There is an old saying – don’t throw out the baby with the bath water. Unfortunately, that is exactly what some are calling for in response to the abuse of Therapeutic Use Exemptions (TUEs). Namely, a total ban. While that reaction may seem like “common sense” to other racers that feel cheated by the abuse of TUEs in the pro peloton, it actually impacts others in an unintended way. In fact, there is one entire team that relies on valid, legitimate Therapeutic Use Exemptions to even compete. TUEs were made for a reason – and we must not let that reason be forgotten.

There is a need for TUEs and that is for someone to treat an illness or a
sickness. They are not intended and should never be used to improve
performance.

Phil Southerland. CEO and Co-Founder of Team Novo Nordisk

First – a little history

Almost all of the substances routinely (and illegally) used as performance enhancing drugs were designed to treat real medical conditions. As anti[doping controls covered more and more substances over the years, it was inevitable that would overlap with professional athletes using these substances for purely medical reasons – without the desire or intent to gain a competitive advantage.

Because of the desire to open the sport to as many legitimate athletes as possible, as well as help ensure the health of the athletes, a mechanism has been enacted to allow exceptions to standard doping rules for those that demonstrate a medical need and will not receive a performance gain from use.

Athletes may have illnesses or conditions that require them to take particular medications.

If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine.

The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to ensure that the process of granting TUEs is harmonized across sports and countries.

World Anti-Doping Agency

There are, unfortunately, possibilities for abuse. And one can definitely understand the anger felt by clean athletes when TUEs are abused in events. A recent publication in the academic news outlet The Conversation even went as far as suggest that TUEs are harmful to athletes by masking symptoms when they should instead be recovering.

If an athlete is ill or in pain, they should rest. Drugs which mask a health problem in order to allow athletes to push themselves for the sake of sport could have an impact in the short and longer term.

Elite sport: time to scrap the therapeutic exemption system of banned medicines

However, this argument falls very much short by refusing to acknowledge that not all TUEs are simply about managing symptoms. The most glaring example of this is the treatment of type 1 diabetes. Diabetics are forced to take insulin – not only to compete, but to stay alive. In is not an optional medication, and it is not something that is used simply to mask symptoms. Instead, in is necessary to use via daily injections in order to replace a vital hormone that is absent in type 1 diabetics. And there just happens to be an entire pro cycling team rostered exclusively by type 1 diabetics.

Team Novo Nordisk

Team Novo Nordisk (formerly Team Type 1) was co-founded by Phil Southerland and Joe Eldridge. The team has become an inspiration for athletes with diabetes world wide. And given that the team is made up entirely of athletes that live with diabetes, each and every one of them has to have a therapeutic use exemption to compete. Ban TUEs, and you ban an entire team.

Team Novo Nordisk is a global all-diabetes sports team of cyclists, triathletes and runners, spearheaded by the world’s first all-diabetes professional cycling team.

Comprised of nearly 100 athletes from over 20 countries, Team Novo Nordisk competes in more than 500 international events each year.

I had a chance to talk with Phil Southerland, as well as Team Novo Nordisk rider Sam Brand, about cycling with diabetes, TUEs, and their reactions to the call for the elimination of legitimate therapeutic use exemptions. Below are their words:

Phil Southerland – CEO and Co-Founder of Team Novo Nordisk

JustAnotherCyclist: Therapeutic Use Exemptions (TUEs) have been in the news quite a bit lately. While researching them for this story, I was somewhat surprised to learn that insulin itself is on the banned substances [list]. Does that mean that every athlete on Team Novo Nordisk has a TUE?

Phil Southerland: Yes, all riders at Team Novo Nordisk race with a TUE. Since the team’s inception in December 2012, we have always been very public and extremely proud that we race with type 1 diabetes. Additionally, we have always been open that we race with TUEs. WADA included the use of TUEs so that an athlete who has a legitimate medical condition can continue to compete. The UCI and the anti-doping organizations recognize that diabetes is a legitimate medical condition and grants all Team Novo Nordisk athletes TUEs to use insulin.

JAC: How many total athletes on Team Novo Nordisk have existing TUEs related to diabetes?

PS: As of January 1, 2018, 28 athletes on Team Novo Nordisk race with TUEs. There are16 riders on the men’s professional team, 11 riders on the development team and one professional female track cyclist, Mandy Marquardt.

JAC: What is the process for an athlete with a legitimate medical need – such as diabetes – to be able to compete while taking insulin?

PS: Our medical staff handles all TUEs, and the process with the UCI includes submitting medical records that show the date of diagnosis, place of diagnosis and the doctor who diagnosed the athlete. All this information is verified to show that our riders are racing with type 1 diabetes and need insulin injections to survive.

JAC: UCI rule 13.3.052 seems to imply that the injection of any substance via syringe in banned. However, the rule does specifically call out diabetes as an example of a permissible situation for athletes to self-inject. Is it a separate TUE for the insulin, and the administration method?

PS: There is an extensive process that we go through with the UCI to prove our riders’ need for insulin. It comes down to life or death for these athletes. The UCI grants all Team Novo Nordisk athletes long-term TUEs for insulin use. As an American-registered team, USADA serves as our anti-doping organization and recognizes and explicitly list on its website that athletes who are insulin-dependent (athletes with type 1 diabetes) are allowed to race under a TUE
while using insulin.

