type of exercise.
One specific example: I had trained well for the California International Marathon and hit the starting line ready to PR and qualify for Boston. Roughly 15 miles into the race, my blood sugar dropped faster than expected, and I immediately went from my PR pace to a walk. Over the next 20 minutes, I tried to take on as many fast-acting carbs as possible to get my blood sugar back up, but my Boston qualification hopes were out the window. In addition to training our bodies, minds, and lungs, we also need to train our diabetes management skills so we can avoid this type of experience.
What advice would you give to someone just diagnosed with T1D?
Over the past decade, I've made a point to connect with as many kids, adults, and families one-on-one to talk through diabetes management and demonstrate how to safely incorporate sports into our lives. My hope is that by showcasing what we can achieve (through accomplishing things like Running Across America in 15 days (2011) with 9 other T1Ds or completing the World Marathon Challenge (7 marathons, on 7 continents, in 7 consecutive days)), fellow T1Ds and their families gain the comfort and confidence to set their own goals and not let T1D stand in the way of their dreams.
There are incredible examples in our community of amazing T1Ds accomplishing incredible feats and they all made the decision to not let T1D stand in their way. We have amazing technology like the Dexcom G6 CGM (continuous glucose monitor), insulin pumps like the Tandem T-Slim w/ Control IQ which, combined the strength of our community, makes successful diabetes management much more of a reality.
Bottom line: diabetes is hard, really really hard. But, we don’t know “quit”. We can’t quit. If we quit when it comes to diabetes, we die. But, because of that daily practice of not giving up, we become that much stronger and that much tougher every day. Then, when we realize that, our limits are endless.
Diabetes Sports Project is a partner with GU International in the USA.
Learn more about Diabetes in New Zealand here.