Sebastien shares tip on avoiding Hypoglycemia during exercise

Johnson & Johnson Website Blog

October 9th, 2015

From Couch Potato to IRONMAN: How I Did it – With Type 1 Diabetes

By Casey Boren


My First Tri

When I was growing up, my parents owned a running store, and I swore I’d never be a runner. Call it rebellion.

Instead, I grew up, got married and was running computer systems for Starbucks. Then, in September of 2003, when I was 33, my wife’s brother and sister and some friends came out to Seattle to do a fun little mini-triathlon. They weren’t extreme athletes by a longshot: This was just a half-mile swim, a 15-mile bike ride, and a 5K run, which is about 3.2 miles.

Of course, at that point in life, my favorite activity was pretty much watching ESPN. But these guys were so enthusiastic about this race, and they kept encouraging me to do it with them. I actually don’t quite know how it all happened. They were like “Come on, man, you can do it!” And I was like, “I haven’t trained!” A few hours (and a few beers) later, they had me convinced.

When I say I was unprepared, I’m not kidding: I didn’t even own a bike. Well, strike that: I had a cute, little hipster-cruiser bike. I didn’t have running shoes – just cross-trainers. I had no idea what I was getting into.

Race day dawned, and I started strong. I beat them all in the swimming segment. Then it was time to get on the bikes, and suddenly I realized I hadn’t paced myself wisely. I actually threw up on my bike.

I might have stopped, but just then, after horking up my breakfast, my brother-in-law passed me and yelled, “Come on, man! Keep going!” So I did. I mean, I finished last in our group, but I did finish.

Becoming a True Triathlete

After that first race, I was hooked. I officially joined a triathlon training group, and the coach’s wife talked me and another guy in the group into anteing up for an IRONMAN competition: Mind you, that’s a 2.4-mile swim, a 112-mile bike ride and a marathon.

“Man,” I remember thinking. “This is out of your wheelhouse.” And it was a far cry from my former existence, but I began training in earnest.

At the same time, my wife and I were considering relocating from Seattle to her hometown of Boise, Idaho. “If you find a great job in Boise, I’ll move,” I told her. I never thought she would. But she did, and I’d given her my word, so it was off to Idaho for us.

That was scary for me. I was training for my first IRONMAN, and I wasn’t an endurance athlete. I needed guidance to understand what was happening to my body. But I was able to hook up with a community online and successfully trained for IRONMAN Coeur D’Alene. By now, I was 35 years old, and my body had changed completely: I’m 6’4”, and I’d gone from 197 to 150 pounds.

When I finished my first IRONMAN with a time of 13 hours, I was ecstatic.

Shortly after that, my body hit the wall. I lost more weight and felt totally lethargic, as if I couldn’t recover. I was so hooked, I wanted to start training for another race immediately, but my coach saw how run-down I was. “Take a month,” he said, “and don’t work out more than 30 minutes a day.”

With all that downtime, I Googled my symptoms, and everything was coming up cancer.

A Surprise Diagnosis

Finally, I went to a doctor, and after all the tests were in, he sat me down. “You have Type 1 Diabetes” he told me. That was the kind of diabetes, he explained, that they used to call juvenile diabetes. It’s not caused by lifestyle issues, but simply your body not producing enough insulin.

“Great,” I said. “That’s not cancer! Give me a pill and let’s get on with it.”

“It’s not that kind of diabetes,” he said, seriously.

“Well, I’m not really a ‘shot guy,’” I retorted.

And I’ll always remember his response: “You are now,” he said.

When people think of diabetes, they generally think of Type 2 diabetes, which can often be controlled by diet because the body does produce insulin, in limited amounts. In Type 1 diabetes, your body isn’t producing the insulin; basically, your beta cells are attacking the insulin that is produced, so you don’t get any. You have no option but to cover the carbs you eat with injected insulin. Typically, that means a shot three to five times a day.

If you don’t do that, your body will inevitably start to break down, and you’ll be hospitalized with complications: Damage to your cardiovascular system, painful nerve damage, kidney damage, blindness – it’s awful. You do not have the option to not manage this disease, and the better you manage it, the longer you can stay healthy.