Currently, the only method for type 1 diabetics is subcutaneous injections. Our athletes are not choosing an injection over an alternative.

JAC: Have riders or team staff ever experienced any negative interactions from other riders or officials as a result of the possession and usage of insulin to treat diabetes during a race?

PS: Early on, we had people see the riders injecting at races and report it to officials. The officials are well versed in our situation and all our riders have documentation that they carry that proves their TUEs.

In general, we receive positive feedback from riders, organizers and officials. To be honest, seeing a rider inject typically opens up a conversation. People often use it as an opportunity to ask questions, which we always welcome.

JAC: What was your reaction when Froome’s test results turned out to be a
substance he had a TUE for?

PS: What concerns me about the Froome situation and anyone else using a TUE for marginal gains or to push the limits into the grey area is that it creates a huge negative perception around the sport and can damage the reputation of the athletes who have a vital need for long-term TUEs. There is a need for TUEs and that is for someone to treat an illness or a sickness. They are not intended and should never be used to improve performance.

We are happy to be a part of this conversation and want to set the record straight by showing the valid and positive side of TUE usage. We are proud and thankful that we have the opportunity to race with a TUE. It is a great concept, and one that we believe needs to be ethically respected. Thanks to TUEs, all Team Novo Nordisk athletes can inspire, educate and empower people around the world affected by diabetes.

Sam Brand – Rider, Team Novo Nordisk

JAC: Can you describe the experience the first time you had to acquire a TUE?

Sam Brand: First, let me thank you for taking the time to talk about TUEs and the valid side of the conversation. As a diabetic and even more so, an athlete for Team Novo Nordisk, I am passionate to speak about this topic and to try and further educate and raise awareness about diabetes.

My first experience acquiring a TUE took a long time. I moved up to Team Novo Nordisk’s professional team as a stagiaire mid-season, so I needed to have it in place before then. It required a lot of paperwork, emails and calls with the various organisations (British Cycling and UKAD) in order to process the application and finally have it granted to me. It wasn’t the easiest task and certainly not as straightforward as people may think.

JAC: There are numerous stories of cheating teams and athletes going to great length to hide syringes used for illegal PEDs. As a diabetic myself I know that keeping syringes on hand wherever I go is just part of diabetes management. Do the team athletes have to jump through any hoops in regards to the handling of their insulin pumps, syringes, or insulin as a result of a UCI license?

SB: As a fellow type 1 diabetic, you understand that all diabetics need insulin to survive. Currently, the only way to get insulin as a type 1 diabetic is through injections. We don’t actually have to jump through any hoops because we aren’t hiding anything. For us, the process is applying and being granted a TUE, and then we can use insulin. If we need to inject during a race, that is fine and we do not feel we have anything to hide. 

JAC: Since the findings against Froome, some have started to question the validity of TUEs at all. Do you have any concerns that regulation changes in response may make it more difficult – or even impossible – for diabetic athletes to compete in sanctioned events? Do you feel that riders abusing TUEs for performance gains impact you in other ways besides performance in the peloton?

SB: I definitely have concerns. There are more and more high-profile athletes calling for bans on TUEs. Additionally, people are claiming that if you need one, then you aren’t fit to race or be a professional athlete. To me, all of that is quite offensive.

This current conversation is about athletes using TUEs to enhance performance, and I completely understand this concern. As an athlete with a long-term TUE, I agree wholeheartedly with the need to sort out the current system, but I adamantly don’t agree with an outright ban on all TUEs. It isn’t the answer and takes a very shortsighted viewpoint.

JAC: Have you ever had any conversations with other riders about your use of insulin at an event? If so, what were some reactions?

SB: In my experience, there are many people around the world, not just riders, who are not well educated in diabetes.  This is why the team’s mission is to inspire, educate and empower everyone affected by diabetes. I greatly enjoy that part of my job because it allows me to have conversations with people about diabetes and help educate them on the condition. In general though, fellow cyclists tend to be genuinely interested in knowing more.

JAC: Have you had to change the way you manage your diabetes to comply with the anti-doping rules?

No, not at all. While everyone’s management is different, it’s relatively straightforward how I manage my diabetes.

There was a time when the idea of diabetic pro cyclists was rare. Common wisdom held that diabetics had too many obstacles to be competitive. However, thanks to the continued efforts of Team Novo Nordisk, we’ve seen that diabetic pro cyclists can compete at the highest levels of the sport. And do it successfully.

Recently two additional riders with type 1 diabetes have made the transition to the pros. Frenchman Quentin Valognes and Dutchman Rik van IJzendoorn have moved up from the Team Novo Nordisk development squad onto the men’s pro squad as stagiaires for the remainder of the 2016 season.

Team Novo Nordisk is a unique team made up exclusively of cyclists with diabetes, so gaining two strong and talented riders is exciting for us. Quentin grew up in our development program over the past several years, starting on the junior squad. He is pure talent and he can definitely win. Now the focus will be on helping him adapt to the pro level.

