Doing It All With Type 1 Diabetes: An Interview With Jay Hewitt

In high school Jay Hewitt played varsity basketball and tennis.  He was a good athlete, but not an endurance athlete.  That changed a few years later when he diagnosed with type 1 diabetes at the age of 23.  After some years of living with diabetes, Jay signed up to run a marathon in order to raise money for the ADA.  He had never run a marathon in his life, and he wanted to prove to himself that he could do it.  Since then Jay has completed hundreds of races, including 14 full Ironman Triathlons (a 2.4-mile swim, a 112-mile bike ride and a marathon, raced in that order and without a break). 

Like Jay, I’ve been motivated by diabetes to run marathons.  However, I’m nowhere in his league, and an Ironman is only a dream for me.  Jay’s accomplishments inspire me to keep pushing myself, and I was thrilled to have the opportunity to ask him questions about how he competes and manages diabetes- and everything else he does- so successfully. 

 

 Diabetes has been a great motivator for me. I don’t know if I ever would have run a marathon, had I not been diagnosed with this illness. Has diabetes pushed you towards your athletic achievements?

Absolutely.  I would not be racing the Ironman triathlon if I did not have diabetes.  Diabetes was my motivation to attempt my first marathon.  I crossed that marathon finish line and was spent, dead, stick a fork in me, I was done.  But I heard about the Ironman triathlon and became determined, more like obsessed, to do it, just to prove that I could.  I wanted to send a message to diabetes that you’re messing with the wrong guy! Then I did another Ironman, then another.  I got better and better and qualified for the U.S. National team.  Soon I was not just completing the Ironman, but rather I wanted to compete with the best in the world, despite diabetes.  And I got in pretty good shape, which was great for my body and diabetes.

You completed your first Ironman in 2002.  How long did you train before deciding to train for an Ironman and how long did you train before your first?

My first Ironman was Ironman Florida, November 2002 in Panama City Beach, FL.  The run training for my first marathon in 2000 was essentially the beginning of the Ironman base training.  I continued to train until I completed the Ironman in November 2002 – a total of almost three years.  During those three years, I ran three marathons, rode a lot of charity bike tours (60 – 100 miles), and did several shorter Olympic distance and half Ironman triathlons, and a lot of training hours and miles.

An Ironman is an incredible challenge for anyone, and even more so for someone with diabetes.   Could you tell us what’s most challenging part for you?

As you might expect, the most challenging part is maintaining my blood sugar in the right range.  I burn over 12,000 calories in the Ironman, lose 5-7 pounds of body weight, drink 2.5 gallons of liquid (sport drink and water), consume 60-80 grams of carbohydrate per hour, and approximately 2000 calories during the day.  Trying to balance my insulin dosage during an Ironman requires a lot of “fitness” training, as well as “nutrition” training. I have to be prepared to react and adapt in the middle of the race to lows and highs, but also be smart and patient, and not overreact.  Plan, prepare, adapt and keep going to the finish line.  Just like life.

How do you manage your blood sugar under control?  Do you use a pump?

I have raced Ironman Triathlons both on injections and different pumps.  My first five Ironmans were on injections, then several on a pump with a tube, and the last five or six have been on the Omnipod pump with no tube.  Whether on injections or a pump, the key is lots of hours training in the pool, on the bike and running to get my body in race shape, and also to practice my nutrition plan.  I practice how much and how often to consume my sport drink and bars and gels, and what kinds I like that sit well in my stomach, and what to eat before workouts for fuel and after workouts to recover for the next day.I test my blood sugar before and after workouts, and about every hour during workouts of 3 to 5 hours (cycling and running).

 

I started pumping a few months ago and am still trying to find the correct balance for long runs (20+ miles).  How do you do it?  Do you reduce your basal rate? Do you disconnect altogether?

