Navigating Through the UnknownFriday, November 23, 2012
Team Type 1 member and endurance athlete, Sebastien Sasseville, successfully completed the Sahara Race. Sasseville shares his experience about running across the Sahara Desert and how this journey parallels diabetes management and the importance in having the right mental approach, no matter what the situation.
By: John Parkinson, Clinical Content Coordinator, DiabetesCare.net
Sebastien Sasseville knows how to suffer gracefully. As an endurance athlete, it’s his job to find ways to manage through terrible situations and face unknown challenges head on. As a person with type 1 diabetes he is not only managing his event performance, he has to keep his diabetes management in front of mind, so he has dual responsibilities.
DiabetesCare.net had an opportunity to speak with Sasseville earlier this year about climbing Mount Everest and some of his other endurance events he has competed in, including having completed three Ironman triathlons at that time—he just completed his fifth Ironman last weekend.
As someone who truly believes in pushing his boundaries, Sasseville saw the opportunity to compete in the Sahara Race, which Time Magazine named as one of the world’s leading endurance footraces, and continuing in his belief that diabetes does not have to limit people.
The race is 250 kilometers (155 miles long) with six stages done over the course of a week with participants carrying their backpacks, and running 40 km (24.8 mi) every day for the first four days and on the fifth day they run 80 km (49.7 mi,) before finishing out the race with a 10k (6.2 mi) on the last day.
This would be a tough race in ideal conditions, but Sasseville (pictured above during the race) ran across one of the most formidable environments on earth.
According to the Sahara Race website, participants in the race could expect temperatures up to 50 degrees C (122 degrees F) during the day and 20 degress C (68 degress F) at night. This event is a self-supported race, which essentially means participants carry their own food and supplies they will need in running across the Sahara Desert. And this means no support teams or people to stay with participants. Runners are truly on their own.
And the terrain is all sand which included running over hills and areas where the ground wasn’t flat and easy to scale.
DiabetesCare.net sat down with Sasseville recently to speak with him about the race, how the extreme temperatures affected his disease management, including some of his blood sugar challenges, and how endurance events parallel having diabetes and how important it is to have the right mentality when dealing with both.
DiabetesCare.net: Going into the Sahara Race, what were some of your biggest concerns?
Sasseville: The actual distance. I didn’t know if I would be able to complete the event. It was going into the unknown. This is a multi-stage event where you are out there for seven days and that was scary to me. I don’t do well in the heat, so I knew I would take a bad beating.
This event was self-supported. This included food, and diabetes supplies. As someone with diabetes, I knew I had very little room for error. And I didn’t want diabetes to be the cause of me pulling out of the race. I was worried about how much weight I was going to carry. On day one, you are literally carrying food for the next seven days. It was all about finding balance between risk and comfort because it is easy to overpack food, a ton of diabetes supplies and be 100 percent sure I was fine, but I would have to end up carrying that heavy bag, and I wouldn’t perform.
DiabetesCare.net: What were your biggest impressions, surprises of the Sahara Race?
Sasseville: The biggest surprise and yet the most amazing thing I learned was it got easier as the days went by. The shift was a mental shift, not a physical one. On day one, we all took such a beating and barely made it into camp. We were all looking at each other and we were all saying, ‘wow we have got three more days of this, and then we have got to do double the distance—and I barely survived today.’ There were all these question marks. You start the next day and you still suffer a lot, but you get it done. On the third day, is when the shift really happened; you know you going to suffer, but you know you can get it done.Towards the end of the week, you say to yourself I have done all this, I should be able to do an 80 kilometer run. It was really cool to see it within myself, but I saw it with other people who were doing the race as well.There was a complete shift in confidence over the days.
DiabetesCare.net: One of the biggest things during endurance races is the mental aspect. What were some of the mental tricks you employed to push yourself during the extreme temperatures?
Sasseville: You do a lot of things and I love using humor. I`ll joke around and talk with myself. And when I’m suffering a lot, I’ll make fun of myself. You do think about the finish line a lot. There is also amazing people you are doing the race with. These types of races tend to attract very interesting people. At times, we were running in packs and I could talk with other people.