Vassili Davidenko, General Manger, Team Novo Nordisk

Quentin Valognes

Quentin Valognes was diagnosed with type 1 diabetes when he was just six years old, but it didn’t stop him from chasing his dream of racing his bike. By age 12, he was competing and quickly grew into a strong sprinter on the track. In his four years with Team Novo Nordisk’s development team, the 20-year-old Frenchman earned a list of accolades, including winning Stage 5 and Stage 6 of the Tour de l’Abitibi Desjardins (2014) and a podium at the French National KeirinChampionship (2014).

It’s an honor to be selected, but I’m aware that I still need to earn my spot on the professional squad. I know this is just the beginning. I embrace my diabetes and I’m excited to have an even bigger platform to inspire, educate and empower people affected by the condition.

Quentin Valognes, Rider, Team Novo Nordisk

Rik van IJzendoorn

Rik van IJzendoorn made his pro debut in the Tour of Utah, where he is helping to support Javier Megias in the team’s efforts. Megias is fresh off of his second place finish at the 2016 Tour de Korea.

Van IJzendoorn was diagnosed with type 1 diabetes within the past year, but his history on the bike is much lengthier. Van IJzendoorn comes from a racing family and was competing by age eight. Since then, he has amassed several achievements, including Dutch Junior National Cyclocross Champion (1997), Dutch Junior National Road Champion (1999), runner-up at Dutch Junior National Cyclocross Championship (2004) and third place at the UCI cyclocross World Cup race in Pijnacker (2004).

I’m very happy to have this opportunity to race at the professional level; it will be a whole new experience for me racing against World Tour riders. Team Novo Nordisk has helped make my dream of racing against the best in the world come true. I’m fully focused on working for the team throughout the remainder of the season and hope to earn a contract for next season.

Rik van IJzendoorn, Rider, Team Novo Nordisk

These two riders represent the up and comers that will help drive Team Novo Nordisk towards their goal towards the 2021 Tour de France – while helping to inspire all of us that face challenges that some would dare tell us are insurmountable.

This year has been huge for the advancement of women’s cycling. But it underscores the fact that women’s cycling has been neglected. The very fact that it still needs “advancement” is in and of itself indicative of the problem. That is why I have really mixed feelings about cyclingnews.com declaring “Women’s Cycling Week.“

Women’s cycling doesn’t need a dedicated week of focus. Instead, what it really needs are 52 weeks of equal focus – every single year. It is great that many media outlets are finally jumping on the bandwagon. But treating it like the “hottest new trend” is kind of, well… disingenuous to me. Women race a lot. And pro women race at the highest levels of competition, while simultaneously holding down other part time jobs because the vast majority of them can’t earn enough on their team salaries to support themselves. UCI rules continue to limit the duration – and thus media exposure – of women’s events in the medieval idea that women can’t ride as hard or as long as men. That limited media exposure directly equates to limited sponsorship potential, which leads to less financial support for teams, which means less money to pay the riders.

Cycling has a long tradition of allowing different skill sets to shine within a long stage race. We’ve got the King of the Mountains, the sprinter’s jersey, the most aggressive rider… all the races within the race. Cycling fans have been trained to understand that the overall winner is not necessarily the person that crossed the finish line first in today’s stage, and that the sprinter can be in the points lead after crossing an imaginary line somewhere in the middle of the stage. So why not extend that model to include women on the same course, at the same time, as the men, racing for women’s versions of the same jerseys? No more nonsense about not enough sponsorship dollars to support the women’s competition – because the logistics wouldn’t dramatically increase.

Unfortunately I can already hear the establishment complaints to this idea: “Growing the pro peloton to allow women would swell the number of riders in the peloton, adding to complications and expenses of running the races. It would create safety concerns that would endanger other riders.”

I would love to hear that statement made publicly, because what does it really say? It says what many of us suspect, and others fear: That the women would actually hang with the men, over the same courses, for the same durations. Because if they couldn’t, the wouldn’t be “part of the peloton” and thus those arguments would be invalid.

And even worse, given the chance to earn a living, they may actually be competitive against the men. Then what would would all do?

One might remind me that we’ve taken small steps, and we should celebrate those small steps as the foundation for more small steps in the future. OK. Fair point. Let’s just be careful not to stand around patting ourselves on the back for a “job well done” when the racing careers of women are still so vastly under supported and under funded compared to the men.

You’ve definitely read a lot about Team Novo Nordisk here on JustAnotherCyclist.com recently. The reasons for that are pretty clear to my frequent readers. But for everyone else, their results alone – aside from their mission – are worthy of note

The team, made up entirely of professional cyclists with Type 1 diabetes, have been at the Tour of California for three consecutive years now. But this year has been particularly successful for the team, driven in a large part by World Tour veteran Javier Megias. Javier took 14th overall in the general classification at the Tour of California, going head to head with some of the best cyclist in the world. In addition to the GC success in California, Martijn Verschoor was able to cross sabres in stage 1 for a 5th place sprint finish.

The Gibraltar climb and the time trial were the most defining moments for me. The climb was insanely challenging while the time trial was just brutal.