So I met with an endocrinologist and told him I wanted to manage my disease, but I wasn’t about to change my lifestyle. “I’m going to do this IRONMAN,” I said. “So what are my options?”

Through him, I learned I had the option of using a pump. In other words, instead of giving myself several shots per day, I could hook this up to my body and set it to release small doses of insulin. There is a little needle that you put just under your skin with the help of a plastic spring-loaded inserter and attach with a round Band-Aid kind of thing. That attaches to a tube that goes into the pump, which slowly releases insulin into your system according to a schedule you set.

I use the Animas® Vibe® pump. I call it “life-ready” – it’s waterproof, so I can wear it swimming, and it has a color screen, so I can easily read my blood-sugar levels and how much insulin is left in the pump. It also has a vibrating alarm that alerts me when my blood sugar has gone outside of the parameters I’ve set.

Meanwhile, on my upper glute, I also attach a sensor for continuous glucose monitoring – a Dexcom G4®. This tests my blood sugar continuously, just like it says, and sends that information wirelessly to the pump, so I can see the data in real time, how my body reacted to my activity and to the food I ate, confirm the reading with a fingerstick test, and adjust the pump if I need to.

But if I can tell diabetic athletes – or people with diabetes hoping to be athletes – one thing, it’s that you have to take charge of your management of this disease. When I started, I would check my blood-glucose levels, run a mile, check my blood again, write it down. I wanted to see how running affected that number: Did it push me into a dangerously low zone? You have to know what’s going on with your body.

And you can’t let this disease stop you. There’s just not a lot of research out there about diabetes and sports, and that’s scary for a lot of people. I wanted to lead by example and show the world that it’s possible to manage your body and achieve your dreams. And I wanted to help others do it, too.

The Diabetes Sports Project is Born

I began to train with other diabetic athletes through organizations that seemed to quickly fade away; none of them are around anymore, so I decided to found my own. I ended up with nine other athletes, and our vision was of an organization where we would run races and compete to provide inspiration.

But once people are inspired, what do they do with it? Next we started free training plans designed to get you off the couch and chasing your dreams – to help people take the practical steps they need to manage this disease and live a more active lifestyle.

The Diabetes Sports Project has just come together in recent months. In fact, the URL isn’t up yet – it’s launching October 10 (, but you can “like” the Facebook page for now.

The other athletes on the team work full-time and still work out and compete at a high level because they love it. This is when we get to unplug from work, talk to friends. People think that we’re these superhero, Greek-god kind of athletes – that’s just not true.

I love running, I love riding, and I have learned to love swimming. What the diabetes has taught me is that if you love something, you can make it happen regardless of your own personal obstacles.

Every year since that first IRONMAN, I’ve done one or two full IRONMANs and finally worked my way to getting a legacy spot for Hawaii, which is the world championship. There are two ways to get there: Win your age group – in 2009, I missed it by six spots – and the other is to do a dozen IRONMANs. I tried for that spot every year, and now I’ve qualified for this legacy spot, and I would not have traded this for any of those other years. This is the right year for me to do this IRONMAN.

Now I look at those pictures of the guy in 2003: He never would have thought he could run across America, complete 13 IRONMANs – he didn’t even know he had this dream. He just had that cruiser bike. Once you start living an active lifestyle, you have no idea where it’s going to take you. That’s what I want to get across to people: Whether you have this disease or not, you can live life to the fullest. And the only goal you should have is that: To experience your journey.

- See more at:


“The learning curve will never stop,” says IronMan with Type 1 Diabetes

By Ginger Vieira

The Diabetes Sports Project (DSP) was founded by Casey Boren. Casey, diagnosed with type 1 diabetes 10 years ago at age 34, has been an athlete all his life. When diabetes came into the picture, he was determined not to let it interfere with his athletic prowess.

The DSP is dedicated to empowering those affected by diabetes through sports-related educational and community engagement. In other words: learning about real-life diabetes management around exercise (versus the “just eat 15 grams of carbs” kind of advice you might be getting from your doctor) and group athletic endeavors and training.

