‘Lack of control stresses diabetics out’

Adam Hoult, 34, is a facilities management professional in Abu Dhabi, and has Type 1 diabetes. Adam is training for the gruelling endurance triathlon Ironman Dubai in February.

I am in a really minuscule minority of people who get type 1 at 30.

When my son was born four years ago, we had a bit of a stressful period, and I suddenly lost 8-9 kilos in 2 weeks. I also started feeling immensely tired, thirsty…all the usual symptoms of diabetes, and I went to the doctor.

Post diagnosis, it didn’t really sink into me then. I was pretty much like a deer in the headlights, with no idea what was going on. About 2-3 days later I sat down with a brilliant doctor in Dubai, and she thoroughly explained that I now needed to learn my body, and it was going to be trial and error. She also gave me my number 1 rule: if in doubt go high (with blood sugar).

But I think the moment when the diagnosis really struck me was when we were chatting one day and she said that my son is now 12 times more likely to get it. That hit me hard. A few weeks later we found out we were going to have another baby, and I thought “oh great now I’ve got two of them with a higher chance of diabetes.” It hit me then that this is for life and could potentially pass on to my kids and potentially their kids. My parents didn’t have it, but my mum’s brother does.

Read: Diabetes risk is noticeable 20 years before the illness

A dietitian then gave me a great cheat sheet, so I could now figure out how many carbs an apple has, or a small McD fries has. It took a few months, but I learnt that well.

But I then took a psychological hit. Suddenly I went from being me to being a decrepit diabetic.

"I’m now toying with the idea of doing the Frankfurt full Ironman," says Adam Hoult. "Someone mentioned tackling Everest recently, and I thought that’d be a great challenge to overcome. Small steady steps."
Anas Thacharpadikkal

I used to be heavily into fitness before the diagnosis. I was in the military in the UK, and what I considered a fun weekend was taking a 20k disc from the gym, putting it into a backpack and go running for 14 hours. So post the diabetes diagnosis, I thought it was the end.

I slowly starting drifting away from the person who would do anything. There was a loss of personal identity, and I struggled. I was the Energizer bunny — endurance man who ran and cycled thousand miles for fun, and all of a sudden I had that taken away from me. So I thought: who is Adam now? What did I have to define myself now?

I used to cycle a lot, go rock climbing, swimming, played regular football. After the diagnosis it was all just doing a little bit here 
and there.

And really, it’s the lack of control that really stresses diabetics out. It amplifies stress tenfold. So the day I decided to make a conscious decision I was going to control the disease, everything changed.

I made a real effort to learn my numbers, my carb ratios. What proved to finally be my window to getting back into fitness was when I got hold of a Libre glucose monitoring system. That device single-handedly proved to be a gamechanger for me.

Until then I would not work out beyond an hour. I’d probably play some football, but run off at half time and check my sugar. I would never do anything remotely endurance. Even walking in the hills back home, I would not stray too far from help, because it was always at the back of my mind that this might go wrong.

‘With the Libre, I started slowly. Cycling 30k, then when I was comfortable doing that, trying 40, then after I was happy with that and my sugars, moving up. That progression went on for a period of about five or six months. I started learning and analysing. What happened to my sugar when I ate a certain type of food, how much hard exercise I could commit to before my sugar started to plummet. Just to be able to learn my body well enough to start pushing myself again was great. And slowly it’s got to a point where now my Friday mornings are spent doing 85k on my bike.

I got progressively endurance focused. Around then, my friend back in the UK just completed his fourth Ironman. And I thought, this was my next challenge. So I decided I’d do the Ironman in Dubai in February.

It’s going to be difficult, but it doesn’t worry me as much. Since I feel like I’ve gotten control of my diabetes, it doesn’t occur to me to allow it to restrict me. Getting over the initial fear was the challenge, and I now feel confident and comfortable. Now there’s never anything I think I won’t do because I’m diabetic. I might think I won’t do it because I’m not fit enough, but not because of diabetes.

The last couple of years has been a steady progression of ‘I can do it’. I’m now toying with the idea of doing the Frankfurt full Ironman. Someone mentioned tackling Everest recently, and I thought that’d be a great challenge to overcome. Small steady steps.

Keeping active is so important to manage diabetes. My wife and I take turns to run our dog every other day for half an hour, so I get some exercise in regularly. I cycle with a group every Friday morning. I also keep active at the beach and pool with the kids. I got a calisthenics frame custom-built into the side of the wooden frame we built for the kids to play. So I integrate some activity into whatever I do with the kids.

Having diabetes doesn’t change anything, aside from concentrating on what your sugar is doing. I joke that it’s like being on the best diet in the world. I’ve got a 100 per cent control, and that’s the key, mentally getting your head around the fact that you’ve got control.

