Thousands of elite athletes from around the world are making their final preparations for the 2010 Winter Olympics in Vancouver, British Columbia. Every snowboarder, short track speed skater, ski jumper and hockey player shares a dream of standing on the medium wearing an Olympic gold medal.
Kris Freeman, a member of the United States cross country ski team has a story unmatched in Olympic competition history. Freeman, 28, is the first athlete with Type 1 diabetes to compete in an Olympic endurance event.
Diagnosed in 2000, doctors initially told Freeman he would have to give up his dream to win an Olympic medal in cross country skiing. Freeman recalls, “I was very concerned that I was going to have to stop racing. Not trying to race never occurred to me. I was going to try, and if I failed I failed but I was certainly going to go as hard as I could to continue on the career path I was on.”
At the time Freeman just given up a full scholarship at the University of Vermont to move to Park City, UT to train fulltime for the 2002 Olympics. He continues, “I put all the eggs into one basket. Being the first American to medal since Bill Koch in 1976 has been my dream since my early teen years. So getting that diagnosis was crushing. But I could see where the doctors were coming from since no one has ever competed at the Olympic level with Type 1 diabetes before. It had never been done and now I’m doing it.”
Freeman is the reigning U.S. National cross-country champion and had his best finish at the Worlds in ‘09 and the best American finish in cross-country in more than two decades. Advancements in diabetes treatment have helped Freeman achieve these world-class results. Freeman explains, “Without a doubt this is the best time in history to have diabetes. The medical advances have been tremendous. I don’t know if what I’m doing now would have been possible 20 years ago.”
Freeman uses Humalog insulin and an Omnipod insulin pump. He reports, “Humalog insulin makes it possible for me to fine-tune my blood sugars before a race and adjust my sugars when I change venues or when I’m traveling and change altitude. It’s fast-acting insulin so it eliminates the need for me to be on a strict schedule in the same environment every day. These things make life so much simpler. I won’t pretend it doesn’t stink to have diabetes but these things make it so much more bearable.”
Training for Olympic caliber events ranging from 15km and 30km classic races to 10km team relays requires pushing yourself to physical and mental limits. Freeman describes his efforts to maintain the proper balance between training and being race ready.
Traveling to competitive venues around the world adds a level of complexity to Freeman’s testing routine. He says,” Testing is much different when I’m constantly changing the country I’m in, the kinds of food I’m eating or even the altitude that I’m at. The different pressures that you are at can put different pressures on the body which makes you absorb and utilize insulin differently.”
Keeping a detailed log about how much insulin he has used in previous World Cup competitions give Freeman a starting point for crafting an insulin regime to follow before each race. He explains, “A normal blood sugar level ranges from a glucose from 70-120 in a non-diabetic athlete. From my own testing I have found that I have no ill effects from my blood sugar from about 70-200 so I try to keep it in that range. If my blood sugar gets much over 200 my lactate levels actually start to increase with the higher blood sugar. The range I have to keep it in is 70-200. That is not that big of window in reality.”
He continues, “The most important thing is that if I get much over 200 my lactate starts to climb. Lactate is what makes your muscles ache and burn. On the flip side I can’t let it go below 70 because then you feel like you have a “bonk” coming on. You have a bonk created by too much insulin and not enough sugar in your system. With a severe enough bonk you can actually lose consciousness. That window is very important for me to keep my blood sugar within.”
Freeman has been using an Omnipod insulin pump in raced for 18 months. Previous pump options featured a thin plastic tube between the pump and a needle to deliver the insulin. Given the environment Freeman competes in, that system was problematic. He explains, “I can race legally in the World Cup with a temperature as cold as of -4 º. The concern that my doctor and I had if this exposed tube would freeze I would be in serious trouble. We stayed away from a pump until the Omnipod came out. It’s actually a patch pump. It adheres to the body with an adhesive. A needle goes from the pump into the subcutaneous fat wherever you happen to stick that patch.”
After years of training and carefully selecting the most appropriate mix of boots, skis, bindings and poles for the racing conditions, Freeman notes that pre-race jitters can also influence his blood sugar levels. He says,” When you get nervous before a race, you leak adrenaline. That adrenaline triggers the liver to dump sugar into your system and you can get an elevated blood sugar [level]. I can’t afford to get incredibly nervous before the Olympics and have my blood sugar get out of whack because it will ultimately hurt my performance.” Relaxation techniques and conversations with a team sports psychologist have helped him address those issues.
Freeman wants his story to inspire other people with Type 1 diabetes to follow their own dreams. Working with Eli Lilly since the 2002 Olympics, Freeman travels around the country to talk with kids about their aspirations and diabetes. He says,” With my initial diagnosis I was told my dream was not going to come true and you will not be an Olympic level ski racer. I feel very passionately about going to these kid camps and making sure that despite having diabetes they don’t let anyone tell them there are limits on their life. Diabetes is very manageable. The medicines and the technology that are coming out are getting better all the time. It’s only a matter of time before it gets cured. Hopefully that will happen in my lifetime. I try to express that in the meantime, the better you take care of yourself the less diabetes will get in your way.
When the Vancouver Winter Olympics begin in February 2010, Freeman hopes to fulfill his lifelong dream to stand on the Olympic medal podium. In his words, that’s not his only motivation. “One of my motivators for trying to get a medal in this endurance sport is hopefully I can get more publicity for the fact that diabetes doesn’t have to hold you back. Anything is possible with diabetes as long as you are diligent about taking care of it.”
Reflecting on his career as an elite, Olympic caliber athlete at the cusp of an Olympic medal Freeman says, “When I look the results I don’t look at the results sheet and say wow I was 12th place today but I was the first diabetic athlete. I look at it and say I was 12th, how am I going to be the best in the world. How am I going to be the best in the world despite having diabetes? Being described as a diabetic has never bothered me. It’s my own expectations that are important to me and my expectation is to be the best in the world.”