David Lozano, Rider, Team Novo Nordisk (pictured above)

But success has not been limited to California. As of June 1, 2016, Team Novo Nordisk had earned six top 5 finishes and eight top 10 finishes, including the teams first overall victory in the team classification at the Tour of Estonia.

Then came the Tour de Korea, where Javier Megias again showed his form earning the teams first ever second place podium finish in the general classification.

The Tour de Korea has been a good race to this team over the years. I am very pleased with the entire squad. It was inspiring to see how aggressive our riders raced all week in breakaways and sprint finishes. Javi finished 14th overall last month at the Tour of California against some of the best cyclists in the world. Now he earned his career best at the Tour de Korea. We’re excited to see what happens throughout the remainder of this season, especially at next month’s Tour de Pologne.

Vassili Davidenko, Senior Vice President of Athletics and General Manager, Team Novo Nordisk

The Tour de Pologne (Tour of Poland) will mark another significant first for the team in 2016: the team’s first world tour stage race. This is critical, as Team Novo Nordisk CEO and Co-founder Phil Southerland has set a goal for the team to be in the Tour de France in 2021.

Phil Southerland is a self-described “…boy that was shaving his legs at 14.” From there he taught himself the ropes racing with a group from a local bike show. He continued riding and racing through college, but eventually found himself pitching the idea of an all diabetic pro cycling team to vendors at Interbike. That idea has continued to grow towards the Tour de France goal since inception. 2016 has all the potential to be the turning point in an effort that has produced not only Team Novo Nordisk, but also the charitable Team Type 1 foundation.

2021 will mark the 100th anniversary of the discovery of insulin – a pivotal moment in history for suffers of Type 1 diabetes that depend on daily insulin injections to manage their condition. Phil Southerland cites this, along with “enough runway” to meet the necessary obligations for a Tour de France wildcard spot, as a perfect target to get Team Novo Nordisk into the most famous bicycle race in the world.

The Tour de France comes down to ranking. We know we need to be in the top 25 professional teams by 2021 to increase our chances at a wild card invitation.

Since 2014, Team Novo Nordisk has seen an annual 20% ranking improvement, but in order to achieve a top 25 ranking we will need more riders, because more riders lead to more points. We also need to get more results so we can earn more points. Finally, we need to compete in bigger races because World Tour races equal more points… a higher ranking gives us the ability to get noticed and be eligible for a wild card spot.

Phil Southerland, CEO & Co-founder, Team Novo Nordisk

With that plan in mind, the results and scheduled races of this year seem to be paving a smooth path towards Paris in 2021. It is unfortunate how often those living with diabetes hear about what they can’t do. Phil Southerland, along with the management and team members of Team Novo Nordisk, are instead showing us what they can do.

Joonas Henttala is a professional cyclist with Team Novo Nordisk. Joonas started the 2016 Tour of California aggressively. We was the first rider to attack after the neutral start of Stage 1. This created a break away with 6 other riders that was off the front for over 85 miles. The break away was reeled back in before the final 3, resulting in a bunch sprint. Joonas’s teammate on Team Novo Nordisk – Martijn Verschoor – was able to capture a 5th place finish against some of the best sprinters in the world.

We caught up with Joonas Henttala before the start of the Tour of California to ask him some questions about his life as a professional cyclist, overcoming Type 1 Diabetes, and competing at the highest levels of the sport.

JustAnotherCyclist: I understand you got started in bike racing at a pretty early age. What interested you about racing bikes?
Joonas Henttala: My dad used to be a racer and I always loved riding my bike. My hometown, Porvoo, has a strong cycling culture for Finland, so that also helped.

JAC: You were diagnosed with Type 1 diabetes at a young age too. Did that impact your racing plans?
JH: My diagnosis didn’t impact my racing plans much at all. I received some good advice from people close to me and my healthcare team and I was able to take charge of my management early on. I have always seen myself as an ambitious bike racer who also happens to have diabetes.

JAC: You’re riding in the upcoming Tour of California. You’ve raced Tour of California before, correct?
JH: Yes, I raced at the Tour of California in 2014 and 2015. It’s a beautiful race and I love that I get to come back and race here again. We are an American-registered team, so this is considered a “home” race for us. We have big goals for the race this year and I hope we can get some results and at the same time, show the world what may be possible with diabetes.

JAC: Do you have to think about your diabetes management differently in a longer stage race compared to one day events?
JH: There are some slight changes, but it really isn’t that different. Diabetes is a very individual condition and for me, I find it less challenging to manage my diabetes on stage races versus one-day races. It’s important to keep in mind that during race days there are many different variables that can affect my blood sugar, including stress, adrenaline, race intensity, weather conditions and altitude.

JAC: Any particular goals or targets for the team in California this year?
JH: There are a lot of climbs this year so we have Javi (Megias) and David (Lozano), who are both great climbers, ready to attack on those stages. Javi is also the rider who is designated to go for the overall win (General Classification). For me specifically, I’m on the hunt to get into breakaways and I’ll help the other guys like Martijn (Verschoor) and Andrea (Peron) to get into good position for the sprint finishes.

