Cycling: It's in Team Type 1's blood

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Diabetes and professional sport do not seem to go hand in glove. But, as Michael Burgess reports, a team with strong Kiwi connections is showing how to deal with the illness.

As a professional cyclist, Australian Fabio Calabria injects himself before every race. He might even help a team-mate with his injections.

This may not seem a strange scenario - especially if you have been reading the news lately - but what makes Calabria different is that all of his injections are permitted and legal.

Calabria rides for Team Type 1, an American-based professional team that recently took out the tour of Turkey and competes in races across the globe. He is one of six riders on their roster who has type 1 diabetes and his pre-race routine is a little different to most.

"I usually check my levels every 10 minutes in the two hours leading up to the start," Calabria told the Herald on Sunday. "My routine tends to be - pin number on; clean sunglasses; fasten cleats; check glucose level; think about race; stretch; check glucose level; listen to music; check glucose level."

It also adds a whole new dimension to butterflies in the stomach.

"Some days I will test myself and my sugars are way up - I think to myself 'right, well, I guess I am nervous then," he laughs.

Calabria, who won the New Zealand under-19 road championships in 2005, says technology has made things easier in the well-resourced team. When he was racing as an amateur in Italy earlier in his career, Calabria would sometimes have to do finger prick tests every hour - in training and races - to check his levels. Now he wears a glucose monitor, while an automated pump - some describe it as a 'manual pancreas' - provides a flow of insulin directly into his stomach.

"Often I can go on feel; After years of racing, I'm almost able to assess my levels just by how my body feels."

Team Type 1 was set up by two American amateur riders who got chatting after seeing each other injecting themselves before a race. From humble beginnings - initially it was a grassroots initiative aimed at showing people how they could control their diabetes using cycling as a platform - the team has gone on to greater things.

They have won the 5000km Race Across America on four occasions, and hold the race record. They compete in Europe, Asia and all across the US and aim to enter a team in the 2012 Tour de France.

Former riders on the team have included Kiwis Glen Chadwick, who represented New Zealand on the road at the 2008 Beijing Olympics, and Tim Hargrave.

Team co-founder and CEO Phil Southerland was diagnosed with Type 1 diabetes at seven-months-old. Doctors told his mother he would be blind or dead by the age of 25. Now aged 29, Southerland is alive and thriving; as well as the cycling team, he also runs programmes that involve 90 other diabetic athletes and has recently published his memoirs Not Yet Dead: My Race Against Disease From Diagnosis To Dominance.

"Diabetes has never held us back," says Southerland. "We're paving the road and establishing guidelines for diabetes and exercise so that parents of diabetic kids never have to worry about their children's safety, and athletes with diabetes have a blueprint for success. We want to be the No 1 resource in the world for diabetes and sports."

Co-founder Joe Elridge still rides with the team and the other Type 1 diabetic riders are Alex Bowden (US), Martijn Verschoor (Holland), Olaf Kerkhof (Holland) and Javier Megias Leal (Spain).

Calabria was diagnosed as a diabetic as a 12-year-old and was subsequently in a coma for three days, spending a week in intensive care. When he later told doctors of his plans to be a professional cyclist, they thought he was "crazy" but friends and family supported his goal, including cherished advice from his mother.

"She told me that she couldn't see without her glasses and that is something she has to do every day. She made me realise that everybody has something to overcome and made me believe it would be possible."

Of course there have been some incidents. Once as a teenager, he ran out of food during a a remote solo mountain training ride but managed to find a house where a woman, who happened to be a nurse, gave him food and drink.

"As a diabetic, we need to follow the same plan as a professional athlete anyway," says Calabria. "It is all about healthy eating, exercising, looking after your body - though obviously the consequences are greater if I make a mistake."

"I am in awe of these guys," says Ben King, a fellow (non-diabetic) rider on the Team Type 1 team. "They have to be so vigilant at all times and it was only when I started flatting with one of them [Martijn Verschoor] that I really realised. Weather can affect blood sugar levels - if it is cold, or humid, or hot - and so can your sleep patterns. Adrenalin - whether from crashes, bumping into other riders or flying down a hill - can send the levels haywire as can nerves and anxiety."

Calabria says the reaction of other riders to Team Type 1 has been overwhelming positive - "When they see us checking our levels they will joke, 'are you calling someone? are you checking your i-phone?" says Calabria.

Spectators tend to be curious: "They will say, 'you are not overweight, how did you get diabetes?' says Calabria.

"There is a lot of misinformation about Type 1 and Type 2 diabetes out there and doctors often tend to manage their patients by preventing them from doing anything."

Insulin is on the banned list for professional cyclists, as it is seen as performance-enhancing, but the Team Type 1 cyclists have a therapeutic exemption.

"For me, being on the team ticks all the right boxes," says Calabria. "As well as racing, it is great to be part of a mission to spread the word. I know diabetes can be a potentially life-threatening situation but I also think that whatever I want to achieve, I can achieve."

WHAT IS DIABETES?

Type 1 diabetes means the body is unable to produce its own insulin.

Without enough insulin in the bloodstream, the body is unable to use or store glucose properly, which is why Type 1 diabetics need to deliver insulin by injection or pump.

Low blood sugar levels can lead to seizures or loss of consciousness. High blood sugar levels are less of an immediate concern, as the brain and body can still function but elevated glucose levels can lead to problems in the long-term - like blindness and damage to organs.

Former New Zealand cricketer Craig McMillan has Type 1 diabetes and lived with it during his sporting career. Other famous sportspeople with the disease have included baseball legend Jackie Robinson, US swimmer Gary Hall jnr (who won Olympic gold medals in 2000 and 2004) and Chicago Bears quarterback Jay Cutler.