Racing and Type 1 Diabetes
Chris Lewis & Don Matz
Photos: Frank Spasaro
Chris Lewis always wanted to race! When he finally got the opportunity he headed for the Willow Springs International Raceway. Chris was 23 years old, driving his car to the track and having a ball. In March of 2009, however, Chris was diagnosed with type 1 diabetes and life, as he knew it, changed dramatically.
Chris really loved racing, however, and wasn’t about to let this disease crimp his style. He was determined to continue.
Chris’s first event, after being diagnosed, was at Chuckwalla. He was driving a 2002 Porsche Boxster S. He didn’t want to miss one run session, but now there were a few hurdles he had to clear before he got in the car. Racing causes an adrenaline rush which, in turn, causes a spike in bloodsugar. This results in fatigue and disoriention…not good qualities for a racecar driver. If Chris’s bloodsugar level rose above 400… he’d be heading straight for the emergency room. Insulin shots are needed to lower bloodsugar levels, especially before meals, and if too much insulin is given he could pass out. So, Chris had to prick his finger, testing his blood with a glucose meter each time he went out onto the track. What a balancing act!
It was October, 2013 when Chris first attended a POC event at the Auto Club Speedway. He’d be racing his 2002 Porsche Carrera 4S in Time Attack. By then he had become fairly proficient at keeping his blood levels in the normal range, he was accustomed to taking insulin shots between each run session. But every time Chris got in the car he was conscious of what was going on in his body and a little uncertain of what might happen if his levels went out of norm while on the track. Somehow, he got by!
A year later, in December, Chris’s insurance carrier came through big time. He was able to get a Continuous Glucose Monitor. His new GCM utilized a small sensor injected under Chris’s skin and a clip-on radio transmitter that sent data to a receiver the size of a pager. Chris was now receiving bloodsugar readings every 5 mins. Then, to add to his good fortune, Chris stumbled upon a Non Profit organization called Nightscout. The members of Nightscout figured out how to plug a Dexcom receiver into an Andriod phone taking realtime bloodsugar data and uploading it to the internet via their software. This allowed for remote monitoring of CGM Data.
This system not only turned out to be a great way for parents to monitor their childs bloodsugar while they were at school, it also turned out to be extremely valuable to a guy behind the wheel of a racecar. Someone, then, developed a Pebble Smartwatch app that displayed bloodsugar and updated it every 5 minutes. With Chris’s background in computer systems and programming he was able to add this component and complete the circle. Now, at a glance to his wrist, Chris could see where his levels were at and feel comfortable going into turn 1 at Fontana at 140 mph. Bonus Perk it would still transmit to his wrist without cell phone reception.
In 2016 Dexcom released a new CGM transmitter which talked directly over Bluetooth. Now Chris had the dexcom app on his iPhone allowing him to see a display on an Apple or Pebble Watch. This reduced the devices he had to carry while keeping him connected to the Nightscout software. In addition, Dexcom also intregrated their own remote monitoring capabilities.
2017 was a landmark year for Nightscout as the developers and collaborators managed to piece together a closed loop Artificial Pancreas system using a Dexcom Transmitter, Older Medtronic Insulin Pumps, a custom Apple iOS app and a custom circuit board called Riley Link.
In March 2017 Chris was able to track down an older insulin pump he needed for his DIY Artificial Pancreas…only certain older medtronic pumps would work. Chris ordered a Riley Link which was a Bluetooth to Radio frequency bridge between the insulin pump and the iPhone. Finally, he downloaded the Loop iOS app files to his iPhone. Within a few hours, he was using a closed loop system.
Running the Loop iOS app on his iPhone monitored his dexcom bloodsugar reading in turn telling the insulin pump to suspend or give insulin automatically. This was based off the predicted sugar levels, an algorithm and Chris’s custom settings. This Artificial Pancreas, however, had an issue. The downside to the system was it’s vulnerability to being hacked. Mainstream Artificial Pancreas systems are still awaiting FDA approval. So, rather than wait, Chris felt that the upside far outweighed the downside and began using it.
Chris was planning on attending his final POC cup racing clinic at Buttonwillow in March and figured it would be a great test wearing the DIY closed loop artificial pancreas on the track. He only had a few days to get the system dialed in and working correctly. There are custom settings that include how quickly or slowly food digests, how much 1 unit of insulin will lower your bloodsugar, and how long insulin stays in your system. Chris already had his diabetes under good control…understanding his carb to insulin ratio, carb absorption time and insulin sensitivities. Chris said “I couldn’t believe how well my first session went on Saturday using Loop. Normally once the excitement and adrenaline kicks in my bloodsugar would blast off to 200 but this time, as his levels started to rise, Loop kicked in and notified the insulin pump to start pumping enough insulin to get me back in target range. Loop managed to keep my bloodsugar levels below 170 mg/dl the whole race weekend”. This not only lead to better driving and completing his clinic but also (WAIT FOR IT) it’s going to put Chris into the Guinness Book of World Records by becoming the first type 1 diabetic to race while wearing a closed loop artificial pancreas. AND, he set a track record in his class!
At the POC Tribute to LeMans event in May, Precision Motion invited Chris to drive on their team during the 3 hour endurance race. He accepted the invitation and drove the first one-hour stint using Loop, his artificial pancreas system. This would be the longest driving session ever by a driver with type 1 diabetes on an artificial pancreas. It was amazing how well Loop kept Chris’s bloodsugar in target range. His pitcrew could also keep an eye on his sugar levels and what Loop was doing. Chris’s team finished the Tribute just shy of the podium and Chris ended up setting the teams fastest lap. Afterwards he submitted another application to Guinness for being the first type 1 diabetic to race in a Porsche endurance race while wearing a closed loop artificial pancreas.