JAC: Do you get assistance from Team Novo Nordisk support and medical staff monitoring your diabetes during the races?
JH: For optimal performance, I need to keep my blood sugar in a target range. If my blood sugar is out of target, I may need to make adjustments and the medical staff is on site during the race support us if we need any assistance.

JAC: Does riding with diabetes present any additional concerns when the UCI talks about banning radios from professional races?
JH: Radios were banned, but they are actually back. Just like other teams, we use race radios for team tactics and can always radio back to the car if we need anything. Even without radio, we always have a member of our medical team in the car and we can drop back to the car and ask them a question if we need anything.

JAC: How did you come to be involved with Team Novo Nordisk?
JH: I visited Team Novo Nordisk’s development team in 2012 and did a few races with them. Based on my time there and some earlier results from that year, it was enough to convince the management to offer me a pro contract for the 2013 season.

JAC: Have you encountered many other Type 1 diabetics out there racing, aside from Team Novo Nordisk?
JH: Growing up, there was a really good masters racer in Finland who also had diabetes. I really looked up to him. I believe he even won the Scandinavian championships. Unfortunately, he passed away from cancer a couple years ago but he was very instrumental in my growth and knowing that I could still chase my dreams following my diabetes diagnosis.  One of the things I love about Team Novo Nordisk is being able to serve as a role model to help inspire, educate and empower people affected by diabetes all over the world.

Read other JustAnotherCyclist.com posts about Team Novo Nordisk, or the 2016 Amgen Tour of California.

Team Novo Nordisk will be returning to the Amgen Tour of California this year with a whole new look that will be exclusive to the US races. The new green kits feature Tresiba^®  – a long-acting insulin produced by title sponsor Novo Nordisk.

Team Novo Nordisk is a global team made up of nearly 100 endurance athletes with diabetes, including cyclists, runners and triathletes. The men’s professional cycling team includes 17 athletes from nine countries, 8 of which will be on the starting line for the Amgen Tour of California.

The Amgen Tour of California is the biggest cycling event on U.S. soil and it’s definitely one of the most important races of the season for Team Novo Nordisk, so we are excited to introduce our new U.S. kit at this prestigious race. This year marks our third consecutive appearance at the Amgen Tour of California, and we are eager to use this opportunity to show the 415 million people around the world living with diabetes what may be possible.

Phil Southerland, co-founder & CEO of Team Novo Nordisk

In addition to the 8 riders traveling to California, directeur sportif duties will be handled by Vassili Davidenko and Pavel Cherkasov. Team medical duties will fall on Dr. David Castol.

Our strategy is for the riders to be in peak performance around this race and so far, everything is going according to plan. The team is strong and ready to race. Our climbers will be ready for the new challenges, and we believe our sprinting duo, Andrea and Martijn, are in good shape and ready to earn top results. Charles is coming up very strong and while Javier has had a bumpy season so far, he should be ready for California.

Team Novo Nordisk Senior Vice President of Athletics Vassili Davidenko

Team Novo Nordisk has had successes in the Tour of California in the past. In 2014, Charles Planet (FRA) wore the race’s Breakaway from Cancer Most Courageous Rider jersey in Stages 2 and 3, while teammate Kevin De Mesmaeker (BEL) sprinted to third place on Stage 4. Over the past two editions, Team Novo Nordisk athletes earned three top-10 finishes and rode in major breakaways on five separate stages.

This race is one of my favorites of the season and I hope I can make the podium this year. One of Team Novo Nordisk’s main goals is to win a stage and show the world what may be possible with diabetes

Team Novo Nordisk rider Martijn Verschoor

Look forward to more interviews with Team Novo Nordisk riders as the Amgen Tour of California progresses.

^{Tresiba® is a long-acting insulin that is manufactured by Novo Nordisk. For more information, go to www.tresiba.com.}

It is, without question, extremely challenging to reach elite levels in any sport. Cycling has its own unique challenges. Couple that with the demands of managing a life long disease like type 1 diabetes and challenging can quickly turn into “daunting” or even “prohibitive.”

However, US track sprinter Mandy Marquardt is a fantastic demonstration that type 1 diabetes is not something to keep people from achieving their goals. Along with the help of Team Novo Nordisk, Mandy is spreading the word that diabetes does not have to be a limiting factor in our lives. We caught up with Mandy via email to talk to her about her experiences as a diabetic athlete.

Mandy Marquardt: Cycling has brought me to all areas of the globe, but my home is in Allentown, Pennsylvania, where I train at the Valley Preferred Cycling Center with Andrew Harris and his program, Sprinter’s Edge. I graduated in 2014 from Penn State Lehigh Valley, and I’m currently the Cycling Coach at Penn State Lehigh Valley and training full-time for UCI track races, UCI Track World Cups and the Olympic Games. I’m also part of the Team Novo Nordisk, a global team of nearly 100 endurance athletes with diabetes, spearheaded by the world’s first all-diabetes professional cycling team.

