I totally freaked out. I cried for days,” says ultra-marathoner Missy Foy. She was certain her career was over when she was told a decade ago that she had type 1 diabetes.

Foy, now 42, had the misfortune of being diagnosed at a time when doctors were still in the dark over how to help athletes continue their careers after being told they had diabetes. Foy visited four endocrinologists before finding a doctor who would help her balance her insulin while continuing to compete.

“Most doctors didn’t have any experience with [competitive athletes],” Foy says. “They thought it would be too difficult to balance insulin and the intensity of training.”

Although exercise is often prescribed as a way to manage type 2 diabetes, athletes with type 1 face special challenges. In people with type 1, exercise can cause blood sugar levels to drop precipitously. Therefore, exercise, food intake and insulin injections must be carefully monitored and balanced.

Fortunately for athletes with diabetes, a lot can change in 10 years. In the past, America’s most popular diabetic was probably Mary Tyler Moore. Today, the public face of diabetes includes basketball players, long-distance swimmers and triathletes.

Today, new technology has made it easier for athletes with diabetes to stay on the field without having to think constantly about the disease. Continuous glucose monitors can track blood sugar and sound alarms if it goes outside of safe ranges. Wireless insulin pumps can deliver insulin as needed without a morass of tubes and wires.

Dr. Larry Deeb, president of medicine and science at the American Diabetes Association, says that in the past, he would have discouraged a patient from intense athletic competition. “Now,” he says, “I want kids with diabetes to be empowered to take care of themselves and to know and believe that there are no impediments before them.”

In April, Denver Broncos quarterback Jay Cutler, 25, announced that he’d been diagnosed with type 1 diabetes. Doctors emphasized that in no way was his football career jeopardized. He joins Olympic swimmer Gary Hall Jr., LPGA golfer Kelli Kuehne, Colorado Rockies pitcher Jason Johnson and Charlotte Bobcats forward Adam Morrison—among many others—as an active professional athlete with the disease.

The evolution of self-monitoring has allowed athletes to continue their careers. Years ago, type 1 patients would check their glucose by testing their urine, which did not provide instantaneous feedback.

These days, an athlete can draw a drop of blood to be read by a meter, which gives results in real time. Insulin pumps communicate wirelessly with glucose meters the size of matchboxes to determine blood sugar levels. Results tell athletes if they should eat more food, ease up or take in insulin.

This was hardly the case 25 years ago, when Phil Southerland’s mother was told that her 7-month-old son would have “renal failure or blindness…if he lives to 25.”

Today, Southerland is the founder of Team Type 1, a cycling team of eight type 1 diabetics. In 2007, the team won the 3,053 mile “Race Across America,” completing the Los Angeles-to-Atlantic City competition in 5 days, 15 hours and 43 minutes.

For Southerland and his teammates, a typical race day is much like that for any other cyclist, except that they are constantly monitoring their blood sugar levels. Every 15 minutes or so during the two hours before the start of the race, they have to check their levels and sometimes have to use food or insulin to adjust because of the importance of being at the correct level once the race begins.

Southerland says regulating glucose levels is still a matter of trial and error.

Although exercise is often prescribed as a way to manage type 2 diabetes, athletes with type 1 face special challenges. In people with type 1, exercise can cause blood sugar levels to drop precipitously. Therefore, exercise, food intake and insulin injections must be carefully monitored and balanced.

“If we have too much insulin on board before the race, we’ll bonk immediately,” he says. “If our blood sugar is too high, we won’t perform our best, and if it’s too low, we won’t perform at all.”

Southerland says he checks his blood sugar 18 to 25 times a day. “We are essentially the CEOs of our own bodies and we don’t get a break from them,” he says.

Team Type 1’s ultimate goal is to have a team composed entirely of athletes with diabetes compete in the Tour de France in four to six years.

“It’s important for the parents of small children with diabetes to know they don’t need to put limitations on their families and their children,” says Type 1 team member Fabio Calabria, 25. “If they put in a little extra work and get everything under control, they can do whatever they want to do and they can do it as well as anyone else.”

When Ironman triathlete David Weingard, 43, was told he had type 1 seven years ago, he had nowhere to turn. His doctor discouraged him from doing another triathlon, he said.

Weingard found that unacceptable. He would continue to be active, he decided, but he would be meticulous about it. He spent one year training for his first post-diagnosis Ironman, simulating the experience down to the time the gun would flare at the starting line, then compiled the information in a 50-page document.

“I figured out what it’s like to go in the pool at exactly the time the race would start, to test myself during the swim, then to come out and see how much insulin I needed to take,” he says. “I learned what my routine would be every single hour.”