This summer, top cycling teams from around the world tackled extreme terrain and intense competition in the centennial Tour de France. The race, one of the most well-known in the sport, is a goal for many professional cycling teams—including an international team of cyclists who all have Type 1 Diabetes. Meet Team Novo Nordisk. As the team trains for a future Tour de France, they are spreading awareness about Type 1 Diabetes with every ride they take.
Riding for a Cause
Team Novo Nordisk, the first all-diabetic professional cycling team, has been making a splash on this year's cycling circuit, spreading awareness about Type 1 diabetes (T1D) with every mile they pedal. After a change of riders and a move to an "all Type 1 diabetes" team lineup with the start of the 2013 season, the team has been cycling a competitive schedule in recent months, including the Tour de Beauce, the Tour de Korea, the Air Force Association Cycling Classic, the Philly Cycling Classic, the Tour of the Gila, the Presidential Cycling Tour of Turkey, the Vuelta a Castilla y Leon, the Bayern-Rudnfahrt, and Post Danmark Rundt.Followers of Team Novo Nordisk's progress through their social media streams are treated to awesome in-action, on-the-bike, rounding-the-curve or cresting-an-incline photos (like the one above) showing their progress this season. Fans know that these riders are constantly on their bikes, but with each location they visit and each race they ride, the Team, who wear "Changing Diabetes" jerseys, is spreading the word about diabetes, raising awareness, and changing public understanding of the disease.
While Type 1 diabetes is a lifelong and serious disease, these riders are showing, day by day, that with proper management, nothing is impossible for someone with Type 1 diabetes—even being a professional athlete. For young people with Type 1 diabetes and parents of children with Type 1 diabetes, the Team's presence on the professional cycling circuit is inspiring and full of hope. These riders all have diabetes, and yet they are healthy, active, and doing what they love. They also list things like "loving lasagna" in their Team bios.
These riders, ranging in age, cycling experience, and years since their diagnosis, have come together as a unified force. Together, they aim to pose a serious challenge to other cycling teams and make a difference in diabetes education, awareness, and care around the world.
Demystifying Type 1 Diabetes
Why create a team of racers who all have Type 1 diabetes?
When you scroll through the biographies of the Team Novo Nordisk riders, you see typical statistics, age, height, weight, country of birth, and, in every case, "age of diagnosis." This team isn't simply spreading the word about diabetes. They are living (and riding) with Type 1 diabetes, and as the team says in one of their public awareness campaigns, they are living "on their terms" as they join together with sponsor companies like Novo Nordisk to increase public awareness of diabetes and foster new understanding of what it really to have Type 1 diabetes.
Many people are not familiar with the signs of diabetes, misunderstand what it means to have diabetes, and do not know the differences between Type 1 and Type 2 diabetes. Misinformation about diabetes is widespread, even among some health professionals. Ask a family who has had a child diagnosed with Type 1 diabetes and received a crash course in diabetes education in a period of hours about what they knew going in, what they learned, and how many times they have since had to explain the basics of Type 1 diabetes to friends, family, and other outsiders. People who have Type 1 diabetes, or have an immediate family member with Type 1 diabetes, take on a neverending role of public education in addition to management of the disease.
With the rise of Type 2 diabetes in recent years, the conflation of information about diabetes in the popular consciousness has multiplied. Many people know "something" about Type 2 diabetes but know much less about Type 1 diabetes or, worse, assume all diabetes is basically the same. Both Type 1 and Type 2 diabetes are related to the pancreas and insulin, but in many ways, the two types are very different.
One misconception is an over-simplification of diabetes as "a diabetic can't have sugar" or, even worse, "diabetes is caused by eating too much sugar." Neither statement is completely true, and each statement has different levels of significance, depending on the type of diabetes. People with Type 1 diabetes can eat almost anything. That doesn't mean there are not some foods that are better choices than others, but dessert is not off the menu. Neither is pizza. Or lasagna. Or brownies. The difference is that no matter what someone with Type 1 diabetes eats, they need insulin for their body to properly process and use the food.
Stopping sugar intake doesn't solve Type 1 diabetes, and there is no cure for Type 1 diabetes.