My sons are just starting to understand now. I hear them telling each other that they can’t eat the sweets in the house because it’s for daddy’s sugar. With my oldest I’m at this point where I can start having the conversation that there is a pretty serious reason for having all those different sweeties lying around the house, that if he finds his dad curled over in a heap on the floor he needs to phone these and these people.

The different legs of Ironman poses different challenges. The swimming doesn’t concern me, I’ll start with some porridge and a slow release of carbs is good earlier on. But eating porridge while hunched over a bike at 35km/h is not going to work. On the bike, if it’s hot, my sugar will plummet, but I can overcome that with the carb powders in my drink. The running is the real challenge; my sugar just nosedives. So I rely on energy gels, but they throw sugar up and down, so it’s a yo-yoing battle. I don’t have a solution for that yet.

On the bike, if it’s hot Adam's sugar will plummet, which he overcomes with the carb powders in his drink
Anas Thacharpadikkal

You’ve just got to play around and learn. As clichéd as it sounds, knowledge is power with diabetes. Once you’ve got enough knowledge of your body and know how it reacts, you’re fine. It’s like anticipating rash drivers on the road; like a sixth sense. You can see a problem coming.

More than the actual event, it’s the training that really worries my wife, especially when I go out on my own. At an event like the Ironman there’s marshals and help on hand. But if I go to Al Qudra alone and don’t contact her she worries I’ve fallen off my bike and been knocked out of consciousness. A few months ago out running I don’t know what happened, my sugar level suddenly plummeted. I live in the Springs, I was 2k away from my house, and my sugar was dangerously low. I was in a really bad state by the time I got home and got my hands on everything sugar. And I remember thinking on the way, if people could see me they wouldn’t know I’m diabetic and I’d be in a coma before I got to the hospital. That was irresponsible, and I now run with a running kit and a trisuit with pockets that I can load up with sweets.

I eat whatever I want, but in moderation. I’ve realised cutting food off is a recipe for disaster. In my younger days at the military I can’t even fathom how I managed to fit all that food into myself, but now I’m more careful.

It doesn’t occur to me now that my diabetes is a limiting factor. Why should it stop me from anything? It really shouldn’t. What does being diabetic have to do with your ability to do anything? It’s not like I’m missing a leg and have run a marathon.

I enjoy now that not only am I the crazy guy who wakes up at 4am and wants to go cycling on his day off, but that I’m diabetic — I love the look on people’s faces when they find that out. It’s also a positive feedback loop, so as people recognise it you want to keep going.

You can allow yourself to be convinced that diabetes is a limiting factor, but that doesn’t make it true. I’m guilty of having fallen into that mindset, and it’s not fun. Get a grip of it as soon as you are diagnosed, and make a conscious effort to not lose your sense of identity.

You have to maintain the positive attitude. Plan and prep your food and nutrition. Go in steady increments. Give yourself time – don’t wake up after years of inactivity and jump into a 10k run. And if in doubt go high!

At one point you have to stop asking why you should push yourself as a diabetic — the question really is, why not?

‘I stay away from sugar before a race’

Sisi Curtis-Oliver, 11, is a Type 1 diabetic and a skiing champion, having raced in slopes from the US and UK to Dubai. She also plays netball, tennis and golf.

Sisi was only 3 when she was diagnosed with diabetes. Her mum Leona says she was in a nursery in Dubai, and the staff kept saying she was tired. ‘They didn’t think we were giving her enough sleep. And I kept her home once when she was ill in school, and she seemed very sleepy, thirsty and hungry.

‘Medically speaking she was in a coma, but she’d keep coming around and saying she was thirsty etc. I took her to a GP, who said we had to go into the hospital immediately. Three days later we left hospital with a type 1 diabetic child.

‘It was then all those questions, all those disappointed dreams. Will my child be able to do anything? Will she not have a long life? Will she be able to do everything she wants to? We were in shock and at the same time were still learning how to manage her.’

Sisi wears a Dexcom monitor, which measures her sugar every five minutes, communicates that to her phone, and her phone shares the information with up to five iPhones

Sisi’s sure come a long way from that diagnosis. She now trains and plays netball with the rugby netball club Dubai Hurricanes. She plays golf, doing a junior tour recently. ‘Occasionally I go with my mum to the ladies golf competitions, where people much older than me play and I’m often the only child,’ she says. She has just gotten back from a three-day camp held close to the border of Oman.

And Leona says all of this has been possible mainly due to all the advanced tech now. ‘Especially what’s on her arm. Dexcom measures her sugar every five minutes, communicates that to her phone, and her phone communicates that with up to 5 iPhones.’

