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He trains about 22 hours during the average week—not counting the additional seven hours of workouts on weekends. Through his twice-daily workouts, he totals nearly 120 miles of bicycling, about 10 miles of swimming and between 50 to 100 miles of running each week. For Ironman triathlete Jay Hewitt, training and diabetes have something in common: Working at them every day is critical to achieve his goals.
A Diabetic in the Most Grueling Sporting Event
Hewitt, of Greenville, South Carolina, competes professionally to beat other athletes in one of the planet’s most grueling sporting events. He also competes with himself to beat one of the most difficult diseases—type 1 diabetes.
“I race Ironman triathlons for the joy of the challenge and to prove that diabetes cannot stop me from achieving my goals,” says Hewitt, who was diagnosed with type 1 diabetes in 1991 at the age of 24.
The Ironman triathlon requires participants to compete in a 2.4-mile swim, immediately followed by a 112-mile bicycle course and then a 26.2-mile run.
Hewitt is a member of the 2005 U.S. National Team for the Long Course Triathlon and will race for the United States at the ITU Long Course Triathlon World Championships in Fredericia, Denmark, in August. He is also racing to qualify for a slot in October’s Ironman Triathlon World Championship in Kona, Hawaii.
In addition to preparing for and facing the enormity of the Ironman race and the exhaustion it brings, Hewitt knows that as a diabetic this is the ultimate way to tell the disease, “You’re messing with the wrong guy.”
“I respect my diabetes, but I will not surrender to it,” he says. “To me, diabetes is an opportunity, not an obstacle. It is a chance to prove that I am stronger than it is, that it cannot stop me, and to inspire others to achieve their dreams and never quit. I see the finish line with every mile I swim, bike and run. That is why I tell myself: “You will not quit.”
As a first-year law student, Hewitt had to study day and night. He didn’t have time to be sick.
“But over the course of about a week, I was getting weaker and weaker and losing weight. I was fit and athletic back then, so it was very noticeable,” he says. “It got to the point where I was almost in a coma. My blood glucose was so high that I could hardly even hold the razor up to my face when I shaved, nor could I climb steps.”
Hewitt thought he simply had a virus.
“I didn’t know what to look out for,” he says. “I was hallucinating and semiconscious. Of course, I was drinking orange juice which was just making it worse.”
Finally he went to the school’s infirmary for medical help.
The experience was scary, he says, because he had never had any exposure to diabetes, its symptoms or what the disease involved.
“I had no warning signs, no history in my family,” he said.
A True Athlete’s Response
Although he was stunned and confused at first, Hewitt soon became proactive about his diabetes.
“I went into complete absorption mode—reading and learning everything I could to understand what it was, its limitations and how to control it,” he says.
Hewitt now sees his diabetes as a sort of blessing.
“My approach has been that once I understood it and I absorbed all the information I could, I set out to try to live my life as a nondiabetic,” says Hewitt, whose last A1C was 5.9%. “Not in a sense of living in denial, but rather living in determination.”
Hewitt’s dedication to his athletic training was fueled by his philosophy on diabetes.
“I wanted to have my body not know it was diabetic. I know it’s not always possible to have normal blood glucose numbers, but my A1C readings were as close to normal as possible,” he explains. “I feel that by taking care of myself, I can live as long and healthy as I want.”
Sharing His Experiences to Motivate Others
Training for the Ironman event alone is hard enough— without the added considerations for diabetes.
“It became an opportunity to prove, first to myself, that I could do it,” he says. “But then it became an opportunity to set an example. I could talk to other people about it.”
Hewitt says his experiences sharing his stories of diabetes and the ultimate athletic challenge—the Ironman triathlon—have been even more glorious than crossing any finish line. He takes great joy in providing a positive example for adults and juveniles. He often does volunteer speaking for the American Diabetes Association as well speaking for corporations and at sales meetings. If fact, speaking has become his second career.
“My message is usually about achieving goals, setting goals, taking things that are obstacles and turning them into positives,” he says. “I share my lessons for an Ironman diabetic triathlete and how people can apply them to achieve any goal in life—as a professional or an individual with a personal goal.”
Hewitt says he plans to write a book soon, with stories about racing and how to apply these lessons to life and to achieving any goal.
To learn more about Hewitt, his public speaking and the Ironman Triathlon events in which he competes, log on to www.jayhewitt.com.
Q: What type of meter do you use?
A: I use the LifeScan One Touch Ultra and UltraSmart meters. The Ultra is super fast, light, durable, painless and always accurate. I wish I could race Ironman triathlons that way! Ultra meters are exactly what I need in my athletic career and my everyday life. The UltraSmart gives me excellent data to control my blood glucose, spot trends and make improvements. As an Ironman triathlete, motivational speaker and attorney, I need a meter that lets me control my diabetes so I can do it all.