DiabetesCare.net: When thinking about this race, you are running across one of the hottest places on the face of the earth. Describe the heat overall and what it did to your blood sugars?
Sasseville: It was unbearable. Living in Quebec City, Canada, I`m used to the cold. And with the cold you can control it wearing the appropriate clothing. You feel very powerless against the extreme heat. There is nothing you can do against it. I believe the temperature reached 42 degrees C (107 degrees F). You can feel it on your whole body, and it’s almost like a burning sensation. You feel so heavy and you are in a race and you have to run as fast as you can. It made the water bottles go warm, and yet staying hydrated keeps your body temperature down. The water was so warm, my reflex to drink water stopped kicking in.
Typically, the heat drives up your blood sugar a little bit. I didn’t notice it at first because conversely, running is an activity that drives down your blood sugar significantly. I saw a huge reduction in my insulin requirements. It was fascinating. My drastic decreases in requirements were due to exercise and recovery and repeating the routine every day.
DiabetesCare.net: How did you store the insulin during the race?
Sasseville: I had a Frio bag, so I kept the insulin in there. It worked, but there was only so much that it could do. It was a seven day race, and I left with enough insulin in my pump for three days and therefore, I only had to refuel once in the middle of the week. I did prime the insulin in the tubing each day, because that was exposed to the sun all day. I didn’t want insulin that went too hot in the tubing. I was trying to keep the pump in a little pocket. The insulin I was carrying in my pack was always in the middle of my pack, and as insulated as possible. The insulin was stored at a higher temperature than it should have been, but that was something I knew I could deal with for a week.
Once, I got back to the hotel in Cairo after the race, I had left more insulin in the fridge in my room. I then discarded the insulin that I had in the desert with me.
DiabetesCare.net: In the extreme heat, were you able to tell if your sugars had shifted?
Sasseville: The cues from the lows were the same and very obvious. What was very costly for me during the race was that I had two very high hyperglycemic episodes. I felt so badly because of the heat, I didn’t pick up on my glucose rising. Because my blood sugar was high, I got dehydrated so quickly, and my muscles got stiff and I couldn’t run.
I felt pain, but I thought it was because of the heat, but then I decided to test my blood. I was in the 300s and then knew where the pain and immobility were coming from. Of course, my blood sugar right then was going to dictate how I was going to feel in 2 or 3 hours. You are suffering physically right at that moment, but mentally you also take a bit of a hit. I was thinking I messed up part of my race.
DiabetesCare.net: When you are competing in endurance events do you find it to be helpful to run a little high?
Sasseville: It can be both. I have heard a lot of athletes say they feel they perform at their best when their blood sugar is around 150 or 160, which is a little too high, but it is still below 180, where people start to become dehydrated. Because people with diabetes can trick their blood sugar and have it running too high—it could be an advantage. However, trying to keep it at a stable level is easier said than done.
DiabetesCare.net: When you had your single biggest race day, running 80K, you said you had encountered some diabetes issues. Can you explain what they were and how you dealt with them?
Sasseville: I had high blood sugar, and it happened with just 7 kilometers to go. I had a good day, and the sun had gone down and I had literally run my fastest 20k in the course of that day. I knew the finish line was coming and I had a burst of energy. I was flying and then I began to feel bad. I stopped and tested my glucose and found out I was in the 300s. I was in around 21st place and had gone down to 16th when I realized my blood sugar was super high. I hit a wall.
I had to walk a little to have the blood sugar come down, and by the time I was able to normalize I had crept back down to 21st place. I was doing so well and I thought my blood sugar would behave the way it had the whole week, and it didn’t for some reason.
I assumed something else was going on in my body and I didn’t test as much in the last 20k. If I had just tested it an hour before, I could have seen it was beginning to rise and done something about it.
DiabetesCare.net: When you did realize you had gone high, you said you walked it off. Did you give yourself any additional insulin?