JustAnotherCyclist: According to your bio on the Team Novo Nordisk website, your started cycling competitively at a very early age. How did you get started, and how did you balance training with school and other “normal kid stuff”?
MM: I was born in Mannheim, Germany and moved to Fort Lauderdale, Florida when I was six years old. My father is German and my mother is originally from Florida. My parents encouraged me to participate in sports when I was young, so it has been a big part of my whole life. I was either at swim practice, taking tennis lessons or running 5k’s with my dad throughout my childhood. In 2002, I did my first triathlon and began focusing on cycling and started competing in endurance road and track events at the Brian Piccolo Sports Park and Velodrome in Cooper City, Florida. Since I was always busy competing on the weekends, I rarely had time for sleepovers.  In school, I was known as the “athletic girl”. As I got a little older, I started to learn how to balance my sport and social life.

JAC: How old were you when you were finally diagnosed?
MM: In November 2007, my world turned upside down. I went in for V02 testing and blood work connected with my training.  They quickly became concerned about my elevated blood sugar levels and I went straight to the hospital. At 16 years old, I was diagnosed with type 1 diabetes.  

JAC: Your […] initial indications of your Type 1 diabetes came through routine testing as part of your training. Did you have any suspicions at all prior to that point that something might be changing?
MM: When I look back at it, I would get headaches after eating high carb meals, and during training and racing, I always took forever to warm up and often felt tired and sluggish. I never thought anything of it. I thought maybe I was just tired from all the hard training, and I needed more sleep or a change in my diet. I was never aware that they were unusual symptoms, so I was surprised.

JAC: The moment when you actually understood that you had Type 1 diabetes, what was your immediate reaction?
MM: I was confused, overwhelmed and frustrated. I questioned if there was something I did to get diabetes. I’ll never forget when a doctor told me, “Mandy, you will never be able to race at a high level again.” I felt like everything I worked so hard for was gone. I felt empty, and physically and emotionally drained.

JAC: What were the immediate impacts from the diagnosis on your training and competition?
MM: I spent the next two weeks in the hospital, seeing multiple doctors and working with my healthcare team to learn how to manage my diabetes. I was determined to get back on the bike and eager to race again. When I began training again, it was tough learning what foods, stressors and training intensity affected my blood sugars. I sometimes neglected taking the best care of myself because I was upset, and at one big race weekend, I left all my diabetes supplies at home, and couldn’t even perform in our team event. It was a pivotal point because I not only let myself down but also my teammates. My parents supported me through it all, but it was ultimately up to me to put in the effort to manage my diabetes. I began to improve on monitoring my training and diabetes regime because I was motivated to win bike races again.

JAC: Did you ever fear that the diagnosis might mean an end to your competitive career plans?
MM: [See question above] It was discouraging when I was told I might have to stop racing. Also, due to all the people who were concerned about me, I felt that having diabetes was a bad thing. Back then, I never heard of any other athletes with type 1 diabetes. One of the reasons I love being part of Team Novo Nordisk is because I think we can serve as role models to young athletes with diabetes and show them you can still pursue your dreams.

JAC: The additional challenges of living with diabetes are talked about a lot. But what challenges do you face due to diabetes in regards to competitive cycling specifically?
MM: During racing, there are many variables that affect my blood sugar, including stress and adrenaline. Since sprints are so short, I’m able to monitor my blood sugars before, during, and after racing. I continually check my blood sugar on race days and work with my health care team to adjust my diabetes regime with these extra variables. Racing with diabetes is just another variable that I factor in, but when I’m on the start line, I’m no different than my competitors

JAC: How does the team support you in the additional challenges?
MM: I’m grateful to be a part of Team Novo Nordisk. Since I joined the team in 2010, we’ve grown tremendously. All the athletes on the team are racing with diabetes and as teammates, we really want to see each other succeed. The team has brought us all together, and the ability to connect with one another on that same level, sharing our ups and downs, is really special.

JAC: How long was it between your diagnosis and joining Team Novo Nordisk?
MM: Approximately three years after my diagnosis, I joined the team. It was 2010 and I was inspired by the other athletes racing with diabetes. It was the first time I didn’t feel ashamed and embarrassed about my diagnosis. Due to the team, I have been able to learn to share my story and fully acknowledge that living and racing with diabetes is possible.

JAC: Do you feel that Team Novo Nordisk has created opportunities as a Type 1 cyclist that you otherwise may not have had?
MM:Absolutely! When the team and I aren’t racing, we are out in the community sharing our stories and meeting other people living with diabetes. One of my favorite experiences with the team was traveling to Rwanda in 2011. The Men’s Professional Team was there to race the Tour of Rwanda, and a group of us were riding all the stages ahead of the race. Once we arrived at the finish, we would go and meet with a local diabetes group. It was by far the most memorable experience of my life, both on and off the bike. It was touching to see the world and inspire people.

Growing up, I told my parents that I didn’t want to be just someone, but somebody. My dad always reminded me never to do anything half-heartedly so when I would do something, I did it with my whole heart and I continue to approach life the same today. I am a firm believer that everything happens for a reason and that sometimes we don’t always know what the reason is; you might not know today, tomorrow or even a year from now. To be honest, if I had a choice, I wouldn’t choose to have type 1 diabetes, but I’ve accepted my diagnosis. Now, I am proud to be living with diabetes. I’m thankful to be alive, healthy, racing my bike, and inspiring, educating and empowering people affected by diabetes.

