Diabetes Forecast

NASCAR Driver Ryan Reed Tackles Type 1 Diabetes

On and off the track, this athlete accepts no limits as he Drives to Stop Diabetes

By Tracey Neithercott , , ,
Ryan Reed

Action Sports Photography

It became obvious to me there were kids out there being told they couldn’t do what they wanted to do because of the disease. I wanted to tell my story.
—Ryan Reed, NASCAR driver

It is often said, usually by adults with a shake of the head, that teenagers believe they’re invincible. That was true of Ryan Reed, who at 17 had become accustomed to hurtling around a wide track at over 100 miles per hour. At that age, Reed was leaving his Bakersfield, Calif., hometown for a professional race car driving career in North Carolina. At that age, Reed discovered just how vulnerable he was.

He learned his limitations not from a car crash but from an illness he couldn’t kick. The 2011 racing season was getting under way when Reed got the diagnosis: type 1 diabetes. “My first question was, ‘How will this affect my racing?’ ” says Reed, now 20. “[The doctor] told me I wouldn’t be able to race anymore.”

It was a crushing blow for a kid who grew up surrounded by fast cars. Reed’s father, Mark Reed, was a NASCAR driver and fostered in his son a need for speed. “I don’t remember a time when I didn’t want to be in a race car,” Reed says. Yet he knew he couldn’t race without medical help. “If my blood sugars weren’t right before the race, how would I deal with that?” he worried.

So Reed sought a second opinion. His Google searches led him to Charlie Kimball, an IndyCar driver who’s been racing with type 1 diabetes for six years. Kimball’s endocrinologist saw patients in Beverly Hills, Calif., a two-hour drive from Reed’s parents’ Bakersfield home. That, Reed decided, was the doctor he needed on his side.

The Medical Crew

Behind every great athlete is a team of coaches and trainers set on preparing him or her for competition. And behind every great athlete with diabetes is a medical team whose goal it is to keep blood glucose levels in line. “What Ryan did was create from the get-go a team,” says his endocrinologist, Anne Peters, MD, a professor of medicine at the Keck School of Medicine at the University of Southern California and director of the USC Westside Center for Diabetes. “Being proactive the way Ryan’s managed is the way to do it. He didn’t sit around feeling sorry for himself. That spirit is something I really respect.”

In addition to her expertise in diabetes, Peters also understands the way racing in particular affects drivers with diabetes. “The key to race car driving with diabetes is to maintain near-normal blood glucose,” she says. Naturally, that’s easier said than done.

That’s because the fight-or-flight response caused by stress increases the production of glucose. “When [drivers are] stressed over a race, that will shoot their sugars up,” Peters says.

Despite the risk of highs, Peters advises Reed not to inject fast-acting insulin before a race. That’s because hypoglycemia poses a greater danger than hyperglycemia. Thankfully, the highest Reed’s blood glucose has risen while racing was 190 mg/dl, which didn’t affect his performance. “If I eat pizza and my blood sugar is 200, I notice that more than if I get in a race car and the adrenaline raises my blood sugar,” he says.

 Another reason it’s OK to start the race with a higher-than-normal blood glucose level: Reed needs the glucose for energy during the race. “Car racing is a lot more physically demanding than you think,” Peters says.

Because the body reacts differently depending on the situation (for instance, Reed doesn’t get hyped up on adrenaline during practice the way he does during a race), he has a different diabetes care regimen on race day than he does the night before the race, and both of those differ from his management plan when he’s training. “It’s really important to adapt what the person does to what’s happening,” Peters says.

Even the track size makes a difference. “The bigger the racetrack we go to, the less it affects my blood sugar,” Reed says. Likewise, smaller tracks, where drivers are constantly in traffic, lead to greater blood glucose surges. “You have to think a lot more,” he says. “It’s more intense. It’s more stressful.”

But Reed has proved he’s adaptable. After meeting with Peters three years ago, Reed started using a continuous glucose monitor (CGM), which helps him track his blood glucose level on and off the track. Peters considered putting Reed on an insulin pump, but was concerned about conditions inside the race car. “I was worried about the pump, about the insulin in the tube getting too hot,” she says. “They sweat, and I worried about him sweating [the infusion set] right off.” In the end, because Reed’s A1C is ideal, he and Peters decided there was no reason to switch to a pump when insulin pens work so well.

Now, Reed works with a dietitian to maintain a strict eating plan that accounts for the amount of protein and carbohydrate he needs on a given day. On race day he may have a breakfast of oatmeal and an egg sandwich on whole wheat bread, then snacks, such as grilled chicken, at the racetrack. “It gets tough going out to eat. I prefer to cook for myself when I can because it makes it much easier,” says Reed, who admits he’s no chef.

Exercise is an essential part of Reed’s management plan. “If I’m really busy and I don’t have a chance to work out, I notice my blood sugars are a little higher, whether I’m inside the racetrack or not,” he says. “The more I work out, the more my blood sugars are in control.” Four times a week, Reed does a mix of strength and endurance training with a personal trainer. Because he’s competing in a triathlon in August, Reed also does solo exercises: weight lifting three days per week and running, biking, or swimming daily.

