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Kris Freeman, 25, is a three-time national champion and the number one cross-country skier in the United States. In the history of American cross-country skiing, Freeman is the second most successful skier of all time.
Freeman also has type 1 diabetes—a condition he manages while excelling at one of the most grueling of all sports. Freeman was diagnosed with type 1 in September 2000 while training for the 2002 Olympics. Needless to say, he thought his skiing career was over.
He quickly learned, however, that with a balanced diet, frequent blood glucose monitoring and insulin therapy, he could gain control of his disease and remain competitive.
We talked with Freeman in Park City, Utah, where he was training for the 2006 Winter Olympics, which will be held February 11 through 25 in Torino, Italy.
What have you been doing lately?
I just got back to Park City, Utah. I’ve been in Alaska doing some training and did four races.
How has having diabetes changed your cross-country skiing?
Nothing has really changed except for the extra preparation that I have to do before and after training and racing. I had to learn how my body reacts to certain types of foods and stresses and how much sugar I need for each hour of training. Once I figured those things out, nothing really changed.
In terms of having extra insulin and eating extra carbs, do you find you have more energy than before?
When we talked to you last, you were taking NPH and Humalog. Are you still on the same regimen?
Three years ago I switched to Lantus for my long-acting insulin, and I use Humalog for my short-acting insulin.
How many units do you take of each?
At this point, 2 to 3 units [of Humalog] before each meal is my norm. For the Lantus, depending on the altitude and the amount of training, I will take 1 to 7 units once a day at bedtime.
That’s not a lot of insulin. How do you know how much to take?
The higher the altitude, the less I take. Also, when I am training for so many hours, my body is so revved up from recovering that if I take any more, I can’t train, because I would go low immediately.
Do you think that if a diabetic like me trained as much as you did, I would require less insulin?
I believe you would. I think the more physical activity you do, the more sensitive you become to insulin and the less you are going to need. Also, the more muscle mass in relation to body fat you have on your body, the less insulin you use.
What is your body fat percentage?
I think it’s at about 4 percent.
That’s very low! What’s your diet like when you aren’t training?
When I’m not exercising, I eat less. Because it’s easier to control the diabetes that way.
Do you need to take more insulin at those times?
When I’m not training, my insulin needs can go to the top end of my Lantus, and I can take up to 20 units of Humalog a day for all of my meals.
So I guess you’ve never had a weight problem, have you?
No. Some people eat for luxury and enjoyment, but I feel that’s not a luxury that a diabetic has. To eat for enjoyment, from my point of view, is self-destructive. So even if you are taking care of yourself, if you drink a Coke, its glycemic index is so high that your blood sugar is going to skyrocket, and then it’s going to drop very quickly if you take insulin to correct it.
I hear coffee can help an athlete’s performance. Do you find that to be true?
Caffeine can have a positive influence on your performance. But I have found that before a race I get so amped up that it makes it hard to control my BGs as is, because you’re releasing adrenaline, which in general raises your BG. Caffeine has the same effect. So I try to stay away from stimulants before I go into a race.
What is your daily meal plan?
For breakfast, I eat fat-free yogurt with bran flakes or granola, or oatmeal with soy milk. My midmorning snack is usually an energy bar, and I’ll drink a sports drink when I am working out to keep my blood glucose higher. For lunch, usually I have a turkey sandwich or wrap and a lot of fresh vegetables. If I’m still hungry, I’ll eat raw carrots or veggies. My afternoon snack is normally low-fat plain yogurt and cereal. I try to eat low glycemic index fruits. When I sit down in a restaurant, I don’t look at what is going to taste the best, I look at my dietary needs and try to balance whatever meal on the menu is the closest to that. And if tastes good, that’s a bonus. I think most people eat too much for their own enjoyment and not for what their body needs. Food is fuel, especially when you are a diabetic. I think it’s a healthy way to eat.
Do you ever drink protein shakes?
I eat energy bars but not protein shakes. I get plenty of protein in my diet.
So you have a variety of energy bars on hand, and you decide what you need at the moment?
Yes, if I’m about to go to bed and need a snack, I go for the bar that’s higher in protein. If I’m waking up and going to run 15 miles, I have the higher-carb bar.
So it’s like fuel and medicine?
That’s the way I have learned to deal with diabetes—totally through diet. By looking at food as, What do I need to eat now to do what I want to do? Not, What do I want to eat now to make myself feel better?
