T1D Relay Team Takes on the Ironman

As if living with type 1 diabetes wasn’t a challenge enough, three bold T1D athletes came together on April 6^th to compete in an arduous 70.3-mile triathlon called the Ironman Oceanside to show the world that diabetes can’t stop them from running after big dreams.

Susan Powell, an avid cyclist and triathlete long before her diabetes diagnosis in 2023 at age 56, fueled the Ironman fire in her friend Tanya Morgan. Tanya, a surgical nurse who was diagnosed with type 1 when she was 18 years old in 1989, had been a runner for many years but had never competed in an Ironman event. When Susan suggested Tanya ease into the triathlon world with a short sprint-distance race, Tanya said, “If we’re going to do this, we’re going to go BIG!” They came up with the idea of doing the Ironman Oceanside as a T1D relay team and went in search of a swimmer.

Through Facebook they found Brad Williams, a 43-year-old T1D firefighter in Arizona, and team  “Dia-Bet-You-Can’t Beat-Us” was born. (Incidentally, the name does not refer to beating their competitors, but rather a proclamation that diabetes can’t keep them from pursuing their passions).

The event presented challenges for each of the athletes, starting with the swim.

Challenge # 1: Leaving Technology Behind

“Obviously going into the swim, the challenge is not having CGM, not knowing what your blood sugar is, and just hoping that the plan in place is working behind the scenes. I think having done a handful of these events and doing hours training in the pool, I felt a lot more comfortable knowing that if I’m at a certain range…most likely I’m going to be at a certain range when I get out.”

He had a Honey Stinger with caffeine (an energy wafer) about 30 minutes before getting in the water – a typical pre-swim snack he had had for the months of training leading up to the race. But his pool training hadn’t prepared him for the frigid ocean water.

“It was rough. The water was 61 degrees. Getting into the water shocked my system and I wasn’t really able to get a good rhythm going until probably 400 or 500 yards in. It took a while for my body to get warm and for me to be able to stick my face in.”

And even for a seasoned athlete, you can still question your motivation as you fight through cold, choppy waves with 5000 other competitors.

“I had all the normal doubts and mental challenges in the first three minutes of, ‘Why are you doing this? You’re not going to be able to make it, you’re already tired, just call it now!’ But I couldn’t quit because Tanya and Susan were relying on me. Luckily I was able to finish and I felt good coming out of the water. When I got out I tested and I was 128, so that part worked out well.”

Challenge # 2: Riding as a T1D Rookie

Susan was standing by at the transition point for the hand-off and her 56-mile bike portion of the event. Although she has a slew of triathlons behind her as well, she’s only been living with type 1 diabetes for about a year, and her biggest challenge when training and competing is hypoglycemia. Because of this she eats a big protein-filled breakfast and packs a ton of food with her when she rides. She has a special computer on her bike that allows her to see her blood sugar the whole time she’s riding. She wears a Tandem pump with a profile she created called “race mode”, which is about 40% of her normal insulin settings.

“Even with all the food I eat before a race I still have to manage things with glucose tabs, jelly beans, and potato chips. The first part of the ride is always about stabilizing the blood sugar level. Once I get that handled I’m able to maintain it. But sometimes it takes a while.”

She’s still learning how her blood sugar reacts in different situations, and the morning of the race was no different.

“I was so cold waiting for Brad to finish his swim, I was shivering so much. I asked my husband to tell me what my blood sugars were so I didn’t have to turn on my bike computer, and it was 90-something. Tanya said ‘I think it’s the cold, you’re using so much energy to keep warm.’  Plus the anxiety…my blood sugar goes down with anxiety. I took seven glucose tabs, trying to choke them down before Brad got there. For the first time ever, when I got on the bike my blood sugar was 177 with an up arrow. But that was the highest it got. It stabilized and was stable almost the entire ride. It was the closest to a perfect blood sugar ride I’ve ever had. I consumed a lot of food during that time, but it worked out.”

Challenge # 3: Experiencing the T1D Version of “Runner’s High”

When Susan arrived at the transition point it was nearly noon, and Tanya’s blood sugars were out of whack from hours of waiting.

“We left the hotel at 4:30 am, so I had a lot of downtime. By 9:00 am I was hungry, so I had some almonds, peanut butter, a banana…I also had some scrambled eggs and half a piece of toast. But I didn’t want to bolus. The thing about race day is you never know what to expect. And there’s nerves, and that will creep up your sugar.”

When she started her 13.1-mile run at 11:50 am, she was about to hit 300 and felt sick to her stomach.

“I’m hydrating, hydrating, hydrating, and taking a little bit of insulin, but not too much because I know when I start running it’s going to come crashing down and I’m going to have all this insulin on board. The first six miles were difficult in that my sugar was creeping up. I put myself on exercise mode and I was taking little boluses just to get myself down. I was afraid of getting dehydrated with high sugar and DKA, so all of that was in my head the first four miles. By mile six I settled into the 150s. The race was slow and steady – I walked every water station and every hill because I didn’t need to exert extra energy. The time was okay…but it really was a success in what it was. When I came in I was 144, and I felt amazing.”

Finishing this race was particularly meaningful to Tanya because the training and focus helped her come out of an 18-month depression that started in 2022 when she was going through menopause and struggling with some changes to her health.

“One of the things I understand is common with diabetes is also depression, and I was feeling caught in this cycle and trying to break out of that. It was really difficult, but running gave me an opportunity to break the cycle and the lack of desire to manage diabetes the way it requires. If you take your eye off of it for a second you can get into trouble. I try to not use the language of being in good control or having good or bad numbers because mentally that can be really difficult. Running has been the biggest blessing in my life, and provided me a way out of what felt like a big hole.”

Finding Your Own Ironman

This T1D Ironman team has no plans of slowing down, and each member is already training for their next event. Brad wants to try open water marathon swimming, Susan is doing a 70.3 Ironman all on her own in May, and Tanya is running the Carlsbad Half Marathon in January. They all hope to inspire others to pursue their dreams, whatever they may be.

“Just because you have diabetes doesn’t mean you can’t go out and do stuff,” Brad says. “Find your Ironman. Your Ironman doesn’t have to be a 140-mile race, your Ironman might be a 5k. It might be a fun run that’s one mile. Find what your challenge is, go out there and do it, and maybe in a couple of months you’ll move to a 5k. Start small and find what you enjoy.”

For Tanya, preparation is key when it comes to diabetes.

“I think for anything with diabetes, the extra steps in planning are worth everything. You always have to have the ability to check your blood sugar, treat a low, and have hydration. Especially with exercise. And be ready to pivot, and have a backup plan. And flexibility, because there are some runs when diabetes takes precedence and I know I need to stop, I need to walk, or I can’t finish the long distance because I can’t get my sugar up.”

Susan adds, “And absolutely get yourself a support system. This was a relay team of three people, but the reality is that our spouses and friends encouraged us and supported us through some really challenging times. And don’t be afraid. I know it’s scary. The fear of having a low while you’re doing these things is valid, but if you get your feet wet, you can do a smaller ride and work your way up. I just hope people will be true to their own dreams. It doesn’t have to be a triathlon, but don’t be afraid. We have diabetes, but we can still live life to the fullest. It might be harder, but we can do it.”