From Ryan’s website:

Ryan Reed began his first full NASCAR Xfinity Season at the start of 2014. He finished 9th in overall standings, with 1 top 5 finish and 14 top 15 finishes. His season best took place at Daytona Intentional Speedway, where he finished 4th. He will start his 2nd Season in the NASCAR Xfinity Series with the No 16 team in 2015.

Reed's racing career began at a young age, capturing the Kid's Kart Track Championship at the age of four. The Bakersfield, California native followed that up by becoming the Junior 1 Comer and HPV Karting Track Champion at age eight.

You can read the rest of Ryan’s bio on his site DriveToStopDiabetes

Alissa:       Can you tell me about your diabetes, how you were diagnosed and what were your symptoms?

Ryan:        In 2011, I was living and loving life. One morning I woke up and was incredibly thirsty. It was so severe! It felt as if I hadn't had water in days. I was continuously drinking water and using the restroom. This went on for two or three months.

I had lost ten to fifteen pounds and didn't feel well at all. When my parents saw me they were terribly concerned and insisted that I seek medical attention. The next day my doctor checked my blood sugar which was 350 fasting. I was diagnosed on the spot with diabetes.

Alissa:       How did you handle your diagnosis emotionally, and how did your parents and family handle it?

Ryan:        My main concern was how it was going to affect my racing. My doctor said I was never going to race again and I was emotionally destitute. I started racing at age four and I was 17 when I was diagnosed. Because I had just started having a lot of success in racing, when I was diagnosed I thought my career was over. My family was very supportive.

Alissa:       Does diabetes run in your family?

Ryan:        No.

Alissa:       What kind of treatment did you initially receive, and how did you find the right doctors and medical support?

Ryan:        I was immediately put on insulin. I started researching athletes with diabetes and I found a story on Charlie Kimball, the Indy car driver. The story spoke of his doctor, Anne Peters, so I researched her. She was in Southern California, only two hours away from my home, and I contacted her and became her patient. The first time I saw her, she was optimistic and confident that I would get back into a race car. That's when things turned around.

Alissa:       How often do you see your endocrinologist and what kind of diabetic regimen are you currently on?

Ryan:        I see my doctor every three months. I used pens and I use a CGM (Dexcom).

Alissa:       You're not on a pump?

Ryan:        No. It gets very hot, about 150 degrees, inside the race car. We didn’t feel confident that the insulin would be effective at those temperatures. We decided the pen was the right treatment for me, and I’m really comfortable with it.

Alissa:       What benefits do you get from Dexcom that made you choose it?

Ryan:        I’m a huge advocate of Dexcom. I went on it very shortly after I was diagnosed. I sometimes go most of the day without checking my blood sugar, and it's always right on.

Alissa:       How did you educate your friends and family when you were younger in school about your diabetes? What kind of diabetic regimen did you follow when you were at school?

Ryan:        When I was diagnosed, I was already in the process of moving to North Carolina and my schoolwork was an independent studies program.  Although I was a senior in high school, I didn’t go to school.  My friends were not only supportive, but they wanted to understand diabetes and the changes that were being made in my life. If I needed anything, they were available. My parents were right there with me the whole time.  I had a really great support group around me!

Alissa:       What is the most common question that you're asked?

Ryan:        I get asked a lot about taking shots every day—does it hurt, or what’s it like?

Alissa:       How demanding is racing? What kind of shape do you need to be in?

Ryan:        There are guys in racing that are in great shape—they’re triathletes and world-class athletes—and then there are guys that aren't. I love being active, and I love being fit—whether racing or not. I do cycling, Crossfit and weight lifting to stay active. In doing so, it benefits for racing endurance.

Alissa:       How did you adjust your diet?

Ryan:        I was really concerned with training and diet limitations. My doctor and nutritionist made sure I could eat and train like an athlete and not have to sacrifice because of my diabetes. It actually motivated me to get in better shape and understand more about what I was putting in my body. I felt like I became healthier and a better athlete.

Alissa:       How did you persevere and become successful in this sport that you're so passionate about when you were told that you may not be able to race again?

Ryan:        It was horrible to be diagnosed and told I couldn’t race. At 17 years old, you take things for granted. My diagnosis motivated me and made me appreciate what I had.

Alissa:       Were you aware of any other colleagues of your race car drivers living with diabetes? If so, were they able to provide you with support or advice?

Ryan:        No one besides Charlie. He was always open to giving advice and I talked to him whenever I was first diagnosed. There really aren’t many people in racing with diabetes—some crew guys, but not any drivers. 

