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Discussion of Diet and Fitness as a tool to manage Diabetes

Alissa is wrapping up 2015 with an interview of 4-time Olympian Skier and T1D Kris Freeman.  From Campton NH, born 10/14/1980, Kris Freeman’s accomplishments include the Under 23 World Champion, 17 X National Champion, and Lilly Diabetes Camp Care Ambassador.  Kris is a Dexcom Warrior and Omnipod user since 2008.  You can keep up with Kris at his site, www.krisfreeman.net

Alissa: Your interest in skiing came at a very early age. Your parents both skied, can you tell me a little about your parents, and how they first got into skiing?

Kris Freeman: My Dad was a pig farmer from Iowa. My mom grew up in a suburb of Chicago. They started skiing in their mid-20s when they moved to New Hampshire.

Alissa: What was it that you loved about watching your parent’s cross-country skiing? What made you pursue this as an athletic sport over other types of professional sports?

Kris Freeman: In my town, there is a private high school that has its own ski jumping facility, cross-country ski trails and downhill mountain. The school opens their facility to residents, offering free coaching. I took full advantage of the facility since I was 5 years old.

Alissa: You're an Olympic and national champion cross-country skier, can you tell me a little about your professional skiing career?

Kris Freeman: At 19, I was titled the youngest national champion. Since then, I've won 16 additional national championships. I competed in the last four Olympics and earned 4th place in the World Champions twice.

Alissa: What age were you when you were diagnosed?

Kris Freeman: I was diagnosed at 19 after taking a routine fasting glucose tested required by the U.S. Ski Team. My glucose came back 240. I was immediately sent to an endocrinologist who diagnosed me within five minutes.

Alissa: How did you handle your type 1 diabetes (T1D) diagnosis emotionally?

Kris Freeman: Although the doctor was kind and supportive, he advised against competing at an Olympic level. I sought a second opinion, but to no avail – the next doctor concurred. Appreciating that I have been working toward my Olympic goal since I was five years old, I became depressed. I continued to research for another doctor, finding one who was willing to work with me to assure that I could continue competition.

Alissa: Were there any signs of symptoms that you missed prior to diagnosis?

Kris Freeman: Absolutely – my vision was blurry coupled with lightheadedness, plus I was going to the bathroom a lot. The signs, however, were easy to miss because I had just moved out to Park City, Utah, which is at 7,000 feet. Training for the Olympics included four hour mountain runs and 30-mile roller skis. It was easy to excuse the symptom as general exhaustion.

Alissa: How did your endocrinologist help support and manage your training schedule? Did you ever become discouraged?

Kris Freeman: It was through trial and error. The doctor expressed confidence that there were solutions but we had to work together to come up with different insulin protocols as well as ways to keep my glucose monitors warm. While there were certainly discouraging moments, I never stopped aspiring to make that Olympic team.

Alissa: Who did you first tell about your diagnosis? Did you fear that this might end your career?

Kris Freeman: Remember, the first two doctors advised that diabetes might end my career so it was of concern. I immediately called my parents, high school coach and closest friends – all of whom were very supportive. Unfortunately, my support network was at a distance because I was living in Utah. I had to rely on the telephone and email.

Alissa: Describe your Olympic training.

Kris Freeman: In total, I would train about 800 hours a year with the longest days equaling five hours of training per day, and the shortest could be up to one hour per day.  Ironically, the majority of training occurred during off-peak competition season. A typical training day began with a 20-mile run in the morning followed by an hour long down pole on roller skis, concluding with a weight room session.

Alissa: How were you able to make adjustments to find the right diabetic regimen?

Kris Freeman: On race days I noticed that my glucose would rise for no apparent reason.  I researched why this was happening and learned that the stress hormones cortisol and adrenaline have strong effects on glucose metabolism.  Cortisol makes the body less sensitive to insulin and adrenaline triggers a release of stored glucose from the liver.  I started doing yoga and basic meditation techniques before races to keep my stress response to a minimum in the lead up to races.  Whenever I notice a pattern in my glucose management that I can't explain,  I research the root causes of it so that I can come up with a plan to control it.


