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Oh No, I’m low!

Being a Type 1 Diabetic for almost eight years now, it’s second nature. Nothing phases me anymore, not even ignorant comments or grueling routine blood draws. As anyone reading this post who either has T1D, or is close to a T1D, knows, there becomes a point where it just becomes a part of you.

I no longer have diabetes; I am a diabetic.

This feeling of figuring I know the way the disease will manifest itself in my day to day life, can quickly shatter as soon as diabetes makes me feel weak.

Being low is never a great feeling, not before or after you down two juice boxes and half a tub of peanut butter without realizing it. Lows as a collegiate athlete are much worse. Learning to combat the shame I feel when I have a 40 mg/dl blood sugar reading half way through a two hour tennis practice, and have to sit out for twenty minutes is an uphill battle. This shame is not induced by anyone but myself, though. The feeling of sitting out when the rest of my team is out practicing, is one of the few times I feel disabled.

I often sit there, repeating thoughts in my head, such as, “You are an idiot for taking insulin before practice”, or “You are pathetic; buck up and get out there”.

However, I am not pathetic. I am not an idiot. In fact, I am someone without a full-functioning pancreas.

I am a someone who has to alter their daily life significantly because of an illness that I did not cause. On top of all of that, I do all of the other things my teammates do, and succeed as a collegiate student athlete.

So where does this shame stem? As a seasoned T1D, I put unnecessary pressure on myself to be perfect, and to get angry with myself for the lows and highs. Having many other T1D friends, I know I am not the only one who does this. These feelings of shame creep up often  during a low on an important test, or during a tennis match, where I am representing my team and university.

While I cannot say the “shameful lows” are completely gone, as I head into my final year of school and as an athlete, I can say, they have substantially lessened in my four years in college. Instead of getting angry at myself for the low blood sugar, I shifted the internal conversations to question why I’d gone low and how I could better prepare for next time I was in a similar situation.

In shifting this focus, I now see lows and highs as a learning and growth opportunity. For highs (which are usually due to adrenaline) during matches, I think of diabetes as a mental game with myself, and laugh off mistakes instead of letting the anger get to me or my blood sugar. For lows, I have tailored my diet and eating times substantially to set me up for success in the classroom and on the court.

Shifting my focus from negatively viewing the disease’s impact on my physical and mental health, to seeing T1D as a way to better understand my body, has helped my mind and my a1c.

D1 and T1: Tips for Killing Your BG and Opponent!

As a Type 1 diabetic for the last seven years, and a lifelong athlete, trial and error with exercise and insulin/eating patterns has been my best friend. No two people are the same, and neither are two workouts. The most important things to remember are to be adaptable, don’t beat yourself up, and get out and move!

While being a highly competitive athlete and T1D can be challenging, being a D1 athlete makes me a more regimented diabetic, and being a diabetic makes me a more disciplined athlete. Here are a few quick that help me be successful on and off the court. Keep in mind that everyone is different though, and I am not a medical professional, just an experienced D1 T1D athlete.

  1. Don’t take insulin before cardio if possible. Before a long tennis match, running, or practice, I try to eat a lower carb meal and avoid taking insulin. Bodies process insulin more efficiently when working out (especially for a long workout), and if I take insulin, I will inevitably go low.
  2. Fats are your friend! I love nut butters, avocados, and coconut oils, especially pre-workout. Because fats are metabolized slower than carbs and protein, they help sustain blood glucose levels pre and post-workout.
  3. Find a low snack that works for you. For me, I love drinking coconut water while playing tennis to keep my blood sugar up while avoiding spikes (which I usually get from Gatorade). I also love apple sauce, and larabars (due to fat content, which helps stabilize) for gradual lows. I always keep energy chews in my bag, too.
  4. Morning workouts>>> I cannot stress the incredible impact morning workouts have on my blood glucose control enough. Late night workouts usually result in 3 a.m. lows. Morning weight lifting helps me maintain BG levels throughout the day.
  5. Make sure your basal levels are adjusting according to your activity level. When I’m in season, I always cut my basal insulin by at least a few units. Talk to your doctor if you find you are running low/high more than usual! Getting my basal insulin in check has been the biggest help in my athletic performance.
  6. Switch it upppp! I love interchanging cardio, HITT, weight lifting, yoga, etc. throughout the week to maintain BG levels and challenge my body. Find workouts that you enjoy! Finding a workout buddy is vital to success.
  7. Be prepared! Never leave for an outdoor run without fruit snacks tucked in a pocket. Whether I’m running, playing tennis, or at the gym, I always have a debit card and low snacks (and insulin and a meter, of course).
  8. Keep track! Keep a log of workout type, duration, and the BG effect it had. I also use an app to track my meals and help me figure out what is the best fuel for active days.
  9. Adrenaline is a factor! My blood levels during practice and a match can be drastically different due to the stressors of competing. Because of this, I have to make sure to keep my emotions in check, and be aware of adrenaline spikes.
  10. Give yourself some credit! Being a T1D is a full time job. That being said, do not let anyone tell you it is impossible for you to be a highly competitive athlete– because that’s far from the truth! #diabadass

Why I Hate Diabetes, But Love Being A Diabetic

Diagnosed just a little over seven years ago, diabetes has become “the norm”. By now, the carb counting, injecting in public, and answering looks and questions from strangers when I stab a needle in my stomach, is all second nature; it doesn’t phase me anymore. But, when I was first diagnosed, at age thirteen, it did. I did not want the world to see me as “disabled”. I thought that if people were aware of my disease, they would see me as weak. Seven years later, I am still the same girl, with the same autoimmune disease, but now, I show the world I am stronger than ever because I am a diabetic.

