By: Mary Milewski
He trains about 22 hours during the average week—not countingthe additional seven hours of workouts on weekends. Through histwice-daily workouts, he totals nearly 120 miles of bicycling, about 10miles of swimming and between 50 to 100 miles of running each week.For Ironman triathlete Jay Hewitt, training and diabetes have somethingin common: Working at them every day is critical to achieve his goals.
A Diabetic in the Most Grueling Sporting Event
Hewitt, of Greenville, South Carolina, competesprofessionally to beat other athletes in one of the planet’smost grueling sporting events. He also competes withhimself to beat one of the most difficult diseases—type 1diabetes.
“I race Ironman triathlons for the joy of the challenge andto prove that diabetes cannot stop me from achieving mygoals,” says Hewitt, who was diagnosed with type 1 diabetesin 1991 at the age of 24.
The Ironman triathlon requires participants to competein a 2.4-mile swim, immediately followed by a 112-milebicycle course and then a 26.2-mile run.
Hewitt is a member of the 2005 U.S. National Team for theLong Course Triathlon and will race for the United Statesat the ITU Long Course Triathlon World Championshipsin Fredericia, Denmark, in August. He is also racing toqualify for a slot in October’s Ironman Triathlon WorldChampionship in Kona, Hawaii.
In addition to preparing for and facing the enormity ofthe Ironman race and the exhaustion it brings, Hewittknows that as a diabetic this is the ultimate way to tell thedisease, “You’re messing with the wrong guy.”
“I respect my diabetes, but I will not surrender to it,” hesays. “To me, diabetes is an opportunity, not an obstacle.It is a chance to prove that I am stronger than it is, thatit cannot stop me, and to inspire others to achieve theirdreams and never quit. I see the finish line with everymile I swim, bike and run. That is why I tell myself: “Youwill not quit.”
As a first-year law student, Hewitt had to study day andnight. He didn’t have time to be sick.
“But over the course of about a week, I was getting weakerand weaker and losing weight. I was fit and athletic backthen, so it was very noticeable,” he says. “It got to thepoint where I was almost in a coma. My blood glucosewas so high that I could hardly even hold the razor up tomy face when I shaved, nor could I climb steps.”
Hewitt thought he simply had a virus.
“I didn’t know what to look out for,” he says. “I washallucinating and semiconscious. Of course, I wasdrinking orange juice which was just making it worse.”
Finally he went to the school’s infirmary for medical help.
The experience was scary, he says, because he had neverhad any exposure to diabetes, its symptoms or what thedisease involved.
“I had no warning signs, no history in my family,” he said.
A True Athlete’s Response
Although he was stunned and confused at first, Hewittsoon became proactive about his diabetes.
“I went into complete absorption mode—reading andlearning everything I could to understand what it was, itslimitations and how to control it,” he says.
Hewitt now sees his diabetes as a sort of blessing.
“My approach has been that once I understood it and Iabsorbed all the information I could, I set out to try tolive my life as a nondiabetic,” says Hewitt, whose last A1Cwas 5.9%. “Not in a sense of living in denial, but ratherliving in determination.”
Hewitt’s dedication to his athletic training was fueled byhis philosophy on diabetes.
“I wanted to have my body not know it was diabetic.I know it’s not always possible to have normal bloodglucose numbers, but my A1C readings were as close tonormal as possible,” he explains. “I feel that by taking careof myself, I can live as long and healthy as I want.”
Sharing His Experiences to Motivate Others
Training for the Ironman event alone is hard enough—without the added considerations for diabetes.
“It became an opportunity to prove, first to myself, that Icould do it,” he says. “But then it became an opportunityto set an example. I could talk to other people about it.”
Hewitt says his experiences sharing his stories of diabetesand the ultimate athletic challenge—the Ironmantriathlon—have been even more glorious than crossingany finish line. He takes great joy in providing a positiveexample for adults and juveniles. He often does volunteerspeaking for the American Diabetes Association as wellspeaking for corporations and at sales meetings. If fact,speaking has become his second career.
“My message is usually about achieving goals, settinggoals, taking things that are obstacles and turning theminto positives,” he says. “I share my lessons for an Ironmandiabetic triathlete and how people can apply them to achieveany goal in life—as a professional or an individual with apersonal goal.”
Hewitt says he plans to write a book soon, with stories aboutracing and how to apply these lessons to life and to achievingany goal.
To learn more about Hewitt, his public speaking and theIronman Triathlon events in which he competes, log on towww.jayhewitt.com.
Q: What type of meter do you use?
A: I use the LifeScan One Touch Ultra and UltraSmart meters.The Ultra is super fast, light, durable, painless and alwaysaccurate. I wish I could race Ironman triathlons that way! Ultrameters are exactly what I need in my athletic career and myeveryday life. The UltraSmart gives me excellent data to controlmy blood glucose, spot trends and make improvements. As anIronman triathlete, motivational speaker and attorney, I need ameter that lets me control my diabetes so I can do it all.
