Proving That People With Diabetes Can Do It All


Trans-Israel is an annual 550 km four day cycling event from the north to the south of Israel. This year the organizers partnered with “Team Type A”, a group of people with Type 1 diabetes, whose goal is to inspire younger people with diabetes to participate in sports and to demonstrate that people with diabetes can do it all.

The Trans-Israel route includes some of the most incredible climbs in Israel and “The Four Seas”, starting at the Mediterranean on to the Sea of Galilee, then the Dead Sea and finally the Rea Sea in Eilat.

On the first day there were 10 riders with diabetes. The day started with an incredible climb up near the Lebanese border and continued through the amazing wine country, past a mixture of Arab, Druze and Jewish villages, past Meron and on to Safed. We made our first lunch stop at Sieff hospital, which serves the eastern and upper Galilee and had lunch in the center for diabetes. There we met and talked to staff and patients about how we manage to do endurance sports. I showed off my CGM and we discussed how much insulin to take with our food. They were very impressed with us and thanked us for coming, wishing us well on our way.

My BGs were floating up and down like the terrain that we were riding. The excitement of the day and the early exertion had sent my sugars up and for most of the morning and early afternoon I was bouncing between very high and ok levels. I was controlling my sugars with small amounts of insulin and trying to eat small amounts of food from time to time. Later, though, all the insulin and hard effort of the day caught up with me and by dinner I was low.

My BGs were floating up and down like the terrain that we were riding.

After a night of decent blood sugars, I had a nice big breakfast, eggs, cheeses, fish, and yogurt. Although I skipped the hardcore carbs, I didn’t take quite enough insulin and my blood sugar climbed for most of the morning. We road flat land for about 30km before starting to climb 600m of altitude on one side (and 450m climbing up the other side) to the top of the Gilboa mountain from both sides, where we took in the incredible view of the Jezreel valley.

We were then transported south to the Dead Sea, and some of us got to add another 45km including the very tough climb to the Dragot cliffs. It was the perfect way to burn off my high blood glucose, and by the end of the day I had perfect levels, just in time for dinner.

A post dinner spike was offset somewhat by an increase in insulin sensitivity, which ultimately led to hypoglycemia in the middle of the night. I was awake for an hour from 3:00-4:00 a.m. I did finally I get my sugar high enough to fall back asleep, but I knew I was in trouble. A night time low is a bad thing on any normal night, but on an endurance bike ride it’s a serious problem. The body repairs itself during sleep, and when that sleep is interrupted for an hour in the middle of the night, it means recovery is interrupted.

Needless to say I woke up on day three feeling tired. The day’s ride was mostly flat on the way down south along the Dead Sea towards the historic site of Masada. From there we had a brief stop and took our bikes to the top (on a cable car) for a photo, following that we carried our bikes down the other side cyclocross style.

Next we were off on the 20km climb to Arad. I started at the back of the group with two of my friends, and we climbed the whole way together. As we climbed I noticed my BGs start to drop, so I decided to eat an energy bar. This was a huge mistake. The bar was very hard to digest, and left me feeling a little sick for the rest of the climb. My blood sugar, however, balanced out nicely and was great for most of the afternoon. After lunch I spent time supporting some of the weaker riders who couldn’t hold the pace of the faster group. It gave me a chance to answer their many questions about diabetes and I took the opportunity to explain the challenges involved and how technology really helps with my performance in these events. As we arrived for dinner my CGM alarm stated beeping telling me it was time to eat something. By the time I went to bed I was floating just above a hypo. I had some gummies (which I always keep next to my bed) and tried to get a better night’s sleep.

Cycling with Diabetes

The final morning was a very early start for the last 160 km dash through the desert to Eilat. As I rode the final 10 km before the last descent, I could no longer ride at the pace of the very strongest guys, there was just nothing left in my legs. I had heart rate drift, an effect of fatigue where you just can’t push your heart rate up. I was still going, I could pedal, but putting in hard effort was out of the question. So I took it easy, enjoyed the amazing scenery, and reflected on the past few wonderful days.

The final stretch of the Trans-Israel challenge, a fast winding downhill to the very southern tip of Israel, brings three countries into view: Jordan, Egypt and Saudi Arabia. The rocks are yellows and reds, and the sea is blue and very inviting. I will be back here again at the end of January for the Israman triathalon. It’s another challenge to prepare for, another opportunity to show that regardless of Type 1 diabetes, I can do it all. As Team Type 1 used to say , diabetes doesn’t stop us, if fuels us.

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