'No Excuses' Training for the Olympics with Type 1 Diabetes

Drs Michael Riddell and Anne Peters speak with Gary C. Hall, Jr, about competing and winning 10 Olympic medals with type 1 diabetes.
https://www.medscape.com/viewarticle/...

-- TRANSCRIPT --
Michael C. Riddell, MD: This is such a privilege for me to be able to speak to both of you. We're on the verge of another Olympics. Because diabetes is such an important topic for me and for Anne, and for you, Gary, I thought maybe we could spend a few minutes talking a bit about what it's like being an Olympian with type 1 diabetes.

Are you okay if I ask both of you some questions?

Gary C. Hall, Jr: Sure. Shoot.
Riddell: Gary, I'll start with you. You're a three-time Olympic swimmer — a legendary representative of the US team in Atlanta, Sydney, and Athens. I guess [you've won] 10 medals, correct me if I'm wrong, over those three games?

Hall: It's easy to remember because I just count them off on my fingers.

Riddell: As far as I understand your story, you were diagnosed, I think in 1999, just before the Sydney games. Is that correct?

Hall: Correct, March 1999. I'd been training for the Sydney Olympics and it came out of the blue, as these diagnoses often do.

Riddell: What's it like to be an Olympian and then get hit with this diagnosis of this disease that maybe you didn't know all that much about, but still have in your mind that you want to compete again?

Hall: Competing was not a consideration initially. I think I went through the stages of grief, and there was certainly panic and what am I going to do with my life now? It was explained to me by a diagnostic doctor and the first endocrinologist that I met with that continuing on in the sport at a high level was not a possibility. It was impossible. I was reeling, thinking it's just a matter of time before I go blind, before I lose the use of my kidneys, have my feet amputated, go impotent — a long list of all the complications.

I felt like a ticking time bomb. I went through those stages of grief, suicide ideation, and grappled with what my future was. It was scary. It's scary for all people diagnosed with this, but this was not just how am I going to contend with insulin shots and testing my blood sugar. This was, what am I going to do, because I've put all of my eggs in one basket? I'm a swimmer. At this point, I've invested everything I have into this, and it's gone.

Riddell: You're known around the world as being such a fighter, such a competitor, and also a real spokesperson for what can be accomplished with type 1 diabetes. Lucky for all of us, we've got Dr Anne Peters, who helps a range of patients with type 1 diabetes.

Anne, what was it like to meet Gary? When did it happen? What were your thoughts when you first met such a warrior with type 1 diabetes?

Anne L. Peters, MD: First, I always just get to know my patients. From the beginning, he was Gary Hall, the human, who was both an Olympian and someone whom I knew had type 1 diabetes.

Remember, he got this before we had all the tools we have now. It was before we really had continuous glucose monitoring (CGM). It was before we had much of the knowledge we have about sports and people with type 1 diabetes. People hadn't been doing the things that people do now.

I first just got to know him. He and Elizabeth, his girlfriend at the time, came to see me. They were late, and I was going to give a lecture. I threw them in my little VW bug that I had at the time and took them with me to go to see the lecture. I loved the human being that was Gary Hall, and it had nothing to do with anything other than I believed in this person.

I didn't know anything about sports. I still don't, except I know something about swimming. I had no idea what anyone was talking about. I didn't actually know how fast you had to go, or how high the bar is for an Olympian, but I believed in the person. I believed that if I helped him, he would be a role model.

It just seemed natural to say, of course you can go and train for the Olympics, but it was actually based on way too little knowledge. I'm so glad I had way too little knowledge, because what happened was obviously what happened. I believe in giving people a chance, and most of all, that when people have new-onset type 1 diabetes, they need to not feel like it's the end of their life.

They need to understand it is a change in their life, but if they get the right tools — nowadays, that puts people on a sensor on automated insulin delivery — it is so livable, as Gary is a testament to. I think you were one of the very first people who ever fought your way through it and just did it.

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