Diabetes Forecast

Sebastien Sasseville Conquers Mountain and Desert

Sebastian Sasseville finishes a 155-mile race across the Sahara desert

By Tracey Neithercott , , ,

Sebastian Sasseville finishes a 155-mile race across the Sahara desert.

Photograph courtesy of Racing the Planet/Scott Manthey

When you’re young, you think you’re invincible, but then life slaps you in the face and gives you diabetes. I learned that if I wanted to live long, I needed to be well controlled.
Sebastien Sasseville, endurance athlete

It's a sunny Monday in November and even though it's 59 degrees in Quebec City, it's downright freezing compared with the place Sebastien Sasseville just left. That would be the Sahara. Sasseville just spent seven days crossing it at breakneck speed with nothing but a small backpack. And no, he wasn't caught up in an elaborate kidnapping-and-torture scheme. He did it for fun.

Of course, Sasseville's idea of fun isn't everyone's. Before he ran through the world's largest desert, he climbed the world's highest mountain. Oh, he's done "average" things, too: Years ago he scaled Africa's highest peak, and he regularly runs triathlons and Ironmans.

On a whole, Sasseville's exercise résumé is impressive. Few could follow in his footsteps. But what makes Sasseville's feats awe inspiring and completely mind-boggling is the fact that he does it all with type 1 diabetes.

Of Mountains and Men

Sebastien Sasseville is not the type of guy who looks back on his college years with nostalgia for his younger body—even if it was diabetes-free at the time. The 33-year-old athlete says he spent more time guzzling beer than working up a sweat, although his "unfit" period did include a 2001 trek to the Mount Everest South Base Camp—that's over 17,000 feet above sea level. The following year, Sasseville was diagnosed with type 1 diabetes, which prompted him to get into peak physical condition. In fact, if it weren't for his diagnosis, Sasseville might be spending most of his day behind a computer instead of pushing his body to its limit.

"I just wanted to be healthy," he says. "When you're young, you think you're invincible, but then life slaps you in the face and gives you diabetes. I learned that if I wanted to live long, I needed to be well controlled." So Sasseville started running and found he liked it. A lot.

A year later, he decided to seriously train for the climb of a lifetime: to the summit of Mount Everest. The training took five years, during which he led a group of teens with type 1 to the top of Mount Kilimanjaro in Africa and then to the Everest base camp in the Himalayas. "We showed that type 1 is not a limitation," he says. "It was really amazing for young kids, taking on such an extraordinary challenge."

The climbs—and dozens of others he did at increasingly high mountains all over the world—prepared him for his greatest challenge yet. But instead of just worrying about the frostbite-inducing temps, whipping winds, low oxygen, avalanches, and dangerous terrain, Sasseville also concerned himself with seemingly impossible diabetes care: "I had so much homework to do in finding out how my diabetes would react," he says. With the help of his endocrinologist, Will Cross (another type 1 climber who reached Everest's peak), and a lot of trial and error, Sasseville plotted both how to manage in below-freezing temps and how to cope with the effect of high altitude on his blood glucose.

The first obstacle: a serious lack of emergency help. Without access to pharmacies or hospitals on the mountain, everything Sasseville might need for his diabetes management had to fit in his and his fellow climbers' packs (they spread his supplies in case a bag was lost). Handling a year's worth of insulin—he packed plenty so he'd have backup in case his supply was lost or damaged—was the tricky part. In order to keep it from freezing, Sasseville packed his extras in a thermos that would keep them cool but not frozen. The rest of his stash was held close to his body, along with his meter, pump, and fast-acting glucose.

The higher he climbed, the more difficulty he had testing. Simply unzipping his layers to reach his meter exposed his body to extreme cold, and each time Sasseville removed his glove, he ran the risk of losing it (or having frostbitten fingers). Plus, no blood glucose meter is approved for such high altitudes, so by the 10,000-foot mark Sasseville mostly depended on intuition. "I had to rely a lot on training and experience. You have to trust yourself," he says. "It probably wasn't perfect, but it was good enough that I knew I was safe."

Altitude posed yet another problem. At close to 10,000 feet and again around the 22,000-foot mark, Sasseville experienced two to three days of soaring blood glucose because low oxygen levels at high altitudes can increase insulin resistance. During this time, dosing insulin became a delicate matter. He was forced to estimate how high the insulin resistance would raise his glucose while also guessing how low the 10 hours a day of climbing would lower it.

The result of all his hard work: He never had a serious problem with his blood glucose and became the first Canadian with type 1 diabetes to reach Mount Everest's 29,000-foot summit.

