“I drank 10 liters of water.” he was diagnosed with diabetes at 19, and now he’s doing Ironman – 09/08/2022

Alexander Paiva was 19 years old when he was diagnosed with type 1 diabetes. Faced with this new reality, the manufacturing engineer from Santos, SP adopted new healthy habits and became a high-performance amateur triathlete, qualifying for the Ironman World Championships in Hawaii. He then tells how he takes care of his body and doesn’t let the disease limit his life;

“At the age of 19, I started studying production engineering at the ABC Federal University in Santo Andre (SP) – since I live in Santos, I used to go up and down the mountain every day. van to stop five times on the way. to urinate, at dawn I could not sleep well because I kept waking up to urinate, besides, I felt insatiable thirst, I, who drank an average of 1.5 liters of water a day, took 10 liters.

On the second day of symptoms I went to the hospital and they found my blood glucose was high. I did a blood test and the result was amazing. the blood glucose (sugar) level was 650 mg/dL, the normal value is 99 mg/dL. The doctor who saw me commented that this was a strong sign of diabetes and advised me to see a specialist.

After 10 days, when the diagnosis of the disease was confirmed by the endocrinologist, I had already lost 5 kg. The doctor gave me basic treatment guidelines and told me to take care of myself because the condition can cause serious consequences such as blindness, heart problems and amputation.

How I got it Alexander Paiva - Personal archive - Personal archive
Image: Personal archive

My parents and I were scared and decided to turn to another specialist as well. After listening to my story, the endocrinologist explained that perhaps the stress I went through during the two years of preschool was a trigger for me to develop type 1 diabetes (we explain the relationship at the end of the article).

At that time, I was finishing high school and taking a preparatory course, there was pressure from my parents to enter a state university. They felt guilty about it, but I don’t blame them for what happened, they just wanted the best for me.

From the beginning, I followed my treatment well and adopted basic habits to control my diabetes. I test my blood glucose before meals, take insulin and eat healthy. I reduced my intake of sugary foods and drinks and increased my intake of fruits and vegetables.

I never rebelled or deprived myself of things because I had the disease, but I went through a process of self-discovery and maturation. During college parties for example, I would go, have fun, drink beer with my friends, but not overdo it, always check my blood sugar before and after so I know my limit.

Over time, I researched what I could do to have a better quality of life. It was then that sports, which had been a part of my daily life since childhood, became a great ally and a turning key in me.

In 2017, at the age of 27, I created a personal challenge and got it in my head that I wanted to become a triathlete, do an Ironman one day. a cross-country event involving a swim of approximately 3.8km, a bike of 180km and a run of 42km.

How I got it Alexander Paiva - Personal archive - Personal archive
Image: Personal archive

I was already doing weight training, swimming and running regularly, participating in sea and street races, but I had yet to incorporate pedaling into my routine. I bought a bike and started training twice a week, from 4:30 to 6 in the morning, on a beach boulevard that is closed to cars and free for cyclists.

Two months later, I participated in my first triathlon, the shortest “sprint” distance (750 m swimming, 20 km cycling and 5 km running). I was in 8th place and realized that if I train more I can be in the top five on the podium. So I started having a regimented workout routine.

Care during training and competition

The doctor cleared me to exercise, his only advice was that I measure my blood glucose before and after each physical activity. Also, I started following up with a nutritionist who pointed out diet and supplements for better results.

Because I have diabetes, I always have to have a quick-absorbing source of energy with me, such as soda, isotonic, carbohydrate gel.

How I got it Alexander Paiva - Personal archive - Personal archive

Alexander uses a device that monitors his blood glucose and injects insulin into his body throughout the day.

Image: Personal archive

I have had several episodes of hyperglycemia and hypoglycemia during training and competition.

When my blood glucose is too high, I have better tolerance for symptoms, body aches and extreme fatigue. When the blood glucose is too low, I feel weak, which can be paralyzing, but I make an effort to transition to another mode, such as swimming to cycling. I take this break and re-test my blood sugar and take a carbohydrate gel or drink a soda to boost my glucose levels. I recover and continue the test until I finish it. I don’t give up.

Iron man

In 2019, I started my Ironman preparation. The training routine became even more intense. I exercised for an average of 15 hours a week, split between swimming, running, cycling and pilates.

