True Grit: A Diabetic Takes on an Ironman

Swim, bike, run...inject insulin? Alan McLean takes it all in stride

Triathlete Alan McLean completed the Lake Placid Ironman with three insulin pumps and blurry vision, and still finished in the top 20 percent of his division. We caught up with him to ask him how he did it.

So you say that doing an Ironman and having diabetes isn’t heroic, it’s just about planning?
The most important part of training with diabetes has nothing to do with your blood sugar, your last correction dose of insulin, or the basal rate on your pump. It’s mental fitness. It’s convincing yourself absolutely and completely that diabetes is a logistical challenge, not a performance limiter. There is a long list of superstar Ironman athletes that prove this point.

I do a few things to make diabetes less of an impediment to the event. For instance, I inserted three infusion sets, one in the butt, one in the abdomen, and one in the thigh. I prefer the abdomen, but I wanted backups just in case. I zip-tie my glucometer to my bike so I can test my sugar while I’m riding. I can ride one-handed, so I can safely test. I would have preferred to race in a tri top, but I used a bike jersey instead so I could fill the pockets with the things I needed.

Can you tell us about the race-day logistics at Lake Placid?
My race ended up being a whole mix of potential things going wrong. I hadn’t anticipated the burst of adrenaline I had at the start. For a diabetic, that really messes up your sugars. I knew it could happen, but it was a lot more than I expected. I didn’t have any nutrition with me but found one of my coaches who did, and tucked two gels in my wetsuit in case my sugar dived. 

I lost my glasses at the swim transition so I was basically blurry for the whole bike ride. And on the run, I knew I was getting low on sugar when I had overwhelming emotions and dead legs. I got my special needs bag and tried to test my sugar. Even though I had packed the glucometer with ice packs around it, it was a long, hot day and the device was too hot to work. So I put it in my jersey and filled it with ice. Eventually, it was restored, and I tested and realized I was dropping pretty hard, so I did surges to release some of the sugar stored in my kidneys.

I came up to another aid station and started taking gels and Perform, the sports drink they had on the course. The second loop of the course was difficult, but I was keeping form and running, just super slow. I came into the Oval at 11:47:02, and overall, I was happy with how I managed my sugar while racing. I probably looked like crap because they took me straight to the med tent. But I signed up for the race again this year.

It sounds like the ordeal didn’t really throw you, how did you manage the stress?
I work in a news environment—I’m a graphics editor at The New York Times—so maybe I’m sort of drawn to stressful situations. I think I respond well under pressure.

And in many ways, an Ironman is a pretty predictable event. That’s the nice thing that you can keep in the back of your head. You know what pace will break you and what will give you space to succeed at the end. You know how many miles you have left. In many ways, an Ironman is one of the easiest things to do because you can prepare for it, as long as you give yourself time and give yourself chances to fail prior to the event. I try to succeed by failing over and over again. Thankfully, I’ve failed a lot. And maybe I’m a pretty good actor, because I was probably pretty stressed when it all happened.