This concludes Part I of II, interview with Ryan Reed.  In the next(and final) part, Ryan talks about how he manages his diabetes while racing, whether or not he uses a CGM, what he does for dehydration and much more!  Register now to be notified when An Interview with Ryan Reed Part II is published!

I’ve been fortunate to have Nicole Brent as been my dietitian.  She has worked closely with me while training for my competitions to manage my diabetes through proper diet and exercise regimen.  Since I’ve known her, I’ve become much more knowledgeable and successful with regulating my blood sugars.  She has always been helpful with diabetic issues that have arisen.  It is such a treat that she has agreed to be interviewed on diabetes, her area of expertise.

Alissa:     Please tell me a little bit about your credentials and how you got involved consulting diabetic clients?

Nicole:   I'm a registered dietitian. I have a bachelor's degree then did an internship; Diabetes is very nutritional-related. Medication, exercise, and diabetes all go together and it's something that I was very interested in and felt that I could be helpful. You need 1000 hours working with patients to be able to become a certified diabetes educator. I attained that goal and became a Certified Diabetes Educator All of this education and experience has provided me with the skills needed to help my patients.

Alissa:     What would be the best way to find a dietitian who specializes in treating diabetics?

Nicole:   The National Certification Board for Diabetes Educators website is http://www.ncbde.org . Your zip code will give you a list of all the Certified Diabetes educators in your area.   Also, if you talk to your endocrinologist, then he/she may have a dietitian that they work closely with. We work very closely with Texas Diabetes and many other physicians and endocrinologists in Austin.

Alissa:     Cost is always a factor when making medical decision.  There are so many expenses that diabetics incur that create financial difficulties. If somebody needs to see a dietitian and they can't afford it for some reason, how do you advise somebody to be able to get that dietary care?

Nicole:   Usually, your insurance covers it if you have diabetes, but it just depends on your insurance.

Alissa:     Are there alternative methods of coverage if insurance doesn't pay for it?

Nicole:   I don't know about that. That would be up to your employer. 

Alissa:     Where can I find a dietitian who works with diabetic patients? Are there special certifications needed for this?

Nicole:   There is a certification, which is not just for dietitians, but for practitioners who works with diabetics. It is called a Certified Diabetes Educator or CDE. You can go to their website, http://www.ncbde.org, to find a CDE.  Practitioners working with diabetic clients, including nurse practitioners, physician's assistants, and dietitians should be a Certified Diabetes Educator or CDE.

Alissa:     Are there specializations or certifications for dietitians to work with children with diabetes?

Nicole:   There's not a certification for a diabetes educator to just work with children, however, there’s a Certified Specialist in Pediatrics or CSP.  You can find board certified specialists in pediatric nutrition at The Commission on Dietetic Registration website, www.cdrnet.org.

Alissa:     Craving sugar is a symptom of diabetics, but could something else cause this?

Nicole:   I don't know that craving sugar is necessarily a symptom of diabetes. It depends on the person. Sometimes, it will come from the fact that someone knows they shouldn't be eating a lot of sugar causing them to want it more.  That’s just human nature.  One thing that will cause craving more sugar is if we are getting inadequate carbohydrate in our diet.

Alissa:     What are the biggest differences between diets for diabetics verse non-diabetics?

Nicole:   If I’m working with a diabetic patient and their goal is weight loss, we would be focusing on carbohydrates, so the emphasis would be carbohydrate counting and making sure that their carbohydrates are under control. Not only does carbohydrate counting help with weight loss, but it also helps to reduce calories because the carbohydrates have the largest percentage of our calories. If diabetes is not a factor, I will still teach carbohydrate counting because it is extremely helpful in weight loss. For non-diabetics total calorie intake and getting adequate exercise are priorities.

Alissa:     What tips do you recommend for measuring carbohydrates?

Nicole:   There are many great apps available to help figure out the carbohydrate content of while eating out.  It is also helpful for foods that don't have labels on them like apples.

Alissa:     The size of apples can vary greatly.  How do you carbohydrate in an accurate way?  Do you need to weigh it with a scale?  Do you need to measure with cups?  What are your suggestions?

Nicole:   Either way.

Alissa:     Is there a rule of thumb, 15 carbs for certain vegetables or fruits?

Nicole:   No, because there are so many different amounts.  The best way to learn is to measure your foods for a little while. You will learn from practice and experience.  If you measure a cup of rice several times then you are able to eyeball it down the road. 

Alissa:     Are there any danger foods or unsafe foods for people with diabetes? What are good treats and desserts for diabetics?

