MOVING
well
GOING THE Endurance sports can be particularly challenging for people with diabetes, but a group of swimmers managed to make the long swim to Rottnest this year – with a bit of help, writes MYKE BARTLETT With summer around the corner, it’s natural that West Australians turn their thoughts to the beach. Swimming might be great, low impact exercise, but most of us won’t swim further than a dozen or so laps – or out to the Cottesloe shark net and back, if we’re feeling adventurous. Some swimmers have bigger fish to fry, however, and have their eye on the horizon. Every year, a hardy breed makes the 20km crossing from Cottesloe Beach to the shores of Rottnest Island, either as part of a small team or a solo effort. While making the channel crossing is an extraordinary achievement for any swimmer, it’s a particular challenge for people with diabetes. That didn’t stop a team of four swimmers with type 1 diabetes from taking to the water earlier this year.
“Without the pumps, I don’t know whether it would be possible,” Jake says. “None of the glucose meters are waterproof. And trying to tread water and finger prick? It would be next to impossible. I managed to do all of my training swims – as well as the actual swim itself – with my pump on. Which was fantastic. That real time feedback of your glucose and the trends means you know if your glucose is steady, or if it’s trending upwards. It’s very reassuring and means you can just focus on the actual swimming.”
Jake O’Brien was one quarter of that team – the T1D Collective – and says he was inspired to take part after watching the swimmers arrive at Rotto the previous year.
Despite a lot of training and planning, the big day itself didn’t quite go to plan. Jake had volunteered to swim the first length of the journey, which meant having to swim a kilometre out to the boat, where his glucose and meter would be waiting.
“I’d gone alone to watch the event, because I had some friends doing it and just got really hooked in from that. I loved the energy from the day and I was like, ‘I have to do this.’”
“I wanted to not have to take any insulin just to get that first kilometre out of the way and not have to worry,” Jake says. “But I think I really stuffed up my insulin dose for my dinner the night before, which I carb loaded for the event.”
Although he was a keen runner, Jake hadn’t swum seriously since high school. Having assembled his team, he soon found swimming laps required a very different kind of fitness to running them.
The adrenalin from the excitement of the impending event saw his blood glucose sit at around 13 or 14% for most of the night, despite three attempts to correct it.
"Your lungs are what gives out when you're swimming. You just can't get enough air.” It also became clear that managing his diabetes for an endurance event would be far more challenging in the water than on land. “I think probably the most challenging thing is the recognition of symptoms, particularly of hypos, as it’s such a different sensation being in the water than being on land. A typical sign like sweating is very different, because you can’t be in the water. Your body’s already wet. You don't know if you're sweating because the water temperature is cold.” 26
It was a case of technology to the rescue. To ensure they could train and compete safely, all four swimmers were armed with insulin pumps and continuous glucose monitoring (CGM).
“And then it came crashing down when I got up in the morning when I was meant to be fasted on no insulin. So the plans that I had and the ones that I’d be using for all the training were thrown out the window. But we adapted and it all worked out well in the end.” One of the more surprising aspects of planning for an endurance event with diabetes was the food of choice. Forget high-tech energy bars or garish drinks loaded with electrolytes. The T1D Collective went back to basics. “Most of the food we had was actually baby food,” Jake says. “Because it's so mashed up, it's really easy to digest. When you’re exercising, the blood flow goes to the muscles and
