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This article was originally published in Diabetes Health in June, 2007.
These days, Doug Burns is a modern Sampson. The reigning Mr. Universe, he’s two hundred pounds of sheer muscle and the picture of good health. Of the skinny little boy with type 1 who used to work out in the woods alone, all that remains are a wry sense of humor and an attractively self-deprecating manner. They’re unexpected in a man who’s triumphed in the uber-masculine world of bodybuilding, but there’s a lot that’s unexpected about Doug Burns.
Doug was born in Washington DC, into a family without a bit of type 1 history. His dad, who worked with NASA, moved the family to the backwoods of Mississippi when Doug was about eleven. By that time he’d had type 1 for four years, ever since a severe episode of keto-acidosis at age seven. He was what used to be called a “brittle diabetic,” taking multiple injections of NPH and Regular, and he had problems with the delayed effect of the Regular. On top of that, he was trying to handle his testing with urinalysis, which could be six hours off the mark. Consequently, he was frequently in keto-acidosis or insulin shock, with constant episodes of both extreme highs and extreme lows.
As a result of his sugar management problems, Doug weighed only 58 pounds by the time he was eleven. Known as “the bag of bones,” he was beaten up by pretty much everybody in school. He still remembers a girl in fifth grade who whacked him with her purse and “beat the hell out of me right in front of the class.” In Mississippi he wasn’t bullied as much, but as an emaciated kid with a disease no one had heard of, he was ostracized as an oddity.
At the age of twelve, in 1977, Doug came across a picture of the Biblical Sampson holding a lion in a headlock. He’d never seen anything like Sampson’s hugely muscular body, and for the skinny, lonely boy, the sight was a revelation. That night he prayed zealously for a half hour to be changed into a Sampson. When he woke the next morning as skinny as ever, he gave up on miraculous intervention and decided to take matters into his own hands.
Doug’s physician tried to forbid him to lift weights, but he was so hell-bent on becoming Samsonesque that he ignored the doctor. Unfazed by the absence of gyms in backwoods Mississippi, he made late night forays to the junkyard and jerry-rigged his own gym with old pulleys and bags of concrete. Using an outdated issue of Ironman magazine as his guide, he trained in his makeshift gym in the woods come hell or high water, in the company of raccoons and bobcats, and once right through a tornado.
About the same time that he started working out, Doug got hold of a home glucose meter. His control improved immediately, and once that happened, his world opened up. No longer a bag of bones, he joined the football team, became the most valuable running back, and found a group of buddies to work out with. He and his friends would go to Wolf River, dive from the trestle, and train out in the sun with weighted dumbbells. Where the river rapids flowed through a canyon, they swam upriver like salmon.
At age fifteen, after only two years with the weights, Doug began power-lifting competitively. He placed dead last in his first competition, but by the time he graduated from high school, he had set American records in drug-free power lifting in the adult open class. Following his success as a powerlifter, he began entering bodybuilding competitions. In November 2006, the boy formerly known as “the bag of bones” became Mr. Universe.
Now the perfect model of a modern Sampson, Doug is 5 foot nine inches and weighs between 187 and 200 pounds. Had it not been for diabetes, he believes, he probably would not have become a body builder. He credits his career to an overwhelming drive to overcome the disease, upped by his initial desire to fit in. And then, “Once you get pissed off about something, you say the hell with it, I’m going all the way.”
Doug went on the pump only last year. He was offered a pump by MiniMed long before, but he was swimming in the Pacific Ocean on a daily basis, so he turned it down. He likes his Animas pump because it’s so easy to moderate his insulin doses, which change drastically depending on how he’s training. When he was powerlifting, he was much heavier, in the 220s, and his cardiovascular work was next to nothing. When he began competing in bodybuilding, however, he did constant cardio, lost twenty pounds, and lowered his body fat from 14 percent to 4.7 percent. As a result, he had to come down 87 percent on his insulin, dropping from a daily 50 to 60 units of basal insulin down to eleven units a day. By the time he was ready for the show, one unit of insulin was more than enough to cover the same amount of carbs that twelve units had covered before.