There are several factors to consider for long workouts.  I used to reduce my basal, but have found that feeding my normal basal gives me a better workout and race performance.  A good pre-workout meal of long lasting carbs (oatmeal) about 30-45 minutes before a long run or bike workout is key.  And consistent consumption of carbs during the bike workout (sipping high carb sport drink and normal sport drink and water, gels, bars).  While running it’s harder to eat and drink so it’s a few gels and drinking the carb drink about every 2-2.5 miles.  I like to run loops and out and back training routes so I stash my bottle(s) of high carb drink in a certain spot and will pass by it 3-4 times in a 20 mile run.  I also run with a fuel belt with flasks on long runs and sip from it.  I wore the fuel belt in the Boston marathon, and usually during an Ironman.

 

What about a continuous glucose monitor? When I run a marathon I’m blind to my blood sugar levels during the race. How does a CGM help your training/racing? How important is  aCGM?

I raced for so many years without a CGM, before they were available, so I had to learn how my body reacted.  It was very helpful to learn by “feel” and not be dependent on technology to tell me about  lows or highs. 

In 2007-2008 I raced several Half Ironman and Ironman Triathlons with a CGM, and the graph data after the race was interesting.  But the accuracy and reliability was too imprecise to make real time race decisions, and it was another device to carry on my body and bike. 

CGM’s are more accurate now, and I would love to race with one that is as accurate and real time as a heart rate monitor.   Overall I think they are great tools, just hard to use in the crazy intensity of an Ironman with all the other gear I’m keeping up with for race day (goggles, swim cap, wetsuit, cycling shoes, helmet, sunglasses, insulin pump infusion set, insulin pump, four blood sugar meters, bike drink bottles, nutrition bars, gels, CO2 cartridges and a spare tire in case of a flat, heart rate monitor, running shoes, watch, electrolyte tablets, fuel belt, race number belt . . .).  I’d love to have a CGM that’s integrated with my pump.

Training for an Ironman takes great discipline, do you feel like the discipline required for managing  diabetes has helped you with this?  Is diabetes partly responsible for your discipline?

I was pretty disciplined before being diagnosed, but yes, being forced to be disciplined with diabetes every day in life helps with the intense discipline required for the Ironman.  As you know, diabetes is a self-management condition/disease, requiring constant attention, keeping up with supplies and factoring in the effect of exercise, food and issues of the day (anxiety, adrenaline, illness, etc.).  You need to plan, prepare, react, and adapt throughout the day.  The Ironman requires the same discipline – plan and execute, then adapt and react, and keep going.  The Ironman is about muscle (fitness) and heart (desire), but also about your mind.  The Ironman is so physically demanding, it’s the smartest athlete who wins, or even completes the race. You can’t do it on fitness and desire alone. Every Ironman athlete must use his/her brain during the race for pacing, nutrition, and hydration, even if they don’t have diabetes.  Diabetes just makes my margin for error a lot smaller, but I don’t know how to race the Ironman without diabetes.  It’s just one more thing in the long list of things that I have to think about during the competition.  But it makes the finish oh so much more special.

Some people, including doctors, think people with diabetes should not participate in extreme sports? How do you feel about this issue?

I’d like to hear one of them tell me that.  They think this because they don’t know how to plan and prepare for it properly. I have trained and raced hundreds of races and tens of thousands of miles – 8 individual marathons, 14 Ironman triathlons, over 20 Half Ironman triathlons, dozens of shorter triathlons, three years on the U.S. National team for long distance triathlon, a lot of bike races and the 3,000 mile Race Across America bike race. But I am smart about it, and plan and prepare – that is the key to diabetes management and to life in general. Prove to your doctor, just like you had to prove to your parents growing up, that you would be responsible and prepared for the challenge.  People contact me all the time for my advice and tips on diabetes products, nutrition and training.

 

When you were a member of the U.S. National Team for Long Course Triathlon did you train with the other athletes? Did they treat you differently? 

Most of the time I trained alone, or with my coach who was one of the world’s elite racers at one time. The other athletes on the U.S. team or at races did not treat me differently.  I suppose many did not know I had diabetes or forgot until I pulled out my blood sugar meter or they saw my insulin pump.  That was my goal, to make my diabetes a non-issue, keep up with it and do what I had to do to compete.  I was honored if I did well and other athletes saw my insulin pump on me or checking my blood sugar and thought “he kicked my butt and I never even knew he had diabetes.”  I tell kids with diabetes that they are role models because other kids will admire them if they handle diabetes that way, even if they never tell them that.