JAC: If you could say anything to other young competitive [athletes] that have recently been diagnosed with Type 1 diabetes, what would it be?
MM: The most important thing to remember is that you can still pursue your dreams, no matter what they are.

JAC: Any specific goals for your career going forward?
MM: One of my biggest goals is to represent my country and Team Novo Nordisk at the 2020 Olympic Games. Not only would it be the pinnacle of my athletic career, but it would also be an incredible platform to inspire, educate and empower anyone affected by diabetes to pursue their dreams.

JAC: When you look forward to your future as a cyclist, does the fact that you have Type 1 diabetes influence your plans or aspirations in any way?
MM: I only see it influencing my future aspirations in a positive way. I am hard on myself and very detail-oriented when it comes to the way I approach my life, work (Penn State Lehigh Valley Cycling Coach) and cycling. I want to reach my highest potential in track cycling and inspire other athletes and people living with diabetes. The support and encouragement I’ve received throughout the years from family, friends, teammates and the community has been incredible, and I want to make them and my country proud.

• Follow Mandy Marquardt on Twitter, as well as her own website at https://mandymarquardt.wordpress.com/
• Team Novo Nordisk is a global team of cyclists, runners and triathletes with diabetes, spearheaded by the world’s first all diabetes pro cycling team. The team’s mission is to inspire, educate and empower everyone affected by diabetes. Find more at http://www.teamnovonordisk.com

I think I’ve watched less pro cycling races this year than in a long time. Actually – I know I have. It wasn’t even a conscious decision. But I do have to admit almost every race I look at, there was some guy that I was suspicious of. And that doesn’t make it any fun to watch. There are a few folks I’ve enjoyed watching race around on bikes a little more than others. It is a short list. As a fan of the sport the names Chris Horner, Jens Voigt and Fabian Cancellara (who just so happened to end up on the same team) always stood out for me somehow. Part of my enjoyment of Horner and Voigt specifically was their age. They showed me that getting older wasn’t an excuse I should even consider.

It would be great to be confident these men – and others like them – have ridden clean. But the pragmatist steps in. They’ve been on teams where other riders and management have been linked to doping. More and more people come out and say they doped. Unfortunately what has happened now is not that specific riders have been identified, but an entire generation of riders are now under suspicion – deserving or not. Every win is subject to a “was he doping” question.

I’m not specifically upset that doping occurred. It is understandable. If you pin paychecks on performance folks will do what they can to improve performance. So what do we do? Chris Horner has been quoted as saying, basically, that if we don’t trust the tests we shouldn’t bother with them. That’s a paraphrase for sure, but it is a valid question. How do we get back to a place where folks can sit down, watch a bike race and not have the specter of doping over every winner. Because I miss enjoying a good bike race.

Maybe I should just stick to my local races and clubs. Or watch women’s racing instead.

Ahhh social media. Not only do you get provocative messages – you get provocative discussions about who the provocative messages actually came from.

Adding to the “intrigue” is the fact that the message was posted to the Greg LeMond timeline at least 13 separate times – the identical post – at the time of this writing. Speculation was already rampant that the posts didn’t in fact come from Greg himself.

Maybe, maybe not. But here’s the full text of the post in quesiton:

http://velonews.competitor.com/2012/10/news/kimmage-felt-rage-deflation-during-mcquaids-armstrong-press-conference_262474
Can anyone help me out? I know this sounds kind of lame but I am not well versed in social marketing. I would like to

send a message to everyone that really loves cycling. I do not use twitter and do not have an organized way of getting some of my own “rage” out. I want to tell the world of cycling to please join me in telling Pat McQuaid to f##k off and resign. I have never seen such an abuse of power in cycling’s history- resign Pat if you love cycling. Resign even if you hate the sport.
Pat McQuaid, you know dam well what has been going on in cycling, and if you want to deny it, then even more reasons why those who love cycling need to demand that you resign.
I have a file with what I believe is well documented proof that will exonerate Paul.
Pat in my opinion you and Hein are the corrupt part of the sport. I do not want to include everyone at the UCI because I believe that there are many, maybe most that work at the UCI that are dedicated to cycling, they do it out of the love of the sport, but you and your buddy Hein have destroyed the sport.
Pat, I thought you loved cycling? At one time you did and if you did love cycling please dig deep inside and remember that part of your life- allow cycling to grow and flourish- please! It is time to walk away. Walk away if you love cycling.
As a reminder I just want to point out that you recently you accused me of being the cause of USADA’s investigation against Lance Armstrong. Why would you be inclined to go straight to me as the “cause”? Why shoot the messenger every time?
Every time you do this I get more and more entrenched. I was in your country over the last two weeks and I asked someone that knows you if you were someone that could be rehabilitated. His answer was very quick and it was not good for you. No was the answer, no, no , no!
The problem for sport is not drugs but corruption. You are the epitome of the word corruption.
You can read all about Webster’s definition of corruption. If you want I can re-post my attorney’s response to your letter where you threaten to sue me for calling the UCI corrupt. FYI I want to officially reiterate to you and Hien that in my opinion the two of your represent the essence of corruption.
I would encourage anyone that loves cycling to donate and support Paul in his fight against the Pat and Hein and the UCI. Skip lunch and donate the amount that you would have spent towards that Sunday buffet towards changing the sport of cycling.
I donated money for Paul’s defense, and I am willing to donate a lot more, but I would like to use it to lobby for dramatic change in cycling. The sport does not need Pat McQuaid or Hein Verbruggen- if this sport is going to change it is now. Not next year, not down the road, now! Now or never!
People that really care about cycling have the power to change cycling- change it now by voicing your thought and donating money towards Paul Kimmage’s defense, ( Paul, I want to encourage you to not spend the money that has been donated to your defense fund on defending yourself in Switzerland. In my case, a USA citizen, I could care less if I lost the UCI’s bogus lawsuit. Use the money to lobby for real change).
If people really want to clean the sport of cycling up all you have to do is put your money where your mouth is.
Don’t buy a USA Cycling license. Give up racing for a year, just long enough to put the UCI and USA cycling out of business. We can then start from scratch and let the real lovers in cycling direct where and how the sport of cycling will go.
Please make a difference.

