Click Here To View
Latest NovoLog Dose Articles
An Interview With Indy Race Car Driver Charlie Kimball
Being a rookie driver on the fast-paced IndyCar racing circuit is pressure enough for any 26-year-old. But for Charlie Kimball, one of four wheel men on businessman Chip Ganassi's IndyCar race team, there's the added need to manage type 1 diabetes while roaring around the track at speeds that often exceed 200 miles per hour.
Charlie, born in England but raised in California, was diagnosed with type 1 only four years ago. Fortunately, his father Gordon's past experience building Indy and Formula One race cars, as well as Charlie's own fascination with go karting and cars from an early age, had created a deep love for racing in him. Instead of making Charlie swear off the sport, diabetes simply became one more factor he had to consider in getting himself ready for grueling high-speed competitions.
Not only his immediate family rallied around him. Ganassi, a former race car driver known for his intensely serious approach to competitive racing (he sponsors four different teams), linked up with pharmaceutical manufacturer Novo Nordisk as a sponsor to introduce Charlie this year as the first type 1 driver ever on the IndyCar circuit.
Diabetes Health publisher and editor-in-chief Nadia Al-Samarrie caught up with Charlie recently at Infineon Raceway in Northern California as he finished practice laps for the upcoming 2011 Indy Grand Prix of Sonoma.
Nadia: What's it like driving 200 miles an hour?
Charlie: I guess the simple answer is, it's fun. For one thing, the car is designed to go that fast, so when you're not going at the limit, you're not living at the limit. The car doesn't feel great then because it's not where it's designed to be. But when you start pushing the edge, pushing the limit, that's where it likes to live. Then, everything's working in its design range-the tires, the engine, the temperatures.
Nadia: And that's your zone, too?
Charlie: Exactly. That's the zone the car gets to, and as a driver I'm working in that zone as well. Just as basketball players talk about being in the zone, and seeing all the players on the court, and being able to see plays developing, for me in the race car it's the same thing. During an Indy-type race, you may have 27 or 32 other cars to keep track of. You have to be very conscientious and aware of who's around you and what's around you. You also have to know personalities.
In a race I can look four cars down the line and pick out a paint scheme and know who that driver is. I know his personality and whether he's prone to make mistakes, or if he's super-aggressive, or if he's on probation, which means you can push the envelope a little bit. You're thinking all of these things and processing them in split seconds.
Nadia: Do you think that works in reverse too? Are other drivers looking to see if your type 1 diabetes might be affecting your driving?
Charlie: I don't think so. Well, I hope they don't think so. But even if they did and thought they could get an advantage, they'd be surprised. I don't believe that I'm any less of an athlete or competitor because of my diabetes. I actually think better because I'm more focused on preparing my body, just like the mechanics who prepare my car.
On race day morning, I prepare by carefully managing my Levemir dose and my NovoLog dose at the meal I eat before I get into the car. I carefully manage my hydration and everything else, so that when I get into the race car I'm as well prepared as I can be. I've built all day, all weekend, all season, and all off-season toward that moment when I climb into the car.
Nadia: You have a Dexcom continuous glucose monitor mounted in your car. How do you work with it?
Charlie: Well, my first use of it this year was at the Indy 500. I gave the team some feedback from it throughout the race and reported my numbers like I reported everything else. I'd be saying things like, "Hey, everything's good here. I have a bit of an understeer, so maybe on the next stop you guys can do half a turn on the front wing. My blood sugar's stable at 205, and I feel good."
While I'm driving, I'm obviously concentrating on driving fast, passing people, and moving forward. That's my main focus. But I also have a secondary check list, like making sure the car feels right and telling my team how it's performing so that they can make any needed changes during a pit stop. There's a constant stream of data back and forth, and just as I check water temperature, oil pressure, speed, gear shifts, and lap time, I check blood glucose as well. The CGM's mounted right on my steering wheel, where it functions as just one more sensor I have to check routinely.
At the start of a race, I'll check the CGM every four or five laps. But toward the end, if my level has been stable and constant, and I feel good about it and it's not throwing me a curveball, I'll check it every 10 to 15 laps.