Nicole:   There is no list of food that is off limits because you are diabetic.  Certainly there are foods that are better choices.  I know that there are certain triggers for me which can be danger foods if you are diabetic. Same thing with safe foods. 

               I teach my diabetics to try to keep their snack to around 15, and for sure less than 20 grams. 

Alissa:     What would you recommend if somebody with diabetes wanted to have a dessert?

Nicole:   Sugar-free Jell-O is carbohydrate free. Sugar-free pudding has only 15 grams. A granola bar that is high protein is a good choice. Desserts and snacks that range @ 15 grams of carbohydrates are wonderful options. 

Alissa:     What if somebody wanted to have a piece of cake or cookie - what would you recommend?

Nicole:   Keep it small, and then if you're on insulin, you have to cover it. You need to be mindful about checking your sugar and making adjustments with insulin. 

Alissa:     Is NutraSweet or saccharin?  Which would you recommend?

Nicole:   According to the Food and Drug Administration, they are all safe, so that's something that I leave to the client. Some people feel more comfortable with Splenda because it's made from sugar. Some people feel more comfortable with TruVia, green leaf, or SweetLeaf because they are from a leaf, so they feel it is more natural.  Be aware of the amount of these sugar substitutes that are being used, so they are not overused. 

Alissa:     Is there a limit on how much sweetener you can use per day? Do they have carbs?

Nicole:   They do not have carbohydrates in them.  Some of them are equivalent to 20 to 22 diet sodas a day, so be aware.

Alissa:     Do sweeteners have long term side effects?

Nicole:   Everything in life is about moderation. That's the key. If you're not comfortable with it, then don't use them.

Alissa:     I really, really appreciate you, Nicole, as my dietitian and how much you've helped me through my competition season.  I have learned so much from working with you.  I thank you so much for giving me your time and helping me so that I can help others.

Nicole:   You are very welcome, my pleasure Alissa. 

I’ve worked with Dr. Joe Klemczewski over the last year in preparation for my figure competitions.  He has helped me lose weight and regulate my diabetes. 

Alissa: Can you tell me a little bit about your background, credentials and how you
are able to help somebody diet in a healthy way to compete in a fitness
competition like myself?

Dr Joe Klemczewski:   I became interested in nutrition when I was about 12 years old. I changed schools in the fifth grade and new friends pulled me into sports, but I was a chubby inactive kid. I wanted to catch up to my peers—I was inspired by performance, athleticism, and the sheer fun of sport. That led to weight lifting and it was a very positive turn for me. By the time I graduated with a degree in physical therapy, I was on my way to becoming a professional bodybuilder. I pursued a masters in health and doctorate in nutrition to support my hobby, but it naturally pushed me into a career in the fitness industry. After owning a health club for 10 years, I created The Diet Doc, LLC, went back to school for another PhD in health education, started writing and publishing nutrition books, and licensing our program around the world.

Alissa:   Do you believe an athlete with diabetes can compete in a professional sport?
What are the pros and cons?

Dr Joe Klemczewski: It’s absolutely possible, but can be extremely dangerous if the athlete isn’t careful and responsible in monitoring the condition. It’s easy to get caught up in training or performing and end up in a compromised state. The pressure of achievement—especially if others depend on the athlete—can push the condition further away as a priority, symptoms can be ignored, and bad things can happen. The pros, of course, is that activity and exercise is a great benefit to a diabetic. It can prolong life, increase quality of life, and reduce complications.

Alissa: What kind of diet would you use that might be different from somebody who
doesn't have diabetes?

Dr Joe Klemczewski:      I’m a fan of healthy, balanced eating and dieting, so there’s no difference in the way I would treat a diabetic. I constantly emphasize that blood sugar and symptoms are more important than the objectives of a diet. If a diabetic is following a diet of any sort, and they ignore symptoms because the diet they’re following wouldn’t allow for a deviation, it’s more than wrong—it’s irresponsible and can be fatal.

Even though my nutrition practice is naturally diabetic-friendly, I would always be careful to not reduce carbohydrates to levels that would compromise the condition.

Alissa:   What are the health advantages of following your diet regimen as opposed to
other diets commonly used?

Dr  Joe Klemczewski:   I’m always going to include an appropriate amount of protein, but not too much. Diabetes can cause the vascular system and fragile tissues to degenerate and excess protein exacerbates that process. I like to include enough dietary fat to allow for flexibility, but also so that healthy fats can be a consistent part of nutrition. That leaves, carbs, and since I’m not going to suggest a faddish or impractical diet (like very-low-carb diets), there is always room for a good, safe amount of quality carbohydrates.