Q: What type of insulin do you use?
A: I use Humalog for meal bolus injections and a night-time Lantus insulin injection for a 24-hour basal dose. Both work great for me. Lantus allows me to race an Ironman triathlon for 10 hours or spend a day in the office with no worries about sudden blood glucose fluctuations. Humalog is dependable and fast.
Preparing for the Tri
Hewitt’s personal coach sets his training schedule according to the race season. But training is a fulltime job for Hewitt. Morning workouts last about two hours. Then he goes to work as an attorney and returns for evening training sessions that last another two hours.
Every day is different, he says. “I may swim 2,000 to 4,000 meters and later bike about 40 miles or for a couple of hours. Then, the next day, I may have a run of eight or 10 miles in the morning and another bike workout that night.”
In addition to his 18 to 22 hours of training during the week, Hewitt also completes seven-hour workouts on the weekends.
Managing Medication and Nutrition Along With Workouts
Hewitt checks his blood glucose at least eight times a day.
“I always have my meter with me on long bike workouts,” he says. “If I’m riding 80 to 100 miles, I’ll check it once or twice during the workout.”
Often, he can tell what his blood glucose number is based on his body’s response during workouts or events.
“I train so much now that I can tell from my performance what it is,” he says. “I can tell if my blood glucose is getting low, because I can’t keep up the same cadence or the same pace, and also because I’m working too much for the desired results.”
Hewitt takes 20 units of Lantus once a day at bedtime. He also uses a Humalog pen at meals.
“The average number of units per day depends on the length of my workouts each day. It’s about 6 to 9 units of Humalog with every meal—so, probably about 50 units daily.”
Hewitt says his body requires large amounts of stored glycogen, which comes from consuming carbohydrates.
“It’s a difficult balance to strike—the most difficult balance for me as an endurance athlete is balancing my carbohydrate intake to span out my body’s requirements during training or actual races.”
He eats three meals a day with smaller meals or plenty of snacks in between. For meals, he eats a lot of carbohydrates before and after long workouts and races, but he complements that intake with protein supplements, fish, chicken and large quantities of fresh vegetables daily.
Not Always an Easy Task
Hewitt’s blood glucose goes low in every Ironman race, but he plans for it to happen.
“I plan for something to go wrong,” he says. “So, if it doesn’t, I’m thrilled because I’m prepared.”
Hewitt struggled with his lowest blood glucose levels during the Ironman USA National Championships a few years back in Lake Placid, New York.
“It was a long, grueling climb up Whiteface Mountain on the second half of the bike course— the last 25 miles. I had emptied and discarded my water bottles at the base, not wanting them to weigh me down during the climb,” he says.
When his energy was low and other competitors started passing him, Hewitt knew he was in trouble.
“It was the most pain I’d ever had in a race. I still had about 2,000 feet to climb,” says Hewitt, and he still had to run a marathon to finish the triathlon. “I checked my blood after that bike segment and it was 42 mg/dl. I took some carbohydrate, but I was already delirious and unable to perform at a competitive level. After four or five miles of slow running, my blood glucose had come up enough.”
Race Day Regimen
Because the triathlon event is so intense and grueling, Hewitt decreases his Lantus the night before to avoid bottoming out with low blood glucose during the race.
He takes no insulin during the race, and he cuts his 4:30 a.m. breakfast Humalog dose in half.
“I can’t afford to have low blood glucose when I’m 2.5 miles out in the ocean,” he says. “The swim is first, and it’s in open water—so I can’t stop to eat and drink.”
His pre-swim strategy is to run his blood glucose up to 180 before the gun goes off —knowing the swim will bring that number down.
“I can do that swim in under an hour,” he says. “In the next transition before the bike, I check my blood glucose again.”
The Bike Race
And then he’s on his bike within a matter of seconds— for 112 miles.
“I’m constantly eating and drinking out there,” says Hewitt, who checks his blood midway, at about 56 miles into the race.
Once the marathon portion of the event starts, Hewitt gets carbohydrates through sports gels and performance bars.
Because the marathon is physically the most difficult part of the race, it’s hard for anybody to eat. But Hewitt forces himself to fuel his workout at every aid station.
“My blood glucose is usually very low in the last 13 miles of the marathon when it’s been about eight hours into the event. I keep gel, sports drink and other carbs and supplies in a special needs bag at the midway station.”
After the Race
After the race, he tests his blood again right away. Then he heads to the race’s medical tent to get intravenous hydration and glucose.
“I’ve got to get carbohydrate in me within 30 minutes after a race or a workout or I will bottom out. That’s a period of heightened insulin sensitivity for anyone.”
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