Alissa: Are you currently on an insulin pump and a Dexcom CGM?

Kris Freeman: Yes, I used the typical Humalog and Lantus injections from the year 2000 through 2007. My endocrinologist and I were initially hesitant to go a pump because we were concerned about freezing. There are temperature controls in cross-country ski racing, but the race can start at -4 Fahrenheit. As a result, I would take up to 12 shots a day to maintain my glucose level. Then in 2008, I went on the Omnipod system, which has a pump that rests on my skin – utilizing my body heat to keep it warm.  I started using Dexcom in 2010.

Alissa: How has using Dexcom helped you?

Kris Freeman: I have a better understanding of what is going on within my body thanks to a reading it provides every five minutes. I can easily monitor myself in the middle of a run as opposed to having to stop and use a blood stick.

Alissa: Does type 1 diabetes run in your family?

Kris Freeman: Type 1 does not run in my family.

Alissa: Tell me about your Olympic journey and the impact diabetes had on it.

Kris Freeman: Diabetes has not affected training or racing. What has changed is my preparation, which includes organizing all of my medical equipment. I can be on the road for five months so I must account for how many pods and glucose test strips I will need. Do I have enough hand warmer packs with me? I also need to start thinking about my eating habits prior to a race. In order to maintain my insulin and diet regimen, I have to assure that I eat breakfast three and half hours prior to the race. So if a race begins at 8 a.m., I wake up at 4:30 a.m.

Alissa: Did you develop your diet plan or do you see a nutritionist?

Kris Freeman: I do not see a nutritionist. When I am not training my diet is high in protein. If my day is going to have a lot of physical activity then I replace the protein with carbohydrates.

Alissa: Are you in close contact with your endocrinologist, do you mostly self-manage?

Kris Freeman: At this point, I mostly self-manage.

Alissa: I have a daughter who is a type 1 diabetic, and she had the honor of hearing you speak at a diabetic camp she recently attended. What kind of message would you like to share as a role model to other type 1 diabetics?  

Kris Freeman: I've been visiting summer camps for kids with diabetes since 2004 on behalf of Lilly Diabetes Camp-Care Program. I realized that I could make the greatest impact on inspiring kids. I am so happy that I have seen a lot of change over the years. Twelve years ago, when I told kids about the two doctors who advised that I couldn’t go to the Olympics, they all nod – like "Yeah, we all heard that too." Today, whenever I tell that story – there is shock in the room. Kids would actually say, "A doctor would actually tell you, you couldn't do something?" I meet kids who are playing sports and aren't scared to get off the couch. I continue to stress to the kids that diabetes doesn’t have to be an obstacle in your life, but it will if you let it.

Alissa: What is a moment from the camps are you most proud of?

Kris Freeman: Probably more private moments. It is the kid who is maybe too shy to speak up in a group but will come to up to me afterwards, confiding that he or she went out for a team because I inspired him or her. It is the best feeling when I know that I actually made a difference.  

Alissa: What are your future career and Olympic goals?

Kris Freeman: Unfortunately I am getting older, and I am reaching the age where skiers do start to retire. Although my last race will be at the next Olympics, I will continue participating in sports. I enjoy triathlons as a hobby, and I would love to compete in the Kona Ironman.  

Alissa: You mentioned Lilly Diabetes. What kind of relationship do you have with some of your sponsors and how do they support you?

Kris Freeman: Cross-country skiing and competing through Europe is expensive.  Lilly has helped me get the equipment I need, which is not really uncommon. All skiers have personal sponsors, mine just happens to be in the diabetes world.

Alissa: How do you plan on spending your holidays?

Kris Freeman: My fiancé and I are going to my parent's house, joined by my brother, his wife and their daughters. The visit will be short though. I am only home for one week and then I am heading out to Houghton, Michigan for the U.S. National Championship.

Alissa: When do you compete for the Olympics tryout?

Kris Freeman: The next Olympics will be in South Korea in 2018. The World Championship will be in Lahti, Finland in 2017.

Alissa: I wish you the best of luck and have a wonderful, happy holiday, happy New Year. Thank you very much Kris for your time. 

 

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