***DSP offers FREE endurance training programs***

Utilizing the world’s most inspirational, experienced, and sought-after diabetes athlete ambassadors, DSP’s goal is to have a powerful, meaningful and sustainable influence on the diabetes community.

DSP’s athlete ambassadors demonstrate that through proper diet, exercise, a positive outlook and effective blood glucose management utilizing the diabetes tools and technology available today, goals can be achieved.

So far, the DSP Team supported two of its athletes racing in the Ironman World Championships in Kona, Hawaii this past October 2015. Upcoming events for DSP athletes include the Boston Marathon and many other major sporting events throughout the upcoming year.

The Team debuted with 2 of its athletes racing at the Ironman World Championships in Kona, Hawaii, in October 2015. Additionally, athletes will be seen at other venues include the Boston Marathon and other premier sporting events throughout the year.

Their goal is to help provide education and insight to fans who are interested in pursuing their own athletic endeavors. We can’t wait to help you reach new goals!

Interview with Casey Boren

Age: 44 years old
Years with Type 1: 10
Day-Job: Information Technology (IT)
Athletic History: 14 full IronMan races including Ironman World Championships, Ran across America in 14 days with 9 other diabetics, represented TeamUSA in the Long-Course World Championships
Marathon Pace: under 3 hours

Ginger: At what age in your life did you realize you wanted to be an athlete?  And then…how did diabetes impact the way you even thought about pursuing idea or goal or dream?

Casey: I played soccer as a young kid but never liked running.  It never crossed my mind that diabetes would ever stop me from pursuing my goals; it just added a few extra steps along the way.

Ginger: What has the learning process around managing your diabetes and being an athlete been like for you

Casey: It’s been an ongoing journey and I don’t think the learning curve will ever stop. As my training change so does the way I have to manage my diabetes. The fundamentals stay the same but my body will change according to the training regimen, thus I will change my strategy on how to manage my diabetes. 

Ginger: What was it like when you started, how much did you know or not know versus what you know about your diabetes today

Casey: I started out knowing absolutely nothing about diabetes and sports, or how those two might fit together. I had to document everything so that I could see how my body would react to different situations. I also made sure I always had a backup plan and extra food with me. I feel that there is still a learning curve at times, but I am much more familiar with what is going on and what to expect.  I also use the Animas Vibe, which gives me more flexibility to my management style.

Ginger: And now, Kona! How has the training process been for you in preparation for this particular event? What were your goals for this race? 

Casey: Kona Training was very special for me. This was a bucket list race. So, I used my experience from my previous 13 Ironmans and also spent a ton of time training in the heat. I had a time-related goal going into the race but that all changed when I started getting sick at mile 20 on the bike course.

I adjusted my goals and made sure I stayed connected with the real reason why I was doing this race. I knew that it would mean something special to people living with diabetes if I could persevere and cross that finish line.  I had an inspirational goal more than just a performance goal, and I was able to make that goal a success!

Ginger: Being a part of the Diabetes Sports Project is not only empowering to you, but to others with diabetes who dream of being competitive athletes! 

What do you hope to get out of being part of this team? What does it mean to you? 

Casey: Diabetes Sports Project means everything to me. I love to race and enjoy living an active lifestyle, and DSP allows me to use sport as a platform to motivate others to chase their dreams. We also want to make sure once we inspire people we also enable them with a path to get started on living an active life style as well.

Ginger: If you could give one piece of advice on being an athlete with diabetes, what would it be? 

Casey: Do not get discouraged if things aren’t going as you planned. Focus on what you cancontrol and enjoy your journey. We need to keep our dreams alive and realize that this doesn’t happen overnight. You will have a lot of ups and downs along the way, so it is important to stay positive! Ask questions, as there is a ton of knowledge out there and you’re not alone.

Ginger: Lastly, what sort of personal message, mantra, thought process or believe do you have as a person living life with diabetes that you feel fuels you, or carries you on?

