Team Type 1 member Adam Driscoll cycles out of the Cuchara Pass in Colorado.

Have you talked to any of the RAAM cyclists?

I've been texting them. And my dad is the crew chief [I talked to him]. When you're done riding your bike [in RAAM], the last thing you want to do is talk to someone! They passed through the halfway point Tuesday night. They had gone over Wolf Creek Pass [in Colorado, which has] 10,000-foot elevation and 40-degree temperatures. . . . Now they're coming out of Illinois. They're about to hit the Appalachians. It's 95 degrees, and they'll be climbing 3- and 4-mile mountains. It's really a test.

What's it like competing in Race Across America, especially with diabetes?

You start at 115 degrees in the desert, and within 24 hours you’re looking at 10,000-foot elevation and 40 degrees. It's really a shock to your system. You come down the mountain and go through Kansas, and every year there are storms when we go through Kansas. One year there were storms causing brush fires.

There's been a few racers on other teams affected by diabetes, but for us it's everyone on our team. We all have to do this race against people without diabetes. We have to make sure that our blood sugars and insulin are where they need to be, and we're always monitoring things. Fortunately we also have Dr. Bill Russell, a pediatric endocrinologist at Vanderbilt University, traveling with the team, and he helps with assessments and situations.

Last year we won and set a new record—with eight people with diabetes—something that four years before people had told me and Phil [Southerland] that we couldn't do with diabetes. That's a testament to the technologies and treatments that are out there now. When I was diagnosed at 10 years old, there was no way I could compete in this race on insulin alone, if I was taking what I took when I was 10. I use Apidra, an insulin pump, and a continuous glucose monitor. If I didn't have the CGM and insulin that works like everyone's normal insulin production, there's no way I could keep up.

What has been the toughest part of the race so far this year?

The biggest problem for RAAM and people with diabetes is the constant change. Your sensitivity to insulin changes and your requirements change, so you constantly have to worry about going low. I know a couple of guys did get some lows, and they are the No. 1 thing you have to worry about. But so far everyone's been able to treat themselves and not require assistance.

How many people do you have providing support for the cyclists, and what do they do?

We have 18 or 19 crew members for each team, doing everything from cooking food to fixing bicycles to driving the vans carrying the riders when they're not riding. They have a difficult job, and they sleep less than the riders.

How do cyclists with diabetes manage their blood glucose during a race like this?

Everybody's different for the most part. Some of the riders use Lantus [insulin, once a day] and multiple injections [of other types of insulin] throughout the day. I use the pump and a CGM. [While training,] I take it to my doctor every three months. . . . The key to being successful is to write down all your data and take it in to your doctor to make sure you're doing things right. And during RAAM we're eating tons of food—8,000 to 9,000 calories a day during the race. There were times I'd lose 10 pounds after all that, too.