Meet the Cycling Team That Runs on TUEs to Beat Diabetes

Team Novo Nordisk have to take insulin to compete – a positive application of the sport’s therapeutic use exemptions (TUEs).

Meet the Cycling Team That Runs on TUEs to Beat Diabetes
Injecting a positive message, the members of Team Novo Nordisk are all diabetic and must use insulin while they compete. Photograph: Tim De Waele

“It is pretty simple,” says Stephen Clancy, in a voice so soft one fears it might shatter. “We don’t abuse TUEs. We don’t get performance gains. For us it is literally a matter of life or death: if we don’t take them we will die. And I think it would be unfair if someone said I shouldn’t be granted one for a lifelong condition.” He pauses, collects his thoughts and tugs another heartstring. “And aside from health reasons, you are going to tear away someone’s dreams.”

The subject is therapeutic use exemptions (TUEs)– certificates that allow athletes to use medication on the World Anti-Doping Agency’s prohibited substances list because of an illness or condition – and whether they should be restricted or even banned. It is an issue that was blasted into the mainstream in September when the Russian hackers Fancy Bears published details of private TUEs of dozens of Olympic competitors. And it is one that appears likely to flare up again, given that Fancy Bears is promising more revelations and Team Sky’s Dave Brailsford is due to appear in parliament next month to answer why Bradley Wiggins received TUEs for triamcinolone – a substance which has a history of abuse in cycling and is otherwise banned – on the eve of the Tour de France in 2011 and 2012 and the Giro d’Italia in 2013.

Yet Clancy, a bright and amiable 24-year-old professional cyclist from Limerick, makes a passionate and persuasive case for why TUEs are absolutely necessary. For he, along with every rider in the Team Novo Nordisk cycling squad, has Type 1 diabetes. And without a TUE for insulin, as well as an exemption to the UCI’s no needles policy, he and his team-mates would not be able to compete.

Not that it an easy existence: the team use continuous glucose monitors – small implants under their skin which let them track their sugar levels and vibrate if they go too high or low – when racing. If they get too low, riders must eat carbohydrates; too high they will use a pen or a pump to inject insulin as they ride. Which has provoked some interesting reactions from others in the peloton, concedes Clancy. “When we started in 2012 there were some startled faces during races but mostly they think it’s pretty cool and impressive,” he adds. “Because more often than not they know someone who has diabetes but also the jersey is hard to miss and the story is strong.”

That story began with an American, Phil Southerland, who in 2005 borrowed $400 to start a diabetes cycling team – Team Type One – with his friend Joe Eldridge when they were students. Initially their goals were modest: Southerland, a diabetic and keen cyclist himself, had seen the rower Sir Steve Redgrave and the swimmer Gary Hall with gold medals in their sports and wanted to set up a cycle team to raise awareness and inspire other diabetics. But within three years Type One had turned professional. And in December 2012 the Danish healthcare company Novo Nordisk began backing the team, which allowed Southerland to set his sights even higher.

Despite a number of injuries the team made its debut in stage races on the WorldTour this year, competing in the Tour of Poland against such forces as Team Sky and Movistar – an impressive feat given it can draw only on a pool of riders with diabetes.

“We are constantly scouring the planet for talent,” says Southerland. “Stephen, for instance, was working in a bike shop when we got him to try out for our development team. We have a lot of good youngsters coming through but it is a big challenge to field an all-diabetic team because there just aren’t many athletes out there.

“When 12 of the 18 guys in the team this year were diagnosed, they were told by their doctors you’ll never race a bike again – that it’s just not possible with diabetes. Fortunately we had 12 stubborn kids who didn’t listen to their doctors.”

Southerland knows, however, that not everyone approves of professional cyclists being allowed to use TUEs. Earlier this year the German André Greipel spoke out about exemptions, saying: “If you have trouble with your illness, then you should not ride a bike [professionally].” Southerland disagrees – but concedes that for the TUE system to work it has to be beyond reproach.

“As a starting point it would be great to see every team join the Mouvement Pour un Cyclisme Crédible [MPCC] – the voluntary code for cycling teams which binds teams to a stricter set of rules,” he says. “And it is a little disheartening not every pro team is on there. It would be great to see Sky and Movistar join because the MPCC is about doing things the right way and keeping the image of cycling to a standard that we all want it to be at.”

And what of Wiggins’ taking such a powerful TUE just before competing in the Tour de France and Giro d’Italia? “I have a tremendous amount of respect for Wiggins. He has been a damn good athlete for a long time,” says Southerland diplomatically. “Everything he did was legal but I think when an athlete applies for a TUE just ahead of a major race for a corticosteroid, we have got to have a closer look.”

For now, though, the American’s main focus is on getting Novo Nordisk to the 2021 Tour de France to coincide with the 100th anniversary of the invention of insulin. But he insists his team will not take short cuts to get there. “The only thing we really need is time,” he says. “It takes time to develop athletes. It takes time to develop champions. We are not going to risk breaking them. But at the same time nothing is going to break us.”

Source: The Observer