Sebastien Sasseville's Feats
at a Glance

Climbed to the Mount Everest South Base Camp

Diagnosed with type 1 diabetes

Reached the summit of Mount Kilimanjaro

Climbed again to the Mount Everest South Base Camp

Reached the summit of Mount Everest

Ran the Sahara Race in Egypt

In Desert and Wilderness

It seems somehow fitting that, after climbing in subzero temperatures, Sasseville's next big project would involve sun, sand, and suffocating heat. He had been competing in triathlons regularly when he heard about a race across the Sahara three years ago. "The race sounded very challenging," he says. "Over the years you get to understand there's a physical challenge, but I look at these things as personal-growth vehicles."

Sasseville, who earns his living as a motivational speaker, kept up a grueling triathlon and Ironman schedule for years leading up to the 2012 race. (He's also a triathlete with Team Type 1.) As the race drew near, Sasseville scrapped the cycling and swimming part of his usual exercise and focused on long runs—25, 30, even 40 miles at a time.

But it wasn't the length of the Sahara Race—a whopping 155 miles—that worried Sasseville. It was the landscape and heat. "The terrain was changing all the time. There were times we would run on sand dunes, which made it so much harder," he says. And that's without taking the scorching temps into account. "I know that I never do well when it's hot. But your body does adapt to higher temperatures. Your body figures out it needs to sweat a little more."

While the heat didn't affect his blood glucose, Sasseville says the nonstop running (about five to seven hours at a time) did. "It was so fascinating to see how little insulin I required." He used about 15 to 20 units per day—delivered via a pump and infusion set held in place with Skin Tac beneath the factory adhesive—which included his background, or basal, insulin as well as insulin boluses he took for meals.

With much lower insulin requirements due to the exertion, "you bolus for a meal and you're like, 'How the hell am I not going to go high?' " he says. "It just goes to show you how the muscles are just grabbing all the glucose." In fact, he scrapped his usual ratio of 1 unit of insulin to 12 grams of carbs for a more appropriate 1-to-35 ratio.

To keep from going too low, Sasseville checked his blood glucose once per hour, which usually coincided with a race checkpoint. He'd use the opportunity to fill up his water bottle and test while he wasn't in motion.

Because he was so sensitive to even the smallest dose during the race, he used very little insulin to correct highs. After two lows during the first couple of days and two highs a couple of days later, Sasseville adjusted to the physical demands and kept his blood glucose in a safe range for the rest of the race.

Sasseville's diet made hypoglycemia prevention harder. The race required participants to bring everything they needed—including food, medication, clothing, a sleeping bag—in a pack they wore on their backs ("Packing to Cross the Sahara," above). His weighed in at 17 pounds, with diabetes supplies accounting for a good portion of the heft. "Sometimes I wondered if I didn't have to carry all [of my diabetes supplies], if I didn't have diabetes, how much faster could I go?" he says. "But there's nothing I can do [about that]. I need to have a positive attitude."

So he packed as much food as he could fit without weighing himself down. In the morning and throughout the day, Sasseville kept his glucose high with energy bars and glucose gels, which let him eat on the run. At night, he feasted on freeze-dried meals (about as appetizing as they sound) that were loaded with calories and sodium (to replenish what he lost in sweat).

In the end, Sasseville says the challenge—even forgoing showers for wet towels—was worth it. He finished in 36 hours and 36 minutes, 21st of 134 runners, and proved once more that people with diabetes can do anything they set their minds to. "Everything I do started with diabetes," says Sasseville, who has already set his sights on the Ironman World Championships. "I don't want people with diabetes to feel like they're limited. In our day and age, we have every tool possible."

Packing to Cross the Sahara

The Sahara Race is self-supported, which means participants have to carry everything they need for the seven-day event in a backpack. Sasseville loaded his with food, essentials such as sunscreen and a sleeping bag, and plenty of diabetes supplies. "I'm really big on having a diabetes plan," he says. "If something else goes wrong, you have a backup. And if that something else goes wrong, you have a backup for the backup. I never really use the backups, but I feel so much better."

Here, the diabetes-related supplies that made the cut:

♦ 7 freeze-dried meals with at least 4,000 calories in each

♦ 14 energy bars

♦ 34 glucose gels

♦ 2 vials of insulin stored in cooling packs

♦ 2 syringes

♦ 10 lancets

♦ 3 containers of 25 test strips each

♦ 2 blood glucose meters

♦ Insulin pen with cartridge of insulin

♦ Backup pump

♦ 3 pump cartridges

♦ 5 infusion sets

♦ 3 containers of Skin Tac adhesive

♦ 2 batteries



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