Kris Freeman InterviewKris Freeman, is the reigning US National cross-country champion. Recently he was selected to compete as a part of the US Ski Team in the 2010 Olympic Games this February, which puts him in a very elite club. He was diagnosed with type 1 diabetes in 2000, before his first Winter Olympics in 2002. He also competed in the 2006 Winter Olympics.
What sets Kris apart from others with type 1 diabetes is that he competes in endurance sports: the 15 kilometer freestyle cross-country (XC) race lasts about 45 minutes. Kris will also compete in the 30k pursuit race, the 50k mass start classic, and the individual and team sprints.
I was given a chance to ask Kris some questions and he kindly answered all of them. I've only edited these to add some hyperlinks.
Q: Your diabetes story: How did you first find out you had diabetes? Had you been ill before this and how did you feel at the time of your diagnosis?
A: I was training full time with the US Ski Team in Park City Utah. Every two months I had a blood test to see how well I was handling the training and to screen for any abnormalities. The tests always included iron levels, cholesterol, red-blood cell counts etc. One screening included a glucose test as well and mine came back at 240. I was sent to an endocrinologist in Salt Lake City who diagnosed me with type 1 in five minutes.
Q: If you remember it, what was your initial BG value?
A: My initial BG levels were low for a new diagnosis because my abnormal blood sugar was discovered very early in the "honeymoon" phase. I had only mild symptoms of diabetes including frequent urination, feeling light-headed and occasional blurry vision. I didn't notice the extent of the symptoms until after the diagnosis.
Q: At the time, your doctors seemed to think that your skiing days were over, what made you sure you could continue?
A: I was crushed when I was first diagnosed and told that my Olympic aspirations were over. I immediately started studying the disease and the history of its treatment. I learned that many breakthroughs in diabetes care had been made recently. Glucose monitors were getting faster and more accurate and pump technology was improving rapidly. The invention of Lilly's Humalog fast-acting insulin excited me most though. With these breakthroughs being so recent, I realized that no one could know what was possible for a diabetic athlete using them, especially when they were told not to try.
Q: What preparation, if any, did you make to return to training with diabetes? How did you change your approach to training to accommodate diabetes?
A: I trained the afternoon of my diagnosis. I went for a kayak with tears in my eyes. I was not going to give up. I didn't change my training at all. I changed my diet and learned the nutritional values of every food I had been eating. I studied the glycemic index and stocked up low index carbs. Over the years I have gotten to the point where I can glance at a plate and know how many carbs are on it where they fall on the index. I prepare for training and racing through a strict diet of what my body needs not what it is most appetizing. Whole grains, lean protein and lots of fruit and vegetables are essential. I try to eat all my food in as close to its natural form as possible. I avoid processed foods like the plague.
Q: Before you started using an insulin pump, how many shots were you taking a day? What changes did you make so you could still exercise while on shots?
A: I used injections for the first seven years I was diabetic. I used Lantus as a basal and Humalog as a bolus. I took my basal at 9:00 PM and the Humalog injections with my five daily meals. I eat about 5000 calories a day when I am in heavy training. I would also take correctional Humalog shots if my sugar was too high after eating. Some days I would take six shots others I would take over a dozen. I do whatever I have to do keep my sugar near normal levels at all times. Diet and a strict insulin regimen make it possible for me to train and race like any other athlete.
Q: For attending a race, what kind of diabetes-related things did you bring with you?
A: I always bring two Lifescan Mini Glucose monitors. I keep one in my water-bottle belt which I keep warm with two chemical hand-warmers. The second monitor I keep in my backpack which I always leave in a heated building. I keep my Personal Diabetes Manager (PDM) for controlling my OmniPod in my waterbottle belt as well. I also bring a vial of insulin and an extra pod in my backpack in case of a freak accident.
Q: Why did you choose an Omnipod over other insulin pumps?
A: In international XC ski races the minimum temperature for holding an event is -4 degrees fahrenheit (-20 C). At that temperature my doctor and I were concerned that the exposed tubing on the infusion set of a traditional pump would freeze. The OmniPod adheres to the skin with the delivery tube going directly into the body. The direct placement allows my body heat to keep the pump from freezing at any legal racing temperature. Also there are occasional high speed crashes in XC ski racing. I have crashed in races going well over 30 mph. Destroying an OmniPod in a crash is not a huge loss since it is replaced every three days anyway. Destroying a traditional pump would be a serious financial and logistical problem.
Q: How has your race preparation and racing changed because of the Omnipod?
A: The OmniPod has allowed me to use only Humalog insulin which is much more predictable than basal insulins. I am able to change the basal drip of Humalog at any time using the PDM. This has allowed me to experiment with different basal rates in training and racing to find the ideal dose for each of my events. My initial testing was done rollerskiing on a huge treadmill at US Ski Team's gym, The Center of Excellence. I was hooked up to an oxygen monitoring helmet and had my glucose and lactate levels monitored at different exertions.
Q: Have you considered using a continuous glucose monitor to reduce time needed to test and correct your blood glucose levels during races?
A: My doctor and I have not learned of a continuous glucose monitor that would work reliably enough to use during a race. I am anxious for the technology to develop though.
Q: It's usually cold where you're training or racing, how do you overcome temperature issues with your Omnipod and testing?
A: The chemical hand-warmers that I mentioned previously keep my glucose monitor and PDM warm while I am skiing so I can make on the fly tests and adjustments. Before a race I always try to make my final tests and adjustments in a heated location for maximum reliability.
Q: Has there been a time when having diabetes helped you in some way? Can you give us some insight into that?
A: Having diabetes has forced me to learn about diet and nutrition. I have also learned more about my physiology than I ever would have without the diagnosis. I am more aware of how I am feeling at all times.
Q: Have you a general message for our readers?
A: The technology exists to treat diabetes in a way that it does not have to have a negative impact on any goal or dream you may have. Be diligent with your diabetes care and there are no limits to what you can achieve.
Type 1 diabetes hasn't stopped Kris from getting to the top of this tough sport. The Winter Olympics in Vancouver start on February 12th. The first cross-country race with Kris is the 15k freestyle on February 15th. You can also find Kris on Twitter.
Update: If you want to keep track of Team USA results the TeamUSA.org web site will have all the latest news. If you're feeling generous, you can also donate to support our team by clicking below.