It’s hard work, no doubt, but Reed’s willingness to hunker down for the sake of better blood glucose is part of what makes him a great athlete. “To be an athlete, there’s a huge amount of being very focused on controlling your sugars,” Peters says. “[Athletes with diabetes] obviously have to work at it.”

Diabetes Behind the Wheel

In a perfect world, Reed’s new life with diabetes would have blended effortlessly with his burgeoning racing career. But after his diagnosis—and the three months away from racing that followed—Reed knew his season was shot. So he used it as a learning experience.

His first race after diagnosis was a short competition that he started with his blood glucose around 115 mg/dl. “I think we finished fifth to last,” he says. “It was awful.”

Still, Reed kept at it, learning how to manage diabetes while concentrating on a race. “It was a brand-new challenge,” he says. “That’s something I had to learn, how to focus on both [diabetes and the race] and not let one take away from the other.”

Reed’s focus is split the minute he steps onto the track. Before diabetes, he’d concern himself with race strategy and preparedness. Now he also makes sure his blood glucose isn’t too low or too high by testing about twice each hour before he slides into the car. From there, he monitors his dashboard-mounted CGM for blood glucose values, much as he does the car’s gauges. “I have to watch water temperature and oil pressure,” he says. “This is just the same. It’s just my blood sugar.”

When his blood glucose dips too low, he can sip a sugary endurance drink that runs through his helmet—a system other drivers use to stay hydrated. “At first I had to get used to it,” he says. But now, “it’s not something that takes my attention away or is distracting.”

Should his blood glucose get too high, one of Reed’s crew is prepared to give him an insulin injection—through an opening in his suit on his inner left thigh—when he pulls into “pit road,” where he stops for fuel and new tires. (He stashes an insulin pen with the crew and stores others on the truck that hauls the race cars, in his motor home, and in a separate bag. A crew member is also prepped to give glucagon, though Reed’s never needed it.) “If I looked down and saw my blood sugar was high and I needed insulin, I have a radio in my car and I’d say, ‘Hey guys, I need insulin,’ ” Reed says. “Within 30 seconds I could be coming down the raceway.”

Despite that safeguard, so far Reed’s pit stops haven’t included insulin injections. Peters advises against a shot of fast-acting insulin unless Reed’s blood glucose shoots over 300 mg/dl because too many variables—the physical aspects of racing, stress, and adrenaline, among other factors—could affect how much the insulin decreases his blood glucose. And becoming hypoglycemic while driving on residential streets is extremely dangerous, let alone during a race.

Part of managing diabetes while racing is considering not just a blood glucose reading but what may be behind the number. “Because we have [Reed] so well controlled, if he went up really high, it probably meant he was dehydrated,” Peters says. That’s a real worry, considering the interior of a race car can heat to over 150 degrees. During a race, Reed must focus on hydration, drinking either water from a bottle he keeps in the car or a sports drink to avoid dehydration—and the elevated blood glucose that comes with it.

It’s a lot to take in, especially while whipping around the track and weaving between other drivers, but when it comes to diabetes management, it’s all Reed knows. “From the beginning, he learned diabetes in the context of racing,” Peters says. “Everything about his diabetes has always revolved around racing.”

Role Model in the Making

A year after he was told he’d never race again, Reed joined the ARCA stock car racing series, competed in 14 races, and finished within the top six almost a dozen times. In 2013, Reed joined Roush Fenway Racing for a few races in the NASCAR Nationwide Series, the second-highest level in NASCAR after the Sprint Cup Series. This year marks his first full season in the series.

But more than a vehicle for furthering his career, his entry into NASCAR racing is an opportunity for Reed to raise awareness about diabetes—a passion he’s had since he was advised to ditch his racing dream three years ago. “It became obvious to me there were kids out there being told they couldn’t do what they wanted to do because of the disease,” he says. “I wanted to tell my story.”

That idea blossomed into the nonprofit Ryan’s Mission, which Reed began at 17. Then, last year, he joined forces with the American Diabetes Association and Lilly Diabetes for the Drive to Stop Diabetes campaign, which gives Reed an opportunity to share his experience and discuss diabetes.

Plus, it makes for a pretty sweet ride. If you didn’t know Reed had diabetes before a race, you’d learn it while watching the No. 16 Drive to Stop Diabetes Mustang—plastered with the word “diabetes”—zip around the track. Of course, that’s the point. “I have a lot of people that come up to me, whether they’re drivers or crew members, who say, ‘I have diabetes’ or ‘My grandma has diabetes,’ ” Reed says. He’s spoken with kids with diabetes who don’t want to give up their dreams after their diagnosis. “I had a huge reality check when I was diagnosed. To be able to inspire somebody while I do what I love? To do that is a huge blessing.”

Catch Him If You Can

Find out where Ryan Reed races next and join him to learn more about diabetes.

June 27–28: Kentucky Speedway
Aug. 22–23: Bristol (Tenn.) Motor Speedway
Aug. 30–31: Atlanta Motor Speedway
Sept. 5–6: Richmond (Va.) International Raceway
Sept. 13–14: Chicagoland Speedway
Oct. 4–5: Kansas Speedway
Oct. 10–11: Charlotte (N.C.) Motor Speedway
Nov. 1–2: Texas Motor Speedway
Nov. 15–16: Homestead-Miami Speedwa



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