Q: What type of insulin do you use?
A: I use Humalog for meal bolus injections and a night-timeLantus insulin injection for a 24-hour basal dose. Both work greatfor me. Lantus allows me to race an Ironman triathlon for 10hours or spend a day in the office with no worries about suddenblood glucose fluctuations. Humalog is dependable and fast.
Preparing for the Tri
Hewitt’s personal coach sets his training schedule according to the raceseason. But training is a fulltime job for Hewitt. Morning workouts lastabout two hours. Then he goes to work as an attorney and returns forevening training sessions that last another two hours.
Every day is different, he says. “I may swim 2,000 to 4,000 meters and laterbike about 40 miles or for a couple of hours. Then, the next day, I may havea run of eight or 10 miles in the morning and another bike workout thatnight.”
In addition to his 18 to 22 hours of training during the week, Hewitt alsocompletes seven-hour workouts on the weekends.
Managing Medication and NutritionAlong With Workouts
Hewitt checks his blood glucose at least eight times a day.
“I always have my meter with me on long bike workouts,” he says. “If I’m riding 80to 100 miles, I’ll check it once or twice during the workout.”
Often, he can tell what his blood glucose number is based on his body’s responseduring workouts or events.
“I train so much now that I can tell from my performance what it is,” he says.“I can tell if my blood glucose is getting low, because I can’t keep up the samecadence or the same pace, and also because I’m working too much for the desiredresults.”
Hewitt takes 20 units of Lantus once a day at bedtime. He also uses a Humalogpen at meals.
“The average number of units per day depends on the length of my workouts eachday. It’s about 6 to 9 units of Humalog with every meal—so, probably about 50units daily.”
Hewitt says his body requires large amounts of stored glycogen, which comesfrom consuming carbohydrates.
“It’s a difficult balance to strike—the most difficult balance for me as anendurance athlete is balancing my carbohydrate intake to span out my body’srequirements during training or actual races.”
He eats three meals a day with smaller meals or plenty of snacks in between. Formeals, he eats a lot of carbohydrates before and after long workouts and races,but he complements that intake with protein supplements, fish, chicken and largequantities of fresh vegetables daily.
Not Always an Easy Task
Hewitt’s blood glucose goes low in every Ironmanrace, but he plans for it to happen.
“I plan for something to go wrong,” he says. “So, if itdoesn’t, I’m thrilled because I’m prepared.”
Hewitt struggled with his lowest blood glucoselevels during the Ironman USA NationalChampionships a few years back in Lake Placid, NewYork.
“It was a long, grueling climb up WhitefaceMountain on the second half of the bike course—the last 25 miles. I had emptied and discarded mywater bottles at the base, not wanting them toweigh me down during the climb,” he says.
When his energy was low and other competitorsstarted passing him, Hewitt knew he was in trouble.
“It was the most pain I’d ever had in a race. I stillhad about 2,000 feet to climb,” says Hewitt, and hestill had to run a marathon to finish the triathlon.“I checked my blood after that bike segment andit was 42 mg/dl. I took some carbohydrate, but Iwas already delirious and unable to perform at acompetitive level. After four or five miles of slowrunning, my blood glucose had come up enough.”
Race Day Regimen
Because the triathlon event is so intense and grueling, Hewitt decreases his Lantus the nightbefore to avoid bottoming out with low blood glucose during the race.
He takes no insulin during the race, and he cuts his 4:30 a.m. breakfast Humalog dose in half.
“I can’t afford to have low blood glucose when I’m 2.5miles out in the ocean,” he says. “The swim is first, andit’s in open water—so I can’t stop to eat and drink.”
His pre-swim strategy is to run his blood glucose up to180 before the gun goes off —knowing the swim willbring that number down.
“I can do that swim in under an hour,” he says. “Inthe next transition before the bike, I check my bloodglucose again.”
The Bike Race
And then he’s on his bike within a matter of seconds—for 112 miles.
“I’m constantly eating and drinking out there,” saysHewitt, who checks his blood midway, at about 56miles into the race.
Once the marathon portion of the event starts,Hewitt gets carbohydrates through sports gels andperformance bars.
Because the marathon is physically the most difficultpart of the race, it’s hard for anybody to eat. But Hewittforces himself to fuel his workout at every aid station.
“My blood glucose is usually very low in the last 13 milesof the marathon when it’s been about eight hours intothe event. I keep gel, sports drink and other carbs andsupplies in a special needs bag at the midway station.”
After the Race
After the race, he tests his blood again right away. Thenhe heads to the race’s medical tent to get intravenoushydration and glucose.
“I’ve got to get carbohydrate in me within 30 minutesafter a race or a workout or I will bottom out. That’s aperiod of heightened insulin sensitivity for anyone.”