I’ll let you be the judge.

I’m not a lawyer, nor do I play on one TV. But I nonetheless found myself spending a whole lot of time yesterday reading over legal documents. It would be cool if I were trying to gain understanding into my legal liabilities if I lead a ride and someone gets hurt. Or perhaps finding ways my auto insurance is legally required to cover myself and/or bicycle in the case of an accident in the saddle. Or how about the technicalities of home owners or renters insurance and a stolen bike.

Nope – as you probably guessed, I was all wrapped up in the USADA Reasoned Decision in the Lance Armstrong case. Across the internet, everyone seems to be writing that as “Reasoned Decision” – in quotation marks – as if it is a sarcastic remark.  Turns out that a reasoned decision is actually a specific type of document that the USADA was required to release. From the publication itself:

Pursuant to Article 8.3 of the World Anti-Doping Code (the “Code”), after a sanction is announced because the sanctioned party has failed to challenge the charges against the party, the Anti-Doping Organization with results management authority shall submit to the entities with appeal rights a reasoned decision explaining the action taken. This document, therefore, sets forth USADA’s reasoned decision describing evidence of Mr. Armstrong’s rule violations (the “Reasoned Decision”), and is being sent to the Union Cycliste International (UCI), the World Anti-Doping Agency (WADA), and the World Triathlon Corporation, the entities with appeal rights relating to the Reasoned Decision.

— USADA Reasoned Decision, Pg 6

Oh – they put it in quotes themselves. OK. I won’t make fun of them for that. But why was I wasting my time reading this cycling news carefully obfuscated as legalese? Frankly, I think I was looking for some sanity, some clarity.

You see, I’ve had a long time to come to terms with the fact that I believe Amrstrong is guilty. I started down this road a long time back – even to Floyd Landis and his claims so long ago. Yes – I do think Floyd is a whack job. Yes, his credibility is strained. But no, I refuse to make the logical leap that Armstrong and his crew have tried to get me to make – that because he is a whack job, everything he says is whack. Nope – even whack jobs can tell the truth. And now, in light of more evidence, I’m faced with a harder question: Isn’t it possible that Floyd Landis is such a whack job because of all the crap he was yammering about?

But back to the point – no, I didn’t care that there was “official evidence” that Armstrong doped. In point of fact, there are still ardent Lance supports that will deny this evidence too. Those that will claim this is the result of a vast conspiracy involving the highest levels of the US government, Sheryl Crow’s ex boyfriends, the entire population of France and Ancient Aliens hell bent on ensuring no one rides a bike too successfully.

No – it was the other riders that actually upset me more. Guys like Levi Leipheimer,  David Zabriskie, Christian Vande Velde and George Hincapie have all publicly stated basically “Yes, he did. And yes, I did with him.”

Levi and Big George, in particular, gave me pause. You see, I haven’t yet processed the idea of them doping like I have with Lance. I think I was clinging to some strand of plausible deniability regarding those that rode with Lance, and that I admire as athletes. Now I have to look hard at that too.

So where does this all leave us? Does this taint any and all riders that are still competing from that era?

No. I don’t think so. Instead, I think we need to look at it differently. Yea, probably most of the folks from that time were doping. But by all accounts it was widespread across the sport – a sort of doping arms race between the teams. Those that didn’t simply were not able to compete… natural selection. But there are indications that the doping cold war is over. The former Soviet Union, err, I mean Lance Armstrong Possee, has broken up. We are in a new era of peace.

I certainly hope that is true, otherwise I’ll have to devote all my sporting attention to the only other sport worth watching – football (with the round ball, sillies). Watching people race bikes is something I’ve loved to do, and it does have a positive impact on my own personal experiences on the bike. I’m not ready to give that up.

So that leaves us all with a personal decision – what do we do with this information?

I suggest we treat it like a day in high school history class. That was then and crappy things were done all around. Let’s do what we can to make sure they don’t happen again. And let’s be thankful that perhaps now we can all enjoy a cycling season without having every major race somehow bring up the “Armstrong Case” during the coverage.