Alissa: How do you advise competitors or athletes to have a healthy lifestyle
(whether or not they are diabetic)?

Dr Joe Klemczewski:   There’s a growing fascination in the general population diet industry and in physique sport with “flexible dieting.” What was once seen as simplistic—counting calories versus using a hyper-specific, restrictive diet—has become the new trend. I think the original problem with tracking calories was that it wasn’t specific enough. Twenty years ago, the programming I introduced into the industry used flexible dieting principles, but included guidance based on goals and circumstances. I created ranges for protein, carbs, and fat, and offered help in meal planning, but the client could select foods they liked. It took a generation, but now it’s becoming the norm, even with big-box diet chains.

Alissa: What type of foods do you recommend? Is it possible for diabetics to have a
variety in their diet?

Dr Joe Klemczewski:   Absolutely. Just like the premises I began with 20 years ago for non-diabetic clients, it’s important for anyone to enjoy flexibility. It just takes a little dedication to learning what is in food.

Alissa:  Are there any healthy splurge foods a diabetic can enjoy?

Dr Joe Klemczewski:   Even a diabetic can process high-glycemic, sugary carbs, but like anyone, it’s not healthy to make that the norm. Small indulgences are, I think, a normal, healthy part of life. If someone decides never to eat something that would be considered “bad”—ever—that’s their choice. I don’t think it’s possible, and it can lead to obsessive or compulsive issues like bingeing, so I prefer to include small, manageable amounts of decadent foods.

Alissa:  Are there any foods that a nondiabetic can eat differently than a diabetic?

Dr  Joe Klemczewski:   A non-diabetic can certainly get away with abusing food without the acute health consequences, but look at our society: there’s still a cost. That’s why type-II diabetes has become such a health crisis.

Alissa:  Can you can help explain what an athlete, or physique competitor, eats during in-season training and the differences off-season?

Dr  Joe Klemczewski:   Someone trying to accomplish body composition goals—getting leaner or gaining muscle—will need to be objective and consistent. They’re going to eat higher-quality food and avoid deviations as much as possible. But, the goal of anyone should be health regardless. Someone who is diabetic or non-diabetic shouldn’t let their weight deviate greatly, and I would hope their eating habits are healthy year-round. Again, someone not in the acute phase of a training need might enjoy more margin for error and not be quite as diligent, and that’s where flexible dieting comes into play, but I don’t consider there to be dramatic differences. 

A question I get asked frequently is what my diet is like. I deviated from my regimen last night . I went out for my trainer’s birthday for about an hour at a later time than I usually go out.  My life is very routine - I try to eat at the same times every day, work out at the same times, and wake up and go to bed at the same time.  In the time that I was out, I danced briefly; however, my last meal had no carbs and left me with an empty stomach.  In other words, I didn’t have any food in me when I went dancing, so my blood sugars went low.

When your sugar goes low, you go into panic mode.  You worry about fast acting carbs , when will they work, will it be enough, is it going to affect my weight, my sleep, my morning routine.  Unfortunately my body required more than 60 carbs overnight which left me exhausted this morning.  Not only did I lose an hour of sleep due to Daylight Savings, I didn’t have energy to go to the gym, which I do every Sunday morning.  I never sleep in because my first meal was at 7 am in the morning.  So what did I do about breakfast?  I ate my morning breakfast as planned but I removed my second meal.  I had the opportunity to go back to sleep and I did as it’s important to keep your body well rested.  I had to go to work this afternoon.  Daylight Savings affected me and I was exhausted, but I got through the day as we all do when we’re tired.  It’s very common to ask ourselves, I’m tired do I need to skip the exercise today? As I’ve mentioned in a previous blog, it’s the days that I’m tired that I feel the most productive with my workout.  After work, I went to the supermarket, to buy my key staples for the week.  This leads me back to what does my diet consist of.  Keep in mind a healthy eating and exercise regimen, I pushed through my fatigue, focusing on the key staples I eat on a daily basis as a diabetic.  I thought I’d share these healthy choices with you.  These products are all great complex carbs, low in sugar and high in protein, that are good staples for your diet, whether you’re a diabetic, athlete, or anyone who’s trying to watch their weight.  I always eat a complex carb with a protein, use portion control, and read the labels on the packages. 

