As the number-one cross-country skier in the United States, Kris Freeman is at the top of his game. A little over a decade ago, however, the 16-time national champion’s life changed overnight when he was diagnosed with type 1 diabetes at age 19. With the help of physicians, coaches, family, and friends, he has successfully managed his diabetes while continuing to dominate his sport. He competed in the last three Olympics and is currently training for his fourth next month in Sochi, Russia. Off the slopes, Kris visits diabetes summer camps on behalf of Lilly Diabetes to share his story and to inspire children with type 1 to pursue their dreams. Here, he answers a few questions about keeping diabetes challenges — both physical and mental — from interfering with that pursuit.
Q: What is it like being an Olympic athlete with type 1 diabetes?
A: I think of myself as an Olympic athlete who happens to have diabetes. I don’t let diabetes take over my identity. I enjoy the lifestyle of an endurance athlete: I train twice a day, six days a week, forcing my body to adapt into the best skiing machine it can be. Keeping precise control of my blood sugar throughout this process is very important. High blood sugar impedes my body’s recovery from hard training; and low sugar makes me too tired to train effectively. Glucose management can be difficult at times, but aside from this obstacle, I think I am very similar to my non-diabetic peers on the world cup skiing circuit.
Q: What are the primary challenges you’ve faced (or are currently facing) as an Olympic skier?
A: I am the first and only person with diabetes to compete in the Olympics in an endurance event. Because of this, there is virtually no information on how to manage diabetes in an elite level sport. I have had to study physiology and nutrition to better understand what is happening in my body while I train and compete. By necessity, all of my insulin dose protocols have been invented through educated guesses and trial and error. Being an Olympic endurance athlete with diabetes would be a lot easier if there was a track record to follow.
Q: How do you overcome obstacles that come up due to that missing track record?
A: Overcoming adversity is part of sports. If you lack the courage to fail to reach your goals, you will never achieve them. When I have setbacks, I am realistic about how I respond emotionally. I will give myself the time I need to heal, but quitting has never crossed my mind. I pick myself up; analyze what went wrong; educate myself on the issue; and plot a new strategy to overcome it.
Q: How do you push yourself physically without risking your health and safety?
A: I monitor my blood sugar at all times and carefully think through my diet, insulin dose, and dosage timing. I also take into account overall fatigue, stress, and other environmental factors that may affect my body. I always carry extra glucose while training and take whatever reasonable precautions I can. Beyond that, my life would be pretty boring without a little risk.
Q: Can you tell us a little bit about the experience of collapsing at the Vancouver Olympics? Was this a wake-up call for you?
A: I have had hundreds of professional races in my career. Only two of them have been negatively affected by low blood sugar. The first took place in Sweden in 2002. I had planned to consume 15 grams of sugar at the halfway point of my race. My coach held out a bottle of sports drink for me to grab as I descended a hill. I dropped the bottle at the handoff and started feeling the effects of low glucose later in the race. The solution to that event was simple. When I need to consume sugar during a race, I make sure that there are multiple people on course ready to feed me. I always make sure there is a backup plan.
In order to win a medal in Vancouver, I knew that I would have to be in perfect physical form and that I would have to have nearly flawless glucose control. If my sugar rises too high during a race, my lactate levels rise as well. Lactate is the substance released into the blood when the body goes anaerobic (into oxygen debt). Lactate is painful and slows the body. If my sugar goes too low while I race, I become exhausted and risk collapsing. Therefore, dosing insulin for races is a delicate balance.
I perform practice races on roller skis during the summer to fine-tune exactly how much insulin is needed for my races. I stop at predetermined locations on the course and record my glucose levels so that I can formulate the ideal insulin dosage for the actual race. I can mimic the strain of racing on my body in all ways except for the stress leading up to the actual start of a major event like the Olympics.
As I mentioned before, I have raced hundreds of times, but I had never been as nervous before a race as I was in Vancouver. Shortly before my race started, the stress caused my blood sugar to rise high enough that it would have affected my performance negatively. I chose to abandon my original insulin dosing strategy and increase the dose to combat the stress hormones in my body. I raised the dose by too much, and you saw the result. It was a calculated risk, and I got burned.
Since that unfortunate race, I have learned basic meditation techniques and practiced yoga so that I can calm myself quickly when my nerves start to rise in intense situations. I plan to use these techniques this winter to counter the chaos and stress inherent to competing at the Olympic games so that I can use my planned insulin doses.
Q: Will the upcoming Olympics be your last or will you keep competing?
A: I will be 33 this winter. Competing in a fifth Olympics depends on whether my body continues to respond positively to training in my mid-30s. I still love ski racing and will compete at the highest level for as long as I am able.
Q: What are your plans for the future?
A: When I retire from ski racing, I will complete my undergraduate degree in psychology. From there, I will either pursue coaching or, if inspired, work toward a master’s degree. I will also stay active in diabetes advocacy.
Q: Why is talking to kids at diabetes camp so important to you?
A: I have been lucky enough to be the ambassador for the Lilly Diabetes Camp Care Package program, which enables me to visit with thousands of kids at diabetes camps around the U.S. When I was diagnosed with diabetes, I was told that I would have to abandon my dream of being an Olympian. Fourteen years later, I have won the U.S. Nationals 16 times; competed in three Olympics; won a world championship; and I am still in pursuit of an Olympic medal. I share my story with the children, recounting the highlights and challenges of my career, in hopes of inspiring them to go for their dreams too and not let setbacks keep them down.
Q: What is your message for kids with type 1 diabetes?
A: The better you care for and understand your diabetes, the less it will dictate your life. There is no reason that diabetes should stop anyone from pursuing their dreams and aspirations.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.