Blood, Sweat and Peers

So why, then, do you think health-care systems aren’t spending more money on preventative exercise programs?
It’s complicated. You’ve got health-care systems that have to move in a different direction. You’ve got insurers and third-party payers and health-maintenance organizations moving in a different direction. You’ve got physicians who have become somewhat apathetic to the cause and maybe think that either their patients just won’t do it and/or the docs don’t understand it. They’re not trained in exercise and nutrition and lifestyle. And they don’t have time to do it. You can’t teach this in 10 to 15 minutes. There are ways you can structure office visits so that you can maybe hit a couple of major points, but it’s really challenging.

But couldn’t a motivated person with diabetes do the same at a general fitness camp, a gym or with a personal trainer?
Prior to this, there have not been camps simply geared toward diabetes and exercise for the adult population that I’m aware of. The critical thing is to get all of the important team members—the docs, the diabetes educators, the exercise physiologist, the coaches, the nutritionist and the person with diabetes, who is the quarterback of the team—into one place, so that there’s this supportive environment to figure out the best strategies on how to manage the diabetes with exercise. First and foremost, there is an emphasis on safety. If we can have people exercising safely we also think it will be fun, and that’s something that just can’t happen in a run-of-the-mill sports camps. Having held three camps so far, we know that you can take somebody, and in just a few days time, introduce them to some very fundamental concepts about how to manage diabetes during exercise. Apply it to them individually—and I think that’s really important because everyone is different—and they employ it right then and there and see results in just a couple of days. That’s going to go a long way to making them feel much more comfortable when they leave camp, whether they want to exercise for an hour or run a marathon or everything in between.

Right, because whenever I’ve tried to start an exercise program, it seems like it wreaks havoc on my blood sugars. Before long I feel like I’ve set myself up for failure.
Yes, and I think many people with diabetes get that sense of failure—"this is just not going to work, this can’t work, I can’t do this"—and the immediate result is that they stop. And some of those people, you lose them. They won’t go back and these are the folks that the health-care system says, "Well, they’re just not going to do it anyway." The health-care system doesn’t understand that a significant portion of those people have tried, and they quit. So this is where it gets tough. But there is a certain amount of hand-holding that has to go on initially, so that you can look somebody in the eye and say, "You can do this. You can absolutely do this. Let’s see what happens and then we’ll go back to the drawing board again and we’ll keep chipping away at it until you can feel really comfortable that everything’s OK."
Now, that’s for the people who come to camp looking for a general fitness program. But I will tell you that even the folks who come into the camp who have had lots of experience with marathons and triathlons, it’s been trial and error for them for so many years that we’re able to really uncover some pretty fundamental points about diabetes and exercise that they’re able to implement right away. And within a week or two’s time I continually hear from these folks that they’re seeing levels of control and performance that they’ve never seen before. And we can only hope that that will go a long way to being a safer way for them to exercise for them. That it keeps them from having to drop out of events, or slow down, because their sugar gets too high or too low.

Some of the coaches in your roster are considered super-elite, among the top in their fields. Why would they be interested in working with people with diabetes, some of whom, like me, are pretty out of shape?
I’m being serious when I tell you this: they love it and they have come back to me repeatedly over the past two years and said, "This is what it’s all about. This is what I do." They are in awe of what the campers are doing. They recognize now, even the coaches who didn’t have a lot of experience with diabetes, what a challenge it is for our coaches and attendees who do have diabetes. And they absolutely love coaching—each and every one of them. We have Olympic athletes, national champions, elite triathaloners on our staff and across the board, all of them demonstrate so much humility. You would never know how unbelievable their résumés are.

© 2007