But having Type 1 diabetes doesn't mean you can't get out and do what you love.
A Lifelong and Growing Disease
Type 1 diabetes (Diabetes mellitus) is an autoimmune disease in which the body attacks and destroys the insulin-producing beta cells in the pancreas. The body needs insulin to break down glucose as it comes into the blood stream from the foods we eat and as it is released by cells where it has been stored as energy. Some glucose comes from simple sugars, like those found in a piece of cake. But all carbohydrates are broken down by the body into glucose. Everyone, even people with diabetes, needs carbohydrates.
Because the body doesn't produce insulin, someone with Type 1 diabetes has to inject insulin throughout the day to handle the process a healthy pancreas does naturally. (In Type 2 diabetes, the body does not use insulin effectively, or is insulin resistant, but the pancreas does produce insulin.)
According to Novo Nordisk, there are more than 371 million people, worldwide, who have been diagnosed with diabetes (of either type). That number is predicted to rise to more than 550 million by 2030. Because Type 1 diabetes is often diagnosed during childhood or adolescence, it used to be called juvenile onset diabetes. A person can, however, get Type 1 diabetes at any age. (Of the 17 members on the current Team Novo Nordisk cycling team, nine were diagnosed at age 16 or older.) The Juvenile Diabetes Research Foundation (JDRF) notes that "as many as three million Americans may have T1D," and each year "more than 15,000 children and 15,000 adults—approximately 80 people per day—are diagnosed with T1D in the U.S."
Living with Diabetes
Managing Type 1 diabetes requires constant monitoring of blood glucose levels and the injection of insulin to balance foods that are eaten. Without naturally-produced insulin to regular blood glucose, a person with Type 1 diabetes must take insulin to control glucose levels. This is not as simple as taking a single dose a day or even a set amount. People who take insulin count carbohydrates and take insulin in a prescribed ratio to help keep their blood glucose within certain levels. Every individual's body chemistry is different, so insulin routines are different for each person with Type 1 diabetes. Glucose levels go up and down, all day long, every day.
Treating diabetes is complicated because both high and low sugar levels can be dangerous. If blood glucose levels run consistently high, patients are at increased risk for a wide range of health problems, including heart disease, stroke, vision problems, and neuropathy. Treating low blood sugar involves giving the body a rapid supply of glucose to help balance the blood sugar. If glucose levels remain too low, a person with Type 1 diabetes can end up in a coma and die.
Because glucose levels are constantly in flux as your body goes through the day (even during the night), successfully managing Type 1 diabetes requires constant vigilance, numerous glucose (or "blood sugar") checks each day, insulin at meals and as a corrective measure in the event of high blood glucose readings, and attention to what the person is "doing" at all times that may change how the body uses and processes energy. Exercise, for example, can make a big difference in how the body uses energy and in how much insulin is needed to handle certain foods.
But, as Team Novo Nordisk shows, Type 1 diabetes can be managed successfully, and people with Type 1 diabetes can do anything—even get on a bike, day in and day out, ride hard all day long, and win.
What foods are good when someone needs a glucose boost? What foods convert to glucose faster than others? Which foods have a minimal impact on blood glucose levels and what does that tell you about the relationship between carbohydrates and other nutritional ingredients? What foods might a professional athlete eat to help boost energy without skyrocketing blood sugar levels during a race?
Students with or without diabetes can learn more about the way the body uses and processes sugar, and better understand the role of insulin, in hands-on science projects like these:
- "Sucrose & Glucose & Fructose, Oh My! Uncovering Hidden Sugar in Your Food": not all foods are converted to glucose in the same amount of time. For someone with diabetes, knowing how the body will deal with and react to fruit juice compared to a slice of pizza, for example, is important. Using the invertase enzyme, students can investigate glucose concentration levels in different kinds of foods. How does the hands-on testing correlate to the information available on the nutritional label on a food's package?
- "How Sweet It Is! Measuring Glucose in Your Food": how do different fruits and juices compare when it comes to glucose? Is eating a piece of fruit the same as drinking a cup of juice in terms of the body's reaction to the sugars? Are some fruits or juices better choices than others when you need glucose to raise blood sugar? In this project, students investigate the glucose concentration in various fruits and juices.