You have completed 14 full Ironman competitions. Have you ever had close calls?

I made a rookie mistake in my second Ironman in Lake Placid, NY on a very mountainous course where they held the 1980 Winter Olympics. My blood sugar was dropping on the last 30 miles of the bike while climbing the mountain.  I thought my blood sugar was fine so I had dumped my sport bottles with my carb drink at the base of the climb to save weight.  My blood sugar kept dropping as I kept climbing, slower and slower.  It was 47 when I got into the transition to start the marathon.  I was okay, just really unsteady and had to drink my high carb drink in transition, then start the marathon very slowly.  Another time I had high blood sugar (250) in Ironman Cour de Alene, Idaho, during the bike ride and that caused me to get dehydrated in the marathon about 3 hours later.  I collapsed at mile 132 of that race, mile 18 of the marathon.  It wasn’t from my blood sugar at that point, just the dehydration caused in part by high blood sugar for several hours earlier.  I have never had a real disaster or catastrophe, just a few lows or highs that messed up my performance in some races.

 

Aside from being an Ironman athlete you are an attorney, a motivational speaker and a husband and father. How do you do it all?

Lots of juggling.  I speak a lot on work-life balance.  I planned my racing career to happen before my kids were born and now I have cut it back while they are young and I am traveling so much to speak.  I planned my speaking career to grow after my racing slowed (literally and figuratively – ha!), to give me more time to travel for speaking engagements.  I am also writing a motivational book on Finish Line Vision for my speaking business.  At one point before I had kids, I had 3 full time jobs – athlete, speaker, lawyer-  but I do more speaking now and work less as a lawyer. I enjoy speaking and motivating people so much.  My career as a lawyer stayed full time while I was racing full time – lots of workouts early in the morning, at lunch, at night, riding an indoor trainer in my basement at 9 p.m. while reading legal work, strength workouts in hotel rooms.  The Ironman triathlon requires you to balance and train three sports at intense levels, just like we must balance family, career, health and personal development in life. I love the challenge to succeed, and also keep priorities in order.

 Do you still compete?

I still train and workout, but I am not racing Ironman triathlons right now.  I accomplished most of my goals after racing intensely for about 10 years, so now I just race for fun.  And that was the plan so I would have more time to speak now. But I do miss the excruciatingly painful intensity of the races and full time workouts. 

 Could you tell us a bit about your motivational speaking?

My company and speaking message is called Finish Line Vision®. It is a motivational message on overcoming obstacles, staying disciplined, achieving personal or professional goals, and work-life balance.  Make the bad thing that happens to you the best thing that happened to you, use it as motivation whether its diabetes, divorce, or business failure.  Turn obstacles into motivation.  Set goals with failure potential, not being afraid to fail and learn from it.  And earn your finish line, with discipline and hard work, when no one is watching you.

My message is emotional and fun, with stories from my racing and life with diabetes, and different high achievers in history.  I customize it for corporate audiences seeking business performance, and public audiences seeking motivation and personal development.  I love doing it and am honored it has helped so many.

 What is your message to people newly diagnosed with diabetes?

You or your child will be okay with diabetes if you do what is required.  But it does take work.  It is hard, and you will have good days and bad.  Diabetes is difficult.  It is a self management condition.  Once you are a teenager, it is your life and your responsibility to manage your diabetes.  Don’t leave it to your doctor, your parents, your spouse or the public’s bankrupt healthcare system to treat the complications because you refused to change your life.  Just make it a part of your life, checking your blood sugar, keep nutrition handy for lows, have your diabetes supplies, eat healthy, exercise.   You are stronger than your diabetes, use it as motivation to prove that it will not stop you.  The rest of your family can/should also use it as motivation to start eating more healthily and exercising.  Crossing whatever “finish line” you have set in your life is so much more rewarding now that you’re overcoming diabetes.  Keep going.  You will get to your finish line.

For more about Jay, visit his website, where his motivational book Finish Line Vision will soon be available. 

Michael Aviad is co-founder of ASweetLife.  He writes the blog Diabetes- It’s an Endurance Sport.

 

 

 

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