The Diagnosis
I was 32 years old, driving to Scotland, and stopping every thirty minutes to use a toilet.
That journey took forever. I did not know it at the time, but the constant urge to urinate is one of the first signs that blood sugar has gone seriously wrong. By the time I arrived I knew something was off. The diagnosis that followed confirmed it. Type 1 diabetes.
I could not believe it. Not diabetes. Not at 32. And not Type 1 — the autoimmune kind, where your own immune system destroys the cells that produce insulin. No lifestyle cause. No cure. I had always trained, always looked after myself. None of that mattered. Type 1 does not care how fit you are.
The first thing I was told was that I could still eat what I wanted. The nurses and my GP said it with the best intentions. I disagreed immediately. I had no interest in managing this poorly and carrying the consequences for the rest of my life. I had seen what uncontrolled diabetes does to a body over time. That was not going to be my story. I changed my diet the same week.
The Honeymoon Phase
What nobody tells you about a Type 1 diagnosis is the honeymoon phase.
In the first year or so after diagnosis, the pancreas still produces small amounts of insulin. Blood sugar is easier to control. You start to think you have this managed. You take less insulin. You eat a little more freely. You think, perhaps, it is not as serious as everyone made out.
It is exactly like a honeymoon. Which means what follows is reality.
The honeymoon phase ends, insulin production stops completely, and suddenly the management that felt manageable becomes something else entirely. I was eating seven small meals a day and injecting seven to nine times a day to match. Every meal required a calculation. Every food became a variable. I will be honest about that: it was taking over my life.
What I Stopped, What I Kept, and What I Got Wrong
I learned quickly which foods spiked my blood sugar and which did not.
Baked potatoes were the first to go. I had always loved a baked potato with tuna. That ended immediately — baked potato is one of the highest glycaemic foods you can eat and the spike it caused was dramatic. Roti, the Asian flatbread, was another. I reduced it to one at a time, then decided it simply was not worth the management.
Rice I stopped entirely in the beginning. That was a temporary solution I later corrected. Once I understood how to calculate the right insulin dose for a portion of rice, I brought it back. Steak and rice. Chicken and rice. Protein with rice became a staple. The lesson was not that rice is bad. It was that knowledge gives you back options that fear takes away.
Alcohol I stopped. If your blood sugar is already running high, alcohol makes it worse in a way that is both dangerous and embarrassing — the symptoms can look a great deal like being drunk. The sleep is poor. The management the following day is harder. It was not a difficult decision once I understood what it was doing.
I ate seven small meals a day throughout, and the same food on rest days as training days. I made that decision deliberately. Introducing different foods on different days added a layer of complexity I could not manage at the time. Consistency made the insulin calculations predictable. Predictable made it controllable.
I also wish I had written everything down from the very beginning. Every food, every insulin dose, every response. I did not, and I am still working from memory and instinct rather than data. That is a genuine mistake. If you have just been diagnosed, keep a food diary from day one.
The Gym
Training with Type 1 diabetes in the early years was its own education.
Exercise causes what is called exercise-induced hypoglycemia. During physical activity, muscles take up glucose independently of insulin — without needing an injection to drive it. This means training on top of insulin already in your system effectively doubles the blood-sugar-lowering effect, and levels can drop fast. I did not fully understand this at first. I learned it the hard way.
What I did know was that I needed to be prepared. I carried a hypo kit to every session — coke, snickers, Mars bars. The looks I got in the gym were something else. Here is this person on a treadmill eating chocolate and drinking full-sugar coke while everyone around him is trying to lose weight. I understood exactly how it looked. I had no choice.
I trained on that treadmill on a steep incline carrying a twenty-kilogram backpack, preparing for a three-month trip across South East Africa in heat that sometimes reached forty degrees Celsius. Managing blood sugar in that kind of environment, away from reliable medical facilities, required preparation that most people never have to think about.
After sessions I would eat protein — steak, chicken — and keep carbohydrates low. Then take insulin. The mistake I made repeatedly was taking too much insulin without eating enough carbohydrates alongside it. I would forget that something as simple as chips alongside the steak were not just acceptable — they were necessary. The result was a significant low.
1.9
The lowest blood sugar reading I have ever recorded was 1.9 millimoles per litre. The normal lower limit is around 4.0.
At 1.9 you cannot speak clearly. You do not know where you are. The person with you is feeding you sugar — coke, whatever is available — trying to bring you around while you have no control over anything happening to you. When you come back, you have no memory of it. Someone tells you what happened and your first thought is that there really should be a cure for this by now.
I have never been hospitalised. I count that as a combination of preparation, fitness, and something I believe I inherited. My grandfather walked for two weeks across the subcontinent during the Partition of India with four young children and nothing to his name. The capacity to endure runs in this family.
Kilimanjaro
Two years after my diagnosis, I stood at the summit of Kilimanjaro.
I checked my blood sugar every few hours on the climb. I carried a full hypo kit throughout. The altitude, the cold, the physical demand — all of it affects blood sugar in ways that are difficult to predict. There were moments on that mountain where I genuinely did not know if I would make it to the top.
I ran the last four hundred metres.
I climbed it for my father, who passed away in 2006. He gave everything to the people around him. Getting to the top of Africa was for him. I think about that on the days when I do not feel like training. It usually works.
What 18 Years Has Taught Me
After eighteen years I can feel when I am running low or running high without always needing to check. The instinct is there now in a way it was not in the beginning, and that only comes from time and experience.
My nutritionist told me early on that she did not think I could maintain the level of training I was doing alongside T1D management. She was pleasantly surprised that I could. I noted that, and moved on.
I researched T1D obsessively for years to the point where it consumed more of my life than the condition itself. That research taught me more than any single consultation. I now read the ingredients of everything I eat. That habit does not leave you.
Eighteen years in, no complications. I do not take that lightly.
"There is no cure coming tomorrow. But there is a version of this condition that you can live with, train through, and refuse to be defined by."
— oldschoolPT
If You Have Just Been Diagnosed
Stop and think clearly about what you are now managing. Type 1 and Type 2 diabetes are not the same condition. They are frequently confused online. Anyone suggesting the same solutions apply to both is not someone worth listening to.
For training specifically:
- Have carbohydrates before your session. Exercise will lower your blood sugar and you need a buffer in place before it starts.
- Carry sugar with you. Coke works. Keep it accessible and do not be embarrassed about using it.
- Go easy on cardiovascular training until you understand how your body responds. The drop can happen faster than you expect.
- Learn your insulin-to-carbohydrate ratios. It takes time, but it gives you back options — foods you cut in year one you may be able to reintroduce in year five once you know how to manage them.
- Write everything down from the beginning. Every food, every dose, every response. I did not, and I still feel the effects of that.
- Keep it simple. The complexity of managing Type 1 is already significant without adding unnecessary variables to your training and diet.
After eighteen years I still train hard. I still manage this every single day. There is no cure coming tomorrow. But there is a version of this condition that you can live with, train through, and refuse to be defined by.
I am the evidence of that.