I feel very good physically and mentally. Sports help me focus, discipline and dedicate myself in all areas of my life.

How I got it Alexander Paiva - Personal archive - Personal archive
Image: Personal archive

In three years, I made great achievements. I placed 5th in my category at Ironman Brazil 2019. In 2021, I finished second in the Brazilian Ultraman, becoming the first athlete with diabetes in the country and the second in the world to finish an ultratriathlon; the competition is held over three days and athletes complete a 10 km swim and a 145 km swim. pedaling on the first day; On the second day, 276 km by bike; and a 84.4 km run on the third and final day.

I have also been twice chosen athlete of the year by the Brazilian Diabetes Association. I finished second in Ironman Brasil 2022 in my category, I completed a 3.9km swim, 180km bike ride and 42.2km run in 8 hours 55 minutes.

That feat earned me a place in the Ironman world, and now in October I will represent Brazil in a competition in Hawaii, USA.

How I got it Alexander Paiva - Personal archive - Personal archive
Image: Personal archive

I have a motto: diabetes only makes me stronger. If it wasn’t for the disease, I wouldn’t have adopted the good habits and gotten to where I am as an athlete and professional.

I hope that my story can inspire other people with and without diabetes and that they understand that we define our limits, not the disease.”

According to Denise Franco, endocrinologist, second secretary of the SBD (Brazilian Diabetes Society), director of the Correndo pelo Diabetes Institute and researcher; CPCLIN:/class (Clinical Research Center: h class), in any stressful situation, the body interprets that there is an additional need for sugar (glucose) in order to “flight or fight” against the danger of having energy. Thus, a number of hormones are released, and therefore we have an increase in blood glucose. This rise in blood sugar is followed by an increase in the hormone insulin, which drives glucose into the cell.

Type 1 diabetes is an autoimmune disease, it doesn’t start when a person is stressed, but stress can be a trigger, that is, a trigger for the development of type 1 diabetes in people who already have pre-existing diabetes. diabetes conditions – genetic predisposition to the disease. However, it is important to note that not every individual who is stressed will develop type 1 diabetes.

For people who already have diabetes and have an episode of stress, blood sugar may rise and require more insulin to compensate.

2 – What care should a person with diabetes take when exercising?

It is necessary for a person to take a glucometer and monitor blood glucose levels before, during and after physical activity to avoid compensation during training and exercise safely. Monitoring will help the individual get to know themselves better and make necessary adjustments to their insulin dose based on the amount of exercise they will be doing.

THE: dose Insulin levels must be adjusted to the type of activity that will be performed, and it is also important to assess what one eats before, during, and after exercise. According to endocrinologist Denise Franco, it is always recommended to provide a reserve of carbohydrates if a person experiences an episode of hypoglycemia during physical activity.

3 – What are the precautions when contesting very long races such as marathons and Ironman?

During longer races, one needs to prepare, know the route, be aware of insulin needs, carbohydrate consumption/intake and hydration.

Any individual in an Ironman or marathon, diabetic or not, needs to eat during the journey. But in patients, the person will have to monitor the blood glucose frequently and make adjustments depending on the glucose level. Franco says you may need to take insulin often during a race, though it’s recommended to use it before or after training. physical.

4 – Does physical activity interfere with blood glucose levels?

disturb In particular, in type 1 diabetes, insulin is more effective when a person is physically active. In aerobic exercise, the guideline is for the patient to have a blood glucose of at least 150 mg/dL before starting the exercise.

Another point is that initial resistance exercise (such as weight training) can cause blood glucose to rise. This is because aerobic exercise uses different energy sources compared to resistance exercise. Therefore, physical activity can both raise and lower blood glucose. This is why blood glucose monitoring and carbohydrate supplementation during physical activity are so important.

5 – What are the benefits of sports for people with type 1 diabetes?

Sport improves mental health and makes an individual happier, increases insulin efficiency, reduces the risk of obesity, reduces the risk of depression, enables better relationships and sharing experiences with other people. People with diabetes can and should exercise. For this reason, it is important for him to have medical support and an interdisciplinary team to ensure that he performs the activity in a safe way.

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