Diabetes Forecast

The Healthy Living Magazine

The Biker: Matt Neal

BMX racer learns on the run about insulin, adrenaline, and glucose

By Tracey Neithercott , , ,
Matt Neal

Matt Neal
Photograph by Jed Strahm

At first after I was diagnosed, I wanted to prove to myself I could still race and I could compete at a high level with diabetes.
—Matt Neal, BMX biker

BMX racing is to bike riding as a NASCAR event is to a scenic drive. And that’s what Matt Neal loves so much about it. He started competing at age 10, turned pro at 20, then took some time off to get his degree in kinesiology. When he got the itch to start racing again, Neal had trouble staying healthy. Despite reducing and ultimately ending his workouts, he kept losing weight, and fast. By the time he was diagnosed with type 1 diabetes, Neal had been back on the BMX track for about six months.

Gearing up to compete again, Neal focused on understanding how the sport affected his diabetes. “I would check my blood sugar probably four times in a two-hour practice session to get a feel for what it would do. Would it go up? Go down?” says Neal, 33. “The thing I can’t simulate is the adrenaline.” That stress-response hormone can increase blood glucose.

“At first after I was diagnosed, I wanted to prove to myself I could still race and I could compete at a high level with diabetes,” he says. “After I won my second race, I had proved to myself I could do it.” From there, Neal focused on fine-tuning his diabetes care. For a while he used insulin pens, but because he’s very sensitive to insulin, he had trouble controlling his blood glucose with full-unit doses. Now that he uses a pump, he can deliver smaller doses and has an easier time keeping his glucose in range.

 Unlike most sports, BMX racing requires more insulin than normal. That’s because races are essentially sprints, which can raise blood glucose. And then there’s adrenaline, which can push glucose levels even higher. “If I’m over 200 [mg/dl], sometimes I’m more likely to cramp up or my legs are a little flat during the race,” he says. “I’ll run out of energy by the end.”

Neal fights highs by delivering more insulin in small increments throughout the day than he would on days off. Those extra boluses add up to about four extra units total during the day. “The harder the race, the more I’ll raise it,” he says.

To be safe, he checks his blood glucose frequently—about 10 times during the six to eight hours he’s at the race, not to mention tests at home before and after the competition. Though high blood glucose is more of an issue, he still prepares to treat hypoglycemia. He packs a bag with plenty of supplies, including fast-acting glucose.

He’s also learned to keep his gear at hand. During one race, on a track that separated Neal from his gear, he felt the effects of low blood glucose. He grabbed a fistful of sugar packets from a nearby refreshment stand. “I ripped them open to get my blood sugar up enough,” he remembers. “I didn’t think I was going to be able to race.” Thankfully, the few minutes before the race were enough time for Neal’s blood glucose to rise, and he ended up winning the competition.

In the five years since his diagnosis, Neal has become somewhat of an expert on BMX racing and diabetes. That, coupled with his desire to show other people that diabetes is compatible with the extreme sport, is why he began Type 1 BMX, an all-ages team with members living in various locations—Neal calls Mesa, Ariz., home. The teammates all compete in their own age brackets, but keep in touch about riding, diabetes, and the intersection of the two.

“[BMX] has that family atmosphere,” Neal says. “Being with this team takes that up to a whole new level. Not only do we have BMX in common, but we have diabetes in common. It’s really a close-knit family.”

Safety Note

Talk to your doctor to make sure engaging in extreme sports is reasonably safe for you.


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