Nadia: You also have something unique that other drivers don't: a CamelBak-type glucose bottle.
Charlie: Yes. All drivers have a bottle of water they can sip from through a tube in their helmet so they can stay hydrated. I have one as well, but I also have a secondary bottle attached to the tube, which I fill with orange juice and glucose. There's a little valve in the cockpit that lets me switch bottles. Just like you can switch between hot and cold water at home, I can switch from water to my high-glucose drink if I'm starting to trend down. That way I don't have to stop.
Nadia: What happens if you're racing and your CGM says that you're trending way down? What do you do? What do you say to your team?
Charlie: It's not that important to say anything unless I've run out of tools for dealing with it. So far, it hasn't come up. Let me give you an example: Say my car is building up a tendency to understeer during the race. I'll use all the tools I have in the cockpit to fix the problem, but if those fixes don't work or I'm getting ready for a pit stop, that's when I'll say something. Now, if my cockpit CGM shows me I'm trending low, I'll drink some of my sugar water, and that almost always corrects the trend. If I successfully make an adjustment, I don't need to tell my team that I did so because the information isn't useful to them. I've already taken care of the problem and want to leave them free to focus their energy on things they can help.
Nadia: Speaking of energy, it must take tremendous strength to hold on to the steering wheel when you're going that fast, and tremendous stamina to race for two or three hours. How do you prepare for that?
Charlie: I spend a lot of time training in the off season and in season. I work with a trainer who works exclusively with Indy car and Indy Lights drivers. Obviously the best fitness program for driving a race car is to drive a race car. But that's cost-prohibitive-you just can't climb into an Indy car every day of the week, so we do a lot of things to replicate that. That might include exercises like manipulating a weighted steering wheel while sitting on a medicine ball and other workouts designed to build shoulder, arm, forearm, and grip strength. We also focus on chest, core, and back strength, although core strength isn't as critical as the others to actually holding on to the cars. But if you do get injured or have an accident, the stronger you are in your core the less severe any injury is likely to be. So you're looking to develop injury prevention, as well as stamina, strength, and cardiovascular fitness. For cardiovascular work, we'll work in the pool, or run, or bike. Sometimes we combine running and biking in one workout.
Nadia: When you're doing this, how hard are you pushing yourself?
Charlie: Absolutely hard. As you can imagine, race drivers are fairly competitive. So, if you put us in an environment like the gym and we're all working out together, it can get pretty heavy. I train with guys like my teammate Scott Dixon and racing rivals like James Hinchcliffe and J.R. Hildebrand. You see one of them benching 200 pounds, and you're like, "I gotta be able to do that, too," so you push yourself that much harder to rise to that level. Dixon is unbelievable in the swimming pool, but I think I'm a lot better on the bike than he is at the moment. So, off track there's different activities we excel at, and we push each other in those environments.
Of course you have to make sure that you don't mistake something like bench pressing weights as a substitute for all the preparation you need to race a car. Obviously you don't bench press a steering wheel, but bench pressing helps give us the strength to turn that steering wheel. We work on a lot of ways to prepare our bodies to perform complex movements during a race, with lots of conditioning exercises to help us make sure that we do things with the right touch. We even do neck strengthening work, especially during the off season, so that we're strong enough to do a full day's practice the first day we get back into a car.
Nadia: I heard that you have an outrageous carb diet that you go on before a race. They say you eat 37 pieces of bread?
Charlie (chuckles): Well, it equates to 37 pieces of bread. But I don't eat all those carbs at once. How it works is that my doctor, Anne Peters, has told me that I have to make sure that my glycogen stores coming into a race weekend are topped up in my muscles. To do that means consuming 500 grams of carbs in the week leading up to a race. That's equivalent to about 37 slices of bread at 15 grams of carbs per slice. I don't consume it all the day or night before a race because the combination of adrenaline, stress, and nerves don't make you want to eat a lot-certainly not anything heavy.
Nadia: How supportive have your parents been about you becoming a racer?