Casey: You need to enjoy what you’re doing.  If you hate what you’re doing, find something else! And always remember somebody would probably love to be in your shoes so be grateful you can do what you can do!

Thank you, Casey!


Diabetes Sports Project To Launch During Hawaii Ironman

Posted by: LAVA Editors , October 8, 2015

Ironman World Championship race day, October 10, will mark the launch of the Diabetes Sports Project 

Dedicated to “empowering those affected by diabetes through sports-related educational and community engagement,” the nine-athlete crew boasts of accomplishments like climbing Mt. Everest, completing the Run Across America in 14 days, victories in 100-mile ultra runs and off-road triathlon world championships.

The team has collectively finished more than 50 Ironman events.

The following piece was written by DSP founder, Casey Boren, who will be racing this Saturday.

My Ironman journey began ten years ago when I decided to register for 2005 Ironman Coeur d’Alene with the goal of just finishing the race. Being fairly new to endurance sports, I didn’t really know what to expect.  While training for this race, I lost 25 pounds (over a year) and experienced what I thought was “bonking” during some of my longer training efforts; complete energy loss to the point of confusion and vomiting.  I rationalized these occurrences as normal for extensive Ironman training.  I finished Ironman Coeur d’Alene in 13:07 and was completely hooked on the sport.  After taking a couple of months of down time, I registered for 2006 Ironman Canada and ramped up my training.  I again started experiencing my previous bonking symptoms along with extreme fatigue, some major leg cramps and excessive thirst.  With these additional symptoms, I decided it was time to consult a physician.

At 34-years-old, I was diagnosed with Type 1 Diabetes.  While this news came as a shock, it explained many of the symptoms I experienced while training the previous year.  After starting insulin therapy, I was able to lower my blood sugar level and noticed immediate improvements. Since that time, I have completed 14 Ironman races, shaving off over three hours since my diagnosis. My experience with diabetes over the last ten years inspired me to take more of an active role in connecting with other diabetics and helping them lead a healthier lifestyle.

This is the very the reason I have co-founded the Diabetes Sports Project (DSP).   DSP is comprised of elite diabetic athlete ambassadors who educate and inspire the diabetes community to achieve their goals and aspirations. Our athlete ambassadors demonstrate that through proper diet, exercise, a positive outlook and effective diabetes management, dreams can be achieved.  I will be racing this October in Kona along with at least one other DSP athlete.

As you well know, Ironman is a sport of planning, nutrition, determination and execution.  During the upcoming race in Kona, I will need to closely monitor my blood sugar level, consume nearly 4,000 calories and adjust my insulin through the insulin pump I wear.  The CDC reports that currently an estimated 29.1 million Americans suffer with diabetes.  In 2014, diabetes was seventh highest cause of death in the United States.  I feel that recognizing DSP and its athletes in Kona will increase awareness of these staggering statistics and the seriousness of living with diabetes.  We also hope to inspire diabetics – and anyone – to recognize their potential, and see that any goal is achievable.


Bradford Gildon and Casey Boren during a live interview on



Dan Reiner, October 1, 2015

When 3,500 runners from across the U.S. head to the starting line at Sunday’s Milwaukee Lakefront Marathon, there will be a lot of blue and gold.

Approximately 90 students, faculty, staff and alumni are registered to run for Marquette’s marathon team as part of the 4th Annual “Claws vs. Paws” University Challenge. The Golden Eagles will face off against the Concordia University-Wisconsin Falcons and the UW-Milwaukee Panthers in the 26.2-mile throw-down for a trophy and bragging rights and to determine which team ‘runs’ the city.

This is Marquette’s first official year in the challenge after University President Michael Lovell brought the tradition over from UWM, where he served as chancellor.

Marquette Running Club President Xander Jacobson, who ran the Lakefront Marathon last year, says being able to run with so many familiar faces will make things easier.

“I am looking forward to being able to run alongside those who I have trained with for the past few years in order to accomplish such a daunting goal,” Jacobson said.

Lovell has spearheaded a running culture in his short time at Marquette, including his Run with the President Facebook group, which has more than 250 members. Members from that group, Marquette Running Club, Marquette Triathlon Club and other runners make up the Marquette marathon team.