I know people who aren’t convinced that food is fuel.
I find it disappointing that 95 percent of the diabetic population is type 2. I would say that 90 percent of those people could improve with a good diet and exercise—nothing too extreme. It’s a matter of getting Coke and Frito Lay to go away! From a nutritional sense, the American public doesn’t know much at all.
So you and I have to be nutritionists?
I think everybody should be looking at their diet. It’s nice to be able to eat something because it tastes good, but that shouldn’t be the case every time you put something in your mouth.
Do you have a back-up kit for your diabetes supplies?
I travel with two LifeScan Ultras. That’s what I think is the most reliable meter as far as accuracy. I can whip it out and take my BG in 10 seconds. I travel with three or four vials each of Humalog and Lantus.
Do you use the meter’s memory features?
I have not utilized the memory features because I haven’t found them useful for my lifestyle. I’m constantly changing environments and time zone and I don’t have a set pattern. My training isn’t the same every week.
How many times do you test each day?
It depends on how long I have been in the area. When I first arrive somewhere, I’ll test very diligently—up to 12 times a day—to figure out what is happening to me in this environment. And once I get it dialed in, I can figure out how much Lantus I need at night and how much Humalog I need before meals.
Have you considered an insulin pump?
My A1C is 5.5% doing what I do now, so if it’s not broke, I’m not going to fix it.
Would you be interested in a continuous monitoring system?
If I were not a professional athlete, I would be on the pump, but because of what I do—intense training out there in the cold—the potential problems I could have outweigh the potential benefits.
Who are your sponsors now?
My personal sponsor is Eli Lilly. I’m also sponsored by LifeScan, Nike, Power Bar and Red Bull Sugar-Free. Lilly is my hat sponsor.
Do you have a good relationship with your doctor?
My first few doctors were very disappointing in that they had such little hope that I could continue to do what I wanted to do. They said being an elite athlete is not an option for a diabetic, and I didn’t want to hear that. That’s why I went home and figured out what I needed to do on my own. One thing was to learn about the glycemic index and how to utilize Humalog insulin.
So you’re pretty much self-educated about diabetes?
If nothing else, I think when it comes to diabetes, the responsibility is mostly your own. Whatever the doctors say are guidelines. Only you can know how your body reacts to sugar 24 hours a day. You doctor isn’t there all the time. Take some responsibility, eat right and balance your insulin appropriately.
Do you have a fan Web site or a way for our readers to contact you?
The best way would be to send me an e-mail at email@example.com.
Does being an Olympic athlete make it easier for you to get a date?
I’ve had the same girlfriend for four years.
Tell us a bit more about cross-country skiing.
It is about the hardest endurance sport there is. I can’t think of any other sport that involves the duration of time you are out there; the number of muscle groups you use; and the coordination and aerobic conditioning you have to have to be a cross-country skier.
What do you think about while you are skiing?
I think about my body. I try to think about not red-lining, because once your body implodes, there are very few rest stops. Generally, I try to think about how fast I can go, how hard I can maintain this pace, how I can be as technically efficient as possible. Sometimes, you want to get as much speed as possible without any thought to energy expenditure, but other times you have to go as fast as you can with the least amount of expenditure. It all depends on how you are feeling and how long your race is. I’ll approach a 10-K completely differently than a 15-K.
Do you feel your heart beating during a race?
We do so much training and monitoring of ourselves. When I am working out easy, I like to keep my lactate threshold below 2, and at the end of a race, it’s at around 12. We monitor it so much that you just kind of learn to feel it. And you learn what your heart rate is in correspondence to lactate threshold.
Do you have to submit to drug testing?
We are subject any time of year randomly by the two bodies of government that test for drugs. Every three months, I have to submit a list of where I will be every day, and if that list changes, then I have to notify them.
Yes. I take supplements from Shaklee. They are a sponsor.
What work do you do for Eli Lilly?
I’m a spokesman for the Lilly for Life program. It’s a program that recognizes people who do extraordinary things with diabetes. There are several different categories, and people submit applications from around the country, and we get some amazing entries.
So you get to review the submissions?
I am a spokesman and I review the admissions. I am an evaluator.
What do you do for LifeScan?
I give talks and go to their diabetes education conferences around the country.
Are kids inspired by your stories?
Yes, I love to see the look in their eyes after being told they can do something they were told they can’t do.
Feb 1, 2006