Charlie: When we were growing up, my parents told my sister and me that "if you do what you love, you will never work a day in your life." It turns out that I was lucky enough to find something I was truly passionate about at a young age. I got into go karting around age 10, and then into cars at 16. It was family thing-my father was a race car designer-and we've always been a sort of team.
Nadia: So you were into racing long before your diagnosis? How did your diagnosis affect your love of the sport?
Charlie: Yes. I was diagnosed only four years ago, when I was 22. I'd already long ago discovered my love for racing, so the diagnosis motivated me to get healthy so I could stay competitive. That's where my family was a big help. They've always been there to give me support in different ways, whether as cheerleaders, or somebody to talk to, or just to give me some tough love.
Nadia: Tough love?
Charlie: Well, in the first few weeks after being diagnosed I'd sometimes say, "Oh, I can't work out today. I have diabetes." They just wouldn't tolerate that as an excuse or treat me differently because of it. All the way through this, my family has been, first and foremost, a big support system that has rallied around me. I'm lucky: I've got my healthcare team, my racing team, and my family team.
Nadia: Thank you, Charlie. Good luck!
Charlie's Race Week Game Plan
Charlie's race week diet is designed to allow him to selectively store a "ready" source of glucose (glycogen) in the event that he becomes hypoglycemic.
Depending on his travel schedule and level of exertion, he usually tries to eat a healthy dose of complex carbohydrates, "carb loading" on mashed potatoes, rice, lightly dressed pasta, and bread-the equivalent of 30 to 55 slices of bread from Thursday to Sunday of race week.
He balances his diet with lean proteins like grilled chicken, simple sugars to maintain his blood sugar and provide a good dietary source of fiber, including strawberries, oranges, bananas, and pineapple, and grilled vegetables and salad for vitamins and minerals.
On race day, Charlie is checking his blood sugar levels from the minute he gets up in the morning until he gets in the car. He takes insulin using an "on-the-go" pen device that does not need to be refrigerated or timed to meals.
He is set up to monitor his blood sugar even while driving 200 mph, using a wireless continuous glucose monitor that is attached with velcro to his steering wheel, so he can check his blood sugar just like he checks his speed, lap time, or oil pressure.
Charlie's team prepares two hydration sources in his race car. Both are fed through a tube system in his helmet (think of a CamelBak-type water system). One is water only, and the second is a sugar-rich blended drink made from protein powder and dextrose. This system allows him to take a sip of sugar-rich drink if his blood sugar levels get too low while racing, without having to stop.
Chip Ganassi answers questions about Charlie:
Nadia: Did you know about Charlie's diabetes when you first invited him to race for you?
Chip: I have known Charlie and his family for a long time and have followed his career, so I knew all about Charlie's diabetes from the beginning. So when we began talking about him driving a car for me, I knew they had it under control. Plus, I knew how dedicated that Charlie is to the sport and that he would do anything and everything that he could to keep it under control.
Nadia: What insights has your experience with Charlie given you?
Chip: I don't think I had a real understanding of diabetes before, but Charlie has shown me that this disease should not keep you from doing anything you want to. You just have to be smart about it and work at it. This is just Charlie's "normal." I don't think it even fazes him anymore. I love that about him. This is simply a part of his life and he deals with it like others deal with whatever challenges face them in their daily lives.
The main thing I've learned from working with Charlie is that having diabetes shouldn't stop you from pursuing your dreams or passions. Charlie should be such an inspiration to anyone anywhere about not letting anything stop you from reaching your goals.
Note from the Editoe:
Follow Diabetes Health as we continue to report on Charlie's car racing events.
Categories: 2011 Indy Grand Prix of Sonoma, Abbott FreeStyle Meter, Blood Sugar, Carbs, CGMs, Charlie Kimball, Chip Ganassi, Dexcom, Diabetes, Diabetes, Diagnosis, Exercise, Gordon Kimball, Gycogen, Indy 500, IndyCar race team, Levemir Dose, Nadia Al-Samarrie, Novo Nordisk, NovoLog Dose, Type 1 Issues