Over the summer, the Lovell’s group and MU Running Club published training schedules that any runner could follow. The groups invited runners to train together and share personal experiences in advance of the marathon.

“One of my favorite aspects of this experience is how it breaks down artificial barriers between students, faculty and staff,” said Tim Cigelske, communication specialist in Marquette’s Office of Marketing and Communication and member of the running club. “You really get to meet and know a variety of people across campus.”

Running a marathon is nothing new for Cigelske, who will run his seventh on Sunday. For others, like former women’s soccer goalie and current graduate student Sofie Schunk, marathon training is a learning experience. She has often led the group workouts and found that no matter the ability, every marathoner has the same goal.

“All of us feel ready,” Schunk said. “We have a few different paces – those going for the win, those looking for a (personal record) and those just trying to finish.”

Schunk has an ambitious goal of finishing the race in under three hours. Others are trying to qualify for the 2016 Boston Marathon. In the end, the race is a community event in which all runners will try to run their best. That community will come together for a pre-race pasta dinner Saturday evening and a post-race social at the Annex on Tuesday, welcome to all Marquette, UWM and CUW runners to share marathon stories. A trophy is just an added bonus.

“I’d compare the post-race party to an ‘easy run’ where everyone is on the same page, conversing with one another about their own story,” Schunk said. “Each person has a say, no matter what (their) pace. It’s all about the camaraderie.” 


A Scientific Solution to (Finally) Stop Muscle Cramps

New findings shed light on cramping, the longtime bane of endurance athletes everywhere

Sep 1, 2015

You’d think that after completing 13 Ironman Triathlons, running across the country in 14 days as part of a nine-member relay team, and clocking a sub-three-hour marathon, Casey Boren would have his training and race-day nutrition and hydration strategy dialed. But throughout his endurance-sports career, he’s been unable to escape painful muscle cramps. “I’ve endured cramping in every Ironman I’ve done,” says the 44-year-old, “to the point that I know if I don’t finish the swim leg in under an hour, my hamstrings will cramp up. On the bike, my quads and hamstrings usually seize up around mile 40.”

He often battles the condition during the run, as well. At a half-Ironman in Knoxville two years ago, his hamstring cramps were so painful that, after he crossed the finish line, he stopped for a second and couldn’t move again. “They told me to leave the area, and I couldn’t,” he says.

Over the decades, Boren has tried everything from sodium tablets to sports drinks. In his experience, “nothing works except slowing down and massaging the tight area and waiting for the cramping to go away, and then hope it doesn’t come back.” But by then, he points out, months of intense training are effectively tossed in the trash. “Once I start cramping, the race stops being about my best performance and is reduced to simply finishing.”

That an experienced and highly trained athlete such as Boren can’t prevent debilitating muscle cramps speaks to their insidiousness and pervasiveness. And he’s not alone. Talk to just about any serious endurance athlete and you’ll hear the same story: When overworked muscles seize up painfully and stop doing what the brain tells them to do, there’s no real fix. To make matters worse, cramps often strike at the worst possible moment. (Exhibit A: LeBron James pulling himself out of the first game of the 2014 NBA Finals due to leg cramps.)

The most popular protocol for battling muscle cramps is to rehydrate using electrolyte-infused fluids. But despite sports nutritionists’ and sports scientists’ best efforts, cramping in athletes has persisted without an effective answer until a turning point in the science took root off the coast of Cape Cod. During a kayaking trip five years ago, a Nobel Prize–winning neuroscientist experienced a painful and potentially disastrous case of muscle cramps.

While paddling well offshore, Dr. Rod MacKinnon felt his arms seize up. The chemical-biology professor at The Rockefeller University wasn’t alone in his agony, either. His kayaking partner, Dr. Bruce Bean, a neurobiologist at Harvard, was suffering the same cramping. Both are fit and experienced paddlers who had been paying careful attention to their nutrition and hydration the whole way. They both eventually made it back to shore, but the ordeal drove them to find out what went wrong. For MacKinnon, a serious athlete who had spent the bulk of his career investigating ion channels, his two worlds collided. And when he found out how little we truly understood about cramping, he became obsessed.