Sasseville: I did take a little bit of insulin. Crossing the finish line that day was incredible. It took 13 hours to cover the distance, which is slow, but you have to remove all that you know about road races due to the terrain, the weight of your pack, and the temperature.
DiabetesCare.net: What was the terrain like running in the race?
Sasseville: It is mostly sand. You are running up sand dunes and there is both soft and hard packed sand. We did encounter some areas where it was road. It was a sandy road, and almost felt like asphalt. And there were other times where we were practically on all fours climbing up dunes.
DiabetesCare.net: So for everyone who participates in the race you are not getting any support from a team. It is a totally self supported event?
Sasseville: Yes. We brought everything ourselves, except the water, which we were give a 4.5 liter of water when we arrived at camp and during the race; we were given 1.5 liters at every checkpoint. They were about 10kilometers away from each other. (In the below picture is Sasseville`s diabetes supplies and food he carried during the race.)
DiabetesCare.net: You ran to support the JDRF. Why the decision to do so?
Sasseville: As much as my motivational message is about living well with diabetes and accepting the disease, it is important to fund the research for a cure. I have seen so many people struggle with it. I have seen so many families have a tough time with it. Kids feeling different, depressed, and feeling limited because of it. It would be nice to see a cure.
The face of the cure has changed a bit. Back in the 90s, the JDRF was focused mainly on finding a cure. Today, the JDRF has expanded into funding different projects. They obviously are still focusing on trying to find a cure, but they are also investing in trying to prevent it. For example, they are trying to come up with a vaccine to give to young infants that prevents them from developing type 1. They also invest in improving the quality of life of people living with diabetes, like with the artificial pancreas project. Whether it is to cure, prevent, or improve lives, JDRF does amazing work and it is a real pleasure in supporting them.
DiabetesCare.net: How did you end up doing in the race?
Sasseville: 134 competitors started the race; 18 of them dropped out; and 116 finished. I finished 21st overall. As it was my first time, I learned so much, met amazing people, and had an incredible experience.
DiabetesCare.net: Do you know of anybody else with diabetes that has done the race?
Sasseville: Roger Haney, who was from Australia, was another type 1 in the race. We got acquainted online and we shared a tent along with 8 other competitors in the Sahara. And we had requested to be in the same tent, if anything for safety. Roger is a great guy and he was also raising funds for the JDRF.
DiabetesCare.net: Any lessons you learned in how you can apply them to future endurance events or diabetes management?
Sasseville: We suffered so much (he laughs) that mentally we pushed our boundaries to the limits. I found out how far I could go. I am doing an Ironman in Arizona [Sasseville competed in it last weekend], and I will definitely think about how to keep myself in the race mentally, and deal with temporary pain. Diabetes wise, it was another race I prepared specifically for and it helped having experienced it as it reinforces my belief everything is possible with the disease. We just need to adapt to what we face, and we can be safe and do anything we want.
DiabetesCare.net: You mentioned you were doing the Ironman in Arizona. Are you doing that as a member of Team Type 1, and how is it being a part of the team?
Sasseville: Yes, and it is a privilege. To be headed to Arizona to spend the weekend with inspiring people that athletically are competing in world class events that have type 1 diabetes—it is incredibly cool. We are doing a few outreach events while we are there. I learn from my teammates everyday and we love sharing the vision of Team Type 1 as well as the little things we are doing, including the mistakes we make and the things that work during races. Every week, I answer questions from Team Type 1 social media about training and it goes out to other athletes as we try to help other people. It is a big community and hopefully we are making a difference.
DiabetesCare.net: As you are a motivational speaker, what is your theme or message when speaking to diabetes groups?
Sasseville: The main message I want people to go home with is that diabetes is not a limitation. And regardless of what they want to do, whatever dream they have, it is possible. Unfortunately, because we have diabetes, it is always going to be more work, but if you do all the little things to be well-controlled, it opens up the door to a world of possibility. You are going to feel great and you are going to be healthy and you’ll be able to achieve the things you want to achieve.
The photo of Sasseville is credited to www.racingtheplanet/Scott Manthey. To find out more about Sasseville or to hire him to speak at your company event, go here.