My blood sugar dropped low while shopping for groceries.  I went back to my most recent blog about the hypoglycemia rule of 15.  This time, I used glucose tablets that I had on hand.  This required me to use 45 carbs within a 30 minute period.  As I sat in the parking lot waiting or my sugar to go up, it was around 4 pm in the afternoon, I was tired, hungry from low blood sugar, daylight savings time-lagged, yet knowing I need to do a work out. I did self talk using my own blogs to help motivate me and get the energy to do a workout at the gym.  I could have used exhaustion or low blood sugar as an excuse to not exercise. Instead I used it as a positive, and went to the gym despite my exhaustion.  I had a very productive workout, I feel refreshed, and I’m glad that I was able to give myself the positive reinforcement using self talk.   This is why I like to blog; I take my own life experiences, which you might be experiencing too, so that we can all learn together.  All of us are in the same boat.  Managing Diabetes is a science.  There’s no explanation for the highs or the lows, but there are healthier ways to self-manage.

Alissa interviewed Dr. Blevins, M.D., Endocrinologist, Texas Diabetes & Endocrinology on the effects of balsamic vinegar on blood sugar

Alissa:  For the last two weeks, I've experienced my blood sugars increase and I realized today after doing some research it was balsamic vinegar.  How does balsamic vinegar affect blood sugar?  Do you recommend using it and how much should you use if you use it?

Dr. Blevins:  Balsamic Vinegar does certainly have calories and it depends on how much you use.  Tell me this – how much were you using?

Alissa:  I use the big bottles you get at Costco – I was using a bottle every 4 days, so probably a quarter bottle a day

Dr. Blevins: I have to admit I don’t know what those bottle look like but, how much is in a bottle? 

Alissa: Let me check… 1 liter

Dr Blevins:  Vinegar can be formulated in different ways, but usually a cup is about 40 grams of carbs or so, but what does it say on the label?

Alissa:1 tablespoon has 2 grams of carbs and 10 calories and 2 grams of sugar

Dr Blevins: A liter is 1000 CCs, so you’re talking about 70 tablespoons.  There’s definitely carb in balsamic vinegar.  The story here has more to do with being very careful about food and look at the label carefully. 

Alissa: Yes

Dr Blevins:  It’s low fat and that’s good, but it’s pretty high in sugar.  It’s liquid, readily absorbable, and it could spike your sugar since it does have a lot of sugar.  So 1 tablespoon is 2 grams, and you’re taking 250 ccs/day, a quarter of the bottle per day.  The math on that would be about 17 tablespoons, so you’re getting mid-30s of grams of carb per day.  That’s quite a bit of quickly, readily absorbable carb.

Alissa: Yes, I’m cutting it out of my diet permanently!

Dr Blevins: Although it’s not hidden, I think the perception many people would have is the same as yours which is that it’s not a high carb source.

Alissa interviewed Dr. Blevins, M.D., Endocrinologist, Texas Diabetes & Endocrinology on caffeine and blood sugar.

Alissa:  Does caffeine affect blood sugar and what effect does it have on exercise?

Dr. Blevins:  I’ve seen some studies that caffeine and coffee can be shown to prevent Type 2 diabetes.  It depends on the person, whether they have diabetes or not, whether it affects their blood sugar or not and also it’s very individual.   We’ve seen quite a number of people who have noticed that when they drink coffee by itself, with nothing in it, no creamer, no sugar, no carbohydrate added, coffee fundamentally doesn't have carbohydrates in it, especially people with type 1 diabetes, that their glucose sometimes briskly, not sky rockets, but rises after drinking coffee.  It’s complicated a bit because, in the morning when people drink the coffee typically, the hormones in the body that normally rise, for example cortisol growth hormone, can cause blood sugar to rise too.  So if a person has nothing to eat in the morning sometimes the blood sugar will rise whether they have coffee or not because of the hormones rising in the morning.  Many people experience when they drink coffee, their glucose, their sugar bumps up even more. That’s not everybody.  It’s not a rule – it’s more of an observation. 

Alissa:  If that were the case and somebody realized that the caffeine in coffee was spiking their blood sugar, do you have a recommendation as an alternative form of caffeine?

Dr. Blevins: I think it’s fundamentally the caffeine in the coffee.  Usually when somebody drinks decaf you don’t see it happen, but I think caffeine probably interacts with the sympathetic nervous system a bit and that can sort of push the blood sugar up a bit, and it has that stimulatory affect and that’s what coffee’s all about and I think it acts on the sympathetic nervous system to cause the glucose sugar to go up.

Alissa: It’s been suggested to me as a figure competitor to stop drinking caffeine and coffee because it creates cellulite.  Is that true? Does caffeine cause cellulite?

Dr. Blevins:             No I wouldn't say so.

Please scroll down and make a comment - I'd love to hear what you think!

Watch for the next blog where the interview with Dr Blevins is continued.