MacKinnon’s research started with a look at traditional sports drinks and other electrolyte solutions. His take: They were predicated on replacing what people believed the body lost through sweat—if the body is losing salt or potassium, then restore those levels. But he also came across stories of marathon runners stirring mustard into water and cyclists downing pickle juice to end muscle cramps. He was curious and asked himself, "What's the story here?"

The more he learned, the more he began to suspect that it wasn’t the muscle that needed help (electrolytes, fluid, carbs), but a short circuit in the ion channels—the system that carries messages among the brain, the nervous system, and the muscle. What the body needed was some sort of stimulation to tell the motor neurons in the spinal cord to, essentially, stop freaking out.

With that realization, MacKinnon spent the next four years in his lab zeroing in on what would eventually become the first clinically proven formula to treat and prevent muscle cramps. By early 2015, he’d arrived at a spicy proprietary blend of ingredients. Here’s how it works: Right before or during a workout, an athlete downs a shot of MacKinnon’s performance cocktail. Ion receptors in the mouth, esophagus, and stomach spring to life, sending signals to the spinal cord, which then shoots out messages throughout the body’s nervous system to keep everything operating normally. Almost everyone has felt this mouth-to-spine-to-body connection when eating ice cream too fast, causing “brain freeze.” Ingesting ice-cold beverages or frosty foods results in a rapid cooling of a cluster of nerves adjacent to the roof of the mouth. For similar reasons, the right formula of spices can trigger a response to cramping.

If MacKinnon and Bean have their way, their research will formally launch a new direction in sports science—one they’re calling neuromuscular performance. Put simply, it’s understanding how the nervous system responds to stress and then manipulating it in such a way that it stays in optimal working order. It’s not mind over matter. It’s not nutrition and energy management. It’s about the nerves, which deliver information throughout the body. The premise is simple: If the pathways are out of whack, cramping happens. Trick them into staying in line, and it doesn’t.

This summer, MacKinnon and his team, who have been working with a select group of unnamed professional and world-class athletes, are wrapping up their research with more trials. (The owners of the New England Patriots and Boston Celtics were early investors in Flex Pharma, the company MacKinnon and Bean set up to research and market their super juice.) If all goes according to plan, Flex Pharma will bring their product to market in 2016.

For Boren, the day can’t come fast enough: “I train and race with a power meter on my bike, and I know that when I’m cramping, it’s not from muscle fatigue—my power is right where it’s supposed to be. And I know it can’t be from dehydration and electrolyte issues, because I follow a strict protocol during a race to stay hydrated. If there’s a theory out there to get rid of muscle cramps, you bet I’m going to try it.”

Diabetes Community Advocacy Foundation

Afterthoughts DSMA Live: ‘Rents | Casey Boren of Diabetes Sports Project

 Posted by DCAF_Lorraine | Thursday, 1 October, 2015 |  

DSP is dedicated to empowering those affected by diabetes through sports-related educational and community engagement. Utilizing the world’s most inspirational, experienced, and sought-after diabetes athlete ambassadors, DSP’s goal is to have a powerful, meaningful and sustainable influence on the diabetes community.

DSP’s athlete ambassadors demonstrate how through proper diet, exercise, a positive outlook and effective blood glucose management by utilizing the diabetes tools and technology available today, dreams can be achieved.

DSP will debut on October 10, 2015, at the Ironman World Championships in Kona, Hawaii, and can be found at other venues include the Boston Marathon and other premier sporting events throughout the year.

DSP’s website,, will be available on October 10, and will feature free 5k, 10k, and half marathon training plans, along with triathlon plans as well. Our goal is to help provide education and insight to fans who are interested in pursuing their own athletic endeavors. We can’t wait to help you reach new goals!

Diabetes Sports Project co-founder, Casey Boren, doing a live interview on Hawaii News Now followng the 2015 Ironman World Championship in Kona, HI talking about racing Ironman while managing type 1 diabetes