Going the Distance

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. 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. “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.’”

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. "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.” 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). “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.” 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 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.” 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. “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

GOING THE DISTANCE

the gut gets deprived a little bit. So trying to break down anything complex is pretty hard for the gut and takes such a long time. But it was weird, standing in the baby food aisle at Coles, wondering which one I’d like.” Even without the complexities of diabetes management, the crossing proved a challenging swim. Jake and the rest of the T1D Collective had spent most of their training in the Victoria Park swimming pool, but open water conditions made for a very different experience. “For the first half it was an absolute breeze and we were actually going really well. We surprised ourselves. But once we got to that 15km mark, when the swell changed and came from a different angle, it was just incredibly choppy. We felt like we were constantly changing swimmers, because we got so tired and felt like we were just going nowhere.” Jake says he doesn’t think any of his team really considered surrender, but there were a few long kilometres when making it through to the other side seemed impossible. All that changed once the Rottnest beach came into view. “Rotto was so close that we were like, this is ridiculous. We can't give it up.” While it’s traditional to celebrate the marathon swim with a beer or three at the pub, Jake’s team satisfied themselves with a handful of biscuits and a catch up with friends. He says the experience has made a serious swimmer out of him, although he’s not sure if he can find the time to train up for a solo swim. “I’ve always enjoyed endurance sport and that challenge of ‘let me prove that I can do this with diabetes’. I think the long duration stuff really feels like proof in the fact that you've got to be able to sustain that – the monitoring and management – for such a long period of time.”

He would encourage anyone else with diabetes who has ever thought about taking swimming more seriously to get along to this summer’s channel crossing and see if inspiration strikes. “If you need any motivation, go along to the event. And then just start swimming. Take it slowly. The more that you do that, the more you get used to it. You find out how your body reacts and adapt from there.”