Which means when she was 10, Sisi went glacier skiing by herself in Norway after she was invited by a ski racing club to go train with them. ‘The diabetic community here were shocked,’ Leona says. ‘They said, you’re letting her go by herself? But she’s got her device.’

It sounds like a lot for an adult, let alone an 11-year-old. Sisi shrugs. ‘I just have to remember to bring my bag with me with my needles and my insulin. And I’ve to be very careful with my device. It’s just the remembering everything that is hard. But I’ve been skiing since I was 2, playing golf since I was 3, tennis since I was 4, and netball from when I was 7. So I’m used to it now.’

Competing in the Anglo-Welsh championships

Sisi’s main sport is skiing, specifically downhill. She’s skied all over the world, from Vermont to Switzerland, France and Norway. She started racing at 8, and has also trained with an Olympic skier Chemmy Alcott. ‘This summer she learnt to crossblock, which we’re told is a big achievement for someone her age.’ This year she also won every UAE interschools event and achieved maximum points to be the overall UAE under-12 female champ. And a few weeks ago she won the under-14 UAE female interschools event. She has won the Dubai Police Ramadan Ski Championships under-12 female, come top 10 in the Anglo-Welsh championships under-14, and top 10 in the GB champs.

Sisi does take her precautions. She cuts insulin by 50 per cent when she goes race training because of the extreme exercise. ‘I know the routine now,’ she says. ‘I stay away from sugar before a race, and if I eat my eggs before I’ll do fine, then at the end I can go eat whatever I want. I can’t eat anything that makes my sugar go high before a race, because I get very thirsty, my muscles start to shake, I get very tired, and I’ll forget things.’

‘But I don’t get worried before a race, just excited.’

Read: Storing insulin in home fridges affects its potency

And she won’t let anything stop her. This summer she fell ill, went into DKA (diabetic ketoacidosis) and nearly died while at home in the UK. ‘I was in hospital for about a week, but a week later I competed in a race, the GB champs. I just got up and decided I wanted to go skiing.’

‘You can’t expect perfection as a diabetic’, Leona says. ‘You have to say I only feel 90 per cent but I’m going to do it anyway. If she can dream it she can do it.’

Sisi says if during a race her sugar goes low, she doesn’t stop and give up. Instead she eats something and carries on. ‘So she has to be a lot more determined than other kids,’ Leona says.

Sisi winning the under-12 female category of the Dubai Police Ramadan Ski Championships

She often tells her parents she wants to inspire other type 1 diabetic children. To canvass other kids whose parents are afraid to let them go on a school trip because they are diabetic. ‘Now they see her and they go ‘oh maybe it’ll be fine’,’ Leona says.

‘Idon’t feel different in any way,’ Sisi says. ‘When I do an activity I like to feel I don’t have diabetes. I like to completely forget about it.’

‘I think what she means is that skiing is a distraction,’ Leona says. ‘When she’s skiing she’s not a Type 1 diabetic. She’s just a girl up on that mountain with the snow.’

Sisi says if you want to do it you need to do it. ‘I don’t like to say I have diabetes and can’t do anything. I think everyone should still do it. It’s not going to ruin your life, but will actually make it better. I have a lot more muscle now so I think that’s really cool. And I can ski down really fast. I feel great about that.’

‘I’ve accepted that diabetes is a 24-hour threat’

Nick Zajicek, 42, is a Dubai-based cameraman. Post his diabetes diagnosis, he travels extensively, shooting in remote terrains and participating in everything from scubadiving to kayaking.

I was diagnosed with type 1 diabetes 30 years ago. I was almost 13, and suddenly was drinking lots of water, even about 10-15 litres a day, and going to the toilet continuously as a result. My mum recognised the symptoms as those of diabetes, and I went for a check-up.

I didn’t really think much about it when I was diagnosed. It felt bizarre. Diabetes doesn’t run in my family. I was overweight as a child, but I don’t know that’s necessarily the reason I got it. It was very different 30 years ago too, all syringes and vials — the testing machines took ages, a blood sugar reading that takes 30 seconds now took about 5 minutes then.

But from that initial stage of eerie calmness, I’ve been quite furious about the diagnosis since. A lot of scare tactics were employed then. Docs would constantly say I’d get brain damage, lose limbs… threat were used to make you control your sugar, which was quite impossible as a 13-year-old.

Filming in the military in Kuwait

I remember walking around as a 13-year-old thinking what’s the point, I’ll be dead soon. I started out with a fatalistic outlook, and looked at it as a death sentence.

But thankfully diabetes did not get to put an end to my travelling bug, which I caught early on. I’ve travelled extensively since I was 15 – when I was 18 I went from London to Egypt by land.

A year after that Egypt trip I almost died. I got seriously ill in England at university after I ran really high blood sugars. When I woke up in the morning at hospital I was told if I was even an hour late I would have been dead. And I remember thinking, if that had happened to me on a boat to Israel, etc I would have been dead.