When he’s getting ready for a contest, Doug moves his testing frequency way, way up. Because his body fat is coming down so drastically, he starts using cardiovascular work to chase his glucose. He begins pulling off of bolus injections; instead, he moderates what he’s eating in conjunction with whatever training he’s doing. So he takes glucose when he knows he’s going to need it, and then does aerobic work right afterward to “just burn the heck out of it.” As his body fat keeps dropping, the whole mechanism keeps improving and improving.
When he was first competing, Doug didn’t know any other athletes who had diabetes. He was aware of one other diabetic bodybuilder way back, but that fellow got into the anabolic scene. Doug’s never used drugs, but he trained at Gold’s Gym in Venice for seven or eight years, and the drug use there, he reports, was rampant. The organization within which he competes, the International Natural Bodybuilding Association, is completely clean and tests for everything under the sun. The two other bodybuilding organizations, however, are sullied by steroids. It’s unfortunate, he says, because steroid use has distorted a previously healthy quest to attain a classic figure, twisting it into a battle of cartoon characters.
Doug’s never run into any prejudice against diabetes in the gym, though he is very open about testing and his pump. People sometimes give him the eye, thinking that insulin might be advantageous in competition, but insulin is of no use to him in that respect because if his insulin ever goes high, he can’t shed body fat and get lean enough to compete. For competitions, he brings his insulin dosage down to probably less than that of a non-diabetic person.
At the moment, Doug is debating whether to re-enter Mr. Universe. In the meantime, he’s preparing for the California Challenge, a cardio event he’s organizing with friends that entails a hike through Yosemite, a bike ride through Death Valley, and a swim from Alcatraz. It’s part of his new quest, following his triumphs in the arena of strength and world of physique, to conquer the cardio world. In the future he’s thinking of doing something on the lines of what Jack La Lanne did, maybe stunts like swimming to Alcatraz towing a boat. He says he couldn’t believe his eyes when he saw Jack, at the age of ninety, bang out twenty pushups like it was nothing. Right now, Doug and his endocrinologist, Dr. Hayes, who also has type 1 diabetes, are starting a social-networking fitness company called Sugar Fitness that will be launched in late April. His book on health, fitness, and weight loss, called The Diabetes Antidote, will also be out at the end of April.
Before he formed his company and was able to arrange group insurance, Doug was without health insurance for two years. When he broke his finger, he had to set it himself because he couldn’t afford the medical bills. Seeking insurance on an individual basis, he was dumbfounded to receive quotes from $1950 to $2,600 per month. During his two years sans insurance, he couldn’t afford to get his eyes checked or have any blood tests, and he felt pressured to work out even more obsessively in order to stave off complications. He is adamant that major changes in the health system are called for, because it’s shamefully hard for people with type 1 to get insurance if they can’t piggy-back onto a company plan.
Doug loves ocean swimming, but does most of his cardio work in the hills of California. He also hits the elliptical pretty frequently and the treadmill on a regular basis. One of the most effective ways he’s found to combine both aerobic and anaerobic exercise is with full-on sprinting. He does 40s and 100s, and he finds that it literally gives a hammering to his metabolism, so he’s geared up for the next ten hours.
Doug’s last A1c was 5.9. His blood pressure is on the verge of being too low, about 100 over 70. His resting pulse rate when he won the Southern States was 39. He tries to keep his sugar readings super tight by forcing himself to pay attention, and his current blood sugars vacillate from the high fifties to 170. He tries to stay between 70 and 110.
Doug has no complications of diabetes at all, and he attributes this mostly to his aerobic work. He has talked with scientists at length about the effect that cardio has on the buildup of AGEs (advanced glycosylated end products), and he’s convinced that the increased blood flow, coupled with adequate to higher levels of water intake, acts like turpentine cleaning a dirty pipe. He believes that active cardio work over an extended period of time is unbeatable for keeping the vessels open.