I was practically born with a tennis racket in my hand. Growing up, there wasn’t a day where I wasn’t in a gym, on a court, or in a field for at least an hour or two.  Sports made sense to me, and I thrived on the heat of competition. When I was taken to the doctor on the morning of January 28, 2010, and soon told I had an autoimmune disease that would potentially hinder my ability to compete at a high level, my earth shattered. My immediate family had no history or real knowledge of T1D, but now I would be surviving on multiple daily injections and religious carbohydrate counting. Cool.

My mother, a tennis coach, urged me to consider “just playing local tennis and volleyball tournaments”, and to not stress if I couldn’t become a Division 1 athlete, my lifelong dream. Her comments and the lack of knowledge my doctor had around competitive athletics and diabetes were my driving force. I realized I would have to train harder and smarter than my competitors, but I didn’t need easy– I needed doable.

Four years later, I ended up graduating high school a year early, at age 17, to accept a tennis scholarship at Seattle University. Since coming to college, in the fall of 2015, I have made diabetes my life. I started the first College Diabetes Network Chapter in the state of Washington, at Seattle University. I started volunteering at my local JDRF chapter, and even babysitting diabetic children. I began experimenting with dietary changes to help negate the highs and lows that can come with poor diet choices. The transition to Division 1 athletics required more of me physically and mentally, and I soon realized optimal diabetes care was more important than ever. By embracing my disease, and advocating as a type 1 diabetic and division 1 athlete, I truly embraced that I was a diabetic, not just someone with diabetes.

I used to hate being associated with the disease and all of the negative impacts it had on my life, but now I rejoice the person diabetes has made me. I realized I cannot change the fact that I am a type 1 diabetic, but I can change how I let diabetes influence my life. I can set a positive example by participating in clinical research, by making healthy dietary decisions, by being active, and by teaching the public about type 1 diabetes and its implications. I can show the world that I am more than diabetes– I am a strong, capable, passionate diabetic.

Yes, diabetes can be grueling, and tiresome, and I would never wish it upon anyone. But, the diabetic community, the friends and connections I’ve made through my broken pancreas, are invaluable. Being a diabetic is the most rewarding, demanding, empowering roller-coaster I’ve ever been on, but I learned how to embrace the ride.

 

When I Lost My Love For Tennis

I used to play tennis every day for more than 1 hour a day – I loved the game, and I was very good at it. This was before I was diagnosed with diabetes – after that, I never won again and I lost my love for the game completely.

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I don’t think diabetes is 100 percent to blame for this, but probably at least 50 percent. When I was diagnosed the summer of 1989, I had just reached the finals of a large national tournament in Sweden. I lost in the final, but overall I had done very well – especially considering I had suffered from tonsillitis three times during the spring preceding this event, and I had been seriously injured the year before.

However, after my diagnosis I lost my confidence in my body. I had never had such a failure in my life and here I was, at 17 years old (I spent my bday in the hospital getting trained on injections and glucose monitoring), feeling like I was suddenly disabled. Little did I know that the complications they warned me about during those first few weeks with diabetes would be a reality less than 20 years later and that I would go through two transplants before I turned 40!

Tennis represented so much to me as a young person, I spent most of my free time either playing tennis, getting to tournaments, working out to play better or preparing ahead of games. I loved going to my club and I even loved hanging out after tennis, relaxing and feeling the work-out in my body and if I had won, feeling strong and confident.

I guess the closest to this feeling in my current life, is when I present at conferences or when I have an important business meeting. I have the same feeling of anticipation, preparation and then during the presentation I have a high, triggered by endorphins, and I am on top of the world for the duration of the event. The problem is coming down afterwards.  Being in the zone is great and all, but afterwards I feel empty, anxious and even sad.

As a diabetic, sometimes these events could be affected by my disease. For example, if my blood sugar was running low and I had to go up on the stage for a presentation, I would need to quickly eat something to avoid the risk of passing out and the absolute certainty of presenting poorly because my brain did not have enough sugar to work with. When I was high, I could also feel it, since I would get slower in my thoughts and especially in my reasoning. I would rather be high than low, and my solution to avoiding this roller coaster was to always keep myself slightly high, but not high enough to be slow, blurry-eyed or lethargic.

After getting my pancreas transplant in January of 2010 I have not experienced any of these feelings and it is such a relief and such an advantage! I sometimes say that I did not know how hard it was living with diabetes before I got a pancreas transplant and realized what normal life is supposed to be and how good I felt. Achieving that feeling for everyone with diabetes is our goal, and while we pursue the cure, we need to identify a range of products that can help people with daily life.

I hope that I will get back to tennis one day, but for some reason, tennis more than any other sport is linked to my life before diabetes. I know that I have a new chance, and should be incorporating tennis into my life, but it is easier for me to exercise otherwise without ever feeling that diabetes, transplants and age have had a negative effect on my performance!

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