So then I accepted it. I accepted that being diabetic is a 24-hour-a-day threat, but that you just have to carry on. I’m always thinking about it, you probably can’t go 30 seconds without, but that didn’t have to necessarily stop me from carrying on with my life.

Which is why I’ve been scuba diving and kayaking. I travel all the time — I’ve been to over 120 countries, I’ve just gotten back from camping in Jordan. I’ve filmed in Palestine, I’ve driven across Russia and every Soviet country, I’ve driven from Crimea to Japan. I’m an advanced scubadiver. I’ve gone on motorbike trips in so many countries across Africa, Asia, South America.

So with my job, I went all around the world. I’ve filmed in the military, gone on helicopters; I’ve been in very tough terrains. Like in an aircraft carrier in the middle of the Gulf in August — it’s an insanely hot, dehydrating experience.

I got diabetic frostbite in Chernobyl filming in the middle of winter in brutal conditions. I had to take my thick gloves off to operate the camera. I lost sensation in two fingers for about three months, and they went black for a while. After that it felt like there was thin air in those areas. It’s like feeling your flesh die. Funnily when I get cold now I start to feel it first in those fingers. As I’ve gotten older my circulation has diminished. I get cold way quicker than anyone else. A cut takes me ages to heal. None of these things came along when I was younger.

Nick has filmed documentaries in extreme temperatures

The beginning of summer in Dubai I get high sugars. If I’m filming on a building site during summer etc I’ll run high. When my sugar gets high it’s not a pleasant experience. I can feel it in my eyeballs, I start getting headaches, my mouth goes dry. People talk of having a bad temper during a high-sugar episode, and I think if your eyeball was being stretched across, you can’t really be in a great mood. I used to have that a lot before, but in the last few years, with my eye, you can feel really rough, so I try maintain good sugars. I go to the gym three times a week. I eat relatively well now, though I didn’t initially. Now I only occasionally eat cheese or high-fat foods.

It’s been pretty awful a lot. I’ve had problems with my eyes, with an onset of diabetic retinopathy. It’s more difficult as you get older too. I ran bad blood sugars even while I was active. I’ve had hundreds of instances where I’ve realised my blood sugars are messed up and have had to go home.

Read: Medication reduces risk of vision issues in diabetics

But you have to have an active lifestyle when you’re diabetic, or you’ll just fall apart. I feel rough if I don’t get enough exercise.

Diving is easily one of the most scary experiences for a diabetic. You’re going to be underwater for 45 minutes with no access to food. You don’t know what’s going to happen when you come up. If you’re diving in quite extreme conditions, you can be a long way away from the boat in pouring rain and be expected to swim or wait for a while. And since I know I can never get into a situation where I get into trouble under water, I’m extra careful and take precautions before and run my sugar too high. Similarly if I go kayaking along the beach here in Dubai, I’ll take stuff with me to avoid a disaster; there’s always a Red Bull there. And I always carry energy bars (after I moved here from England, I learnt quickly that chocolate doesn’t do very well in bags in Dubai temps!)

I avoid doing team sports. If I kayak or gym or hike on my own I can pre-empt it, but it’s difficult when there’s other people involved. For instance I can go home in the gym, but not in the middle of a football match.

I don’t like the idea of pumps attached to my body; I have a sort of resentment towards being diabetic. I don’t want to have that invasiveness. I do measure my blood sugar, but that’s all.

If I had to pick one piece of advice to give those who’d like to keep extensively active, I would say understand the disease; I didn’t for many years. If you don’t understand it you’ll be shooting in the dark and if you exercise and for instance, pass out, you will probably never want to do it again. Understand the difference between high-shock exercise and sustained low-impact exercise and how it affects your sugar. If you don’t get why you’re having various symptoms, your fitness plan will be a mess.

Nick filming in Abu Dhabi

Even after 20 years. I’m still learning about the disease. A doctor will give me some really crucial information and I’ll think “why hasn’t someone told me this for 20 years!” So everyone’s out there not knowing, and understanding is the way forward. You might think it’s too much information, but once you do know it all, you aren’t as worried about it.

The link between diabetes and depression is well established. And to be honest I didn’t think I’d make it this far. I’ve established a middle ground with the seriousness of the disease. You can’t go overboard, but then I’ve also met diabetic people measuring out every grain of rice and thought that’s not much fun. It’s all about a balance.

But through it all, I never felt like I can’t do anything. And bottom line with diabetes is you can do anything you want, if you really want to. As long as you make an effort to understand diabetes, you’ll be fine.

Supplied photos courtesy of Tony Masters and www.racer-ready.co.uk