Doug emphasizes that for him, it’s not about diet and exercise: It’s about exercise and diet. Exercise is primary. He says that diets are misleading, in that they promise that you can simply eat your way to health. He does have a particular diet that he follows, leaning a little more on protein. He “eats very, very clean” throughout the week and gives himself one day to enjoy whatever he feels like having. He loves Cajun food with a passion, and his favorite beer, Chili Creek, is spiced up by a big hot pepper inside the bottle.
Doug doesn’t take any meds except children’s aspirin, but he takes a lot of supplements, including isolated whey plus whey concentrate, multi-vitamins and minerals, essential fatty acids, L-glutamine and carnatine. He notes a distinct beneficial effect when he takes supplements, which he uses to advantage when preparing for competition: He works without supplements until he is in the best possible shape, and then adds the supplements to take it up a notch. He notes that his way is the antithesis of the public’s inclination to take the magic potion right from the get-go. He has always done the work first and then used the supplements as an adjunct to the hard work.
Doug has virtually every meter, but likes the Ultra Smart, especially the five-second reading, though most meters have that now. He also has the Ultra 2, and he likes the Dex 2 meter by Ascensia with the little circular cartridge inside because the cartridges are especially handy while driving. He’s been thinking about moving to a continuous glucose monitor, maybe the Paradigm, but sees CGMs as still pretty chunky relative to a pump. He thinks that a CGM would be hard to wear and that he might end up wrecking it.
Doug developed his self-deprecating sense of humor as a way of disarming his childhood adversaries, and it’s been part of him ever since. Poking fun at himself after a low blood sugar makes the incident easier to stomach and less daunting to others. When he makes light of something, it’s a way of defining it for himself and for everyone else too. Recently, however, during an incident which cannot be lightened with humor, he was beaten by police during an episode of hypoglycemia. Despite his medic alert jewelry and wallet cards, the police assumed that he was intoxicated. The incident serves to underscore the fact that police and security guards need to be far better educated about diabetes and hypoglycemia.
Doug says that when he speaks at diabetes conferences, the kids in the audience sometimes assume that because he’s a successful professional athlete, diabetes somehow went away and doesn’t apply to him anymore. He’s quick to emphasize that he faces the same daily struggles that they do. He always has to pay attention, and the pitfalls never cease to exist. Kids sometimes feel that when they go low or have a bad day, they’re all alone, the only ones who have such problems. When they hear that someone who’s set a record still has to struggle just like they do, it’s a revelation to them. Doug makes it clear that he still has bad days and doesn’t feel like training, but that’s where his sense of discipline comes in.
Diabetes has been a spur to Doug. He believes that the discipline required to manage the disease ultimately benefited him, carrying over into the discipline that he needed to succeed as an athlete. He advises kids to accept diabetes for what it is, simply an obstacle like any other, one that they can use instead of letting it use them. He tells kids, number one, don’t think of yourself as defective merchandise because that’s just not the case, and number two, pursue your dream no matter how far-fetched it might seem. Just make diabetes come along with you. Never give up.
That stubbornness may be why Winston Churchill, the relentless bulldog of a man who refused to quit no matter what, is one of Doug’s favorite people. He was also inspired by Sampson, of course, by Dr. Billy Graham, and by Bo Jackson, whom he reveres as one of the greatest athletes of all time. His biggest inspirations are his three kids, ages twelve, ten, and eight. He’s no longer too concerned that his children will get type 1, but when they were younger he used to test their sugar on the sly when they were asleep. His son remembers being awakened by his dad poking his toe to test his sugar, just to be sure. Now his kids are active as heck. His little girl can bang out 50 pushups nonstop.
If Doug were advising kids going into weightlifting, he’d tell them to give the pump a try if they’re able to. Sometimes they’re not able to: At the conventions where he’s spoken, some of the kids are on the impoverished side, toting around meters that are ten years old. He always tells them, hey, you don’t have to have to have the best of the best of equipment. He assures them that they can do it with virtually nothing. After all, Mr. Universe started out in a homemade gym out in the backwoods.