In 2007, athlete Stephen England, an ultramarathon runner, was watching the New York City Marathon and had a life-changing epiphany. Diagnosed with type 1 diabetes in 1994 when he was 14, Stephen had struggled with his diagnosis over the years, never feeling he could compete at the same level that he had pre-diagnosis. There were so many glucose calculations he needed to do to race—so many extra things to manage—that he felt as if his diabetes put him at a disadvantage.
His biggest setback came a decade later, when he trained as hard as he could to run the London Marathon. When he hit mile 22, he became hypoglycemic and had to walk the next two miles. “It really hurt to not achieve my time goal because of my condition, and I kind of gave up then on long-distance running,” Stephen says.
Then, just a few years after that race, as he watched fellow Brit Paula Radcliffe win the New York City Marathon, he felt a jolt of inspiration: He would run competitively again. The following week, Stephen joined the Nike Run Club, also known as RUNNYC, and he has not slowed down since—competing not only in marathons, but in ultramarathons as well. This past August, he finished his first 100-mile race, the Leadville Trail 100, in the Colorado mountains. Covering 9,000- to 12,600-foot elevations, the race is considered one of the hardest endurance challenges in the world, with only a 42 percent completion rate. Stephen finished in 28 hours, and ranked among the top 200 of 800 starters.
“Now, I’m actually proud to have diabetes. I want to show people that you can do whatever you want to and have [this condition]. Whatever you are passionate about, go after it and achieve it,” he says. “My best advice is to do more blood tests, to get better control.”
Disease management is crucial to Stephen’s race performance. While some people drift off into a Zen-like state while running, when Stephen runs, he is continuously monitoring his heart rate, his pace, and his blood glucose levels. During the Leadville 100 race, he tested his blood sugar levels every hour.
“I’m always thinking, ‘Am I tired from the running, or am I actually [hypoglycemic]?’” he says. “To me, it’s part of the challenge. I just have this second factor: Can I finish the race while keeping my blood sugar in a normal range? If it’s too high or too low, I'm in trouble, especially in a race like Leadville. I actually enjoy the challenge.”
Despite his determination, Stephen has not had an easy time finding a doctor to help him manage his athletic lifestyle over the years. Because he is so active, his blood sugar levels are inconsistent.
“When you do extreme sports with diabetes, there are more variables that can affect your blood sugar, during the activity and after it has ended,” said Stephen’s nurse, Emily Coppedge, BSN, diabetes educator at the Naomi Berrie Diabetes Center. “Athletes often need higher-than-normal blood glucose levels to begin exercise and are fueling consistently during the activity. The adrenaline from long-distance sports can also cause high blood-glucose levels immediately post-exercise, but lower levels later in the day. Frequent blood-sugar checking is essential during the activity, and it often takes athletes more than one race to fine-tune their diabetes regimen."
Stephen says that all of the endocrinologists he saw after he started running marathons advised him to work harder to maintain a better A1C level. “I felt as if I were being punished for being so active. They made me feel as if I would have better control if I just had a simpler life, with less running. It wasn't realistic and, quite frankly, it was frustrating to hear.”
When Stephen came to the Naomi Berrie Diabetes at Columbia University Medical Center, it was the first time he met a doctor who understood that he was a diabetic athlete. “I needed a team that would understand that my A1C would never be really low because I am so athletic,” he says. “When I saw Dr. Goland and her team at the Berrie Center, it was clear that they had experience working with diabetic athletes.”
Emily Coppedge agrees: “The philosophy at the Naomi Berrie Center is to achieve your dreams, to not let diabetes deter them. Stephen is a great example of an athlete living with diabetes. He shows that, with the right mindset and attitude, people with diabetes can achieve anything while continuing to have great control.”
Stephen is now set to compete in a number of races this fall: the Chicago Marathon on October 7, the JFK 50 Mile on November 17, and the California International Marathon on December 2 (his first race as a Team Type 1 athlete). His 2013 goals include the Boston Marathon, an Ironman, Western States 100 Miles Endurance Run (America's oldest 100-mile race), and the Ultra-Trail du Mont Blanc, arguably the world's toughest 100-mile race, run in the Alps through France, Italy, and Switzerland.
This past May, Stephen started a blog RunDiabetes, which chronicles his journey as a diabetic athlete and where he also inspires others living with diabetes. In a blog post “My Dream Team: Naomi Berrie Diabetes Center,” Stephen wrote:
“Don’t be a frustrated diabetic if you live in NYC, especially if you have an active lifestyle like me. I know there must be another ten or hundred people in my shoes who have not found the right management team for them. Speak to The Naomi Berrie Diabetic Centre and schedule an appointment.”
To read Stephen’s blog, RunDiabetes.com, CLICK HERE.