In February of 2014, 25-year-old Robin Arzon, a NYC-based marathoner and Peloton cycling instructor, was preparing for a race when she found herself feeling extremely thirsty and fatigued. A visit to the doctor for a blood test turned out to be a diagnosis of type 1 diabetes. "I was shocked," says Arzon.
But she was also determined to prevent diabetes from defining her. Within weeks she was using an OmniPod insulin pump on her arm and a Dexcom continuous glucose monitor to keep an eagle eye on her blood sugar levels as she continued to train —and finish the half-marathon.
“I was nervous about the race. I didn't know what was going to happen with my blood sugar. At that point I was really figuring out my insulin levels, I had zero clue how my body was going to treat it," she says. "I think I use fear as fuel to do more stuff."
Using fear as her fuel appears to be working. The loquacious and sassy Arzon, who always has clementines and sugar gels with her during exercise, has since competed in numerous marathons and ultra-marathons, trains 30 to 40 hours a week on runs through the streets of New York City, and continues teaching vigorous Peloton cycling classes. In May, Arzon completed a 100-mile race in 29 hours with just one blood sugar low.
"Diabetes is a constant thing that you have to be aware of, there's never a time when you are not checking your blood sugar. It's really trial and error, there is no other way to do it. You really need to take interest in your diabetes management and I’ve had that interest since the beginning, " says Arzon. "I understand if one is a child how much harder that could be but certainly with the adults with type one, I think there is the technology is out there and you have to pay attention to how you are eating, how much you're moving, to how you're feeling because emotions can effect blood sugar highs as well. I just think I try to invest in self awareness and that definitely informs how I treat my body to make sure it's not going too high or too low," she says.
"My training has increased, it's much more aggressive than it used to be as my competing has advanced," she says."It's just one more opportunity to show how strong I am."
Type 1 diabetes presents many challenges for athletes, says Steven Griffen, M.D., senior vice president of research at JDRF. A person with Type 1 can't produce insulin and must take regular insulin injections to regulate blood sugar. Since exercise affects blood sugar, one must learn to adjust how much more —or less— insulin and carbohydrates to take in during activity, he says.
If not properly monitored, Dr. Griffen says, low blood sugar created by exercise can lead to seizures, passing out or, even death. "In addition to pushing through all the running, she has to keep her mind on her diabetes management and her blood sugar," says Dr. Griffen. "It's a complicated task."
Regarding Arzon's 100-miler, Dr. Griffen says: "Without diabetes it is an amazing accomplishment, but to do it with diabetes is just incredible. I don't know how she does it, she's amazing.”
Arzon is still searching for a primary care doc or endocrinoligist who understands how to work with ultra marathoners. Does she feel as though she is pushing her body past its limits? "I am perhaps contrarian by nature. I do think there is a form of acceptable risk and you have to decide how much is acceptable for you in terms of the risk and for me. I am pretty risky, and I know my body much better than most medical professionals I've dealt with because they have not done the physical things I've done with my body. I know what I can do. That said, blood work is blood work and insulin is insulin."
However, she adds "Once you are getting into 100-mile running territory, it's a pretty rare thing to do and most doctors haven't had patients that do that. But specifically for type 1, It's very very rare, I have a few friends who are type 1 diabetics who are endurance athletes and they've given me some recommendations, but I am dealing with a basic team right now, and it's worked so far but I would always be interested in speaking to someone with experience for sure."
Following law school, Arzon was working as a corporate litigator for a top New York law firm, but finding herself most looking forward to one thing: her post-work runs. After seven years of practicing law, Arzon quit to pursue her passions of running and other athletic ventures.
She regularly shares her passion for competition on social media and currently has more than 80,000 Instagram followers. She attracted Adidas as a sponsor, and earlier this year, she published the running book "Shut Up and Run."
"I think if you don't try you don't know," she says of the significant life changes — and accomplishments —she's made in the last several years. "If you don't try to run a mile, you will certainly never run a mile. You are sealing your fate before you even allow failure to do it."
"I've failed so many times, and it's all been really worth it in the end. What is the point of staying in a place that you know isn't making you happy. You may as well try for something and if it doesn't work out, you pivot. You figure something else out."
Soon after Arzon's diagnosis she had to figure out how to use an Omnipod. Since Arzon's taut abdomen wasn't an option because it's so lean, it was suggested she wear it on her arm.
"At first I said 'Absolutely not'. I teach every single day on the Peloton bike in front of literally thousands of people,'" she says. (Peloton classes are broadcast worldwide to subscribers.)
"And literally two days later I slapped it on. After I made that decision, I never thought about it again. I live my life in a sports bra and shorts and I run around and this is just another layer of body acceptance."
Arzon likens having diabetes to being on a tightrope—always anticipating how her body will react before she eats or does anything. "These decisions are 24 hours a day," she says. "You do your best and you guess."
She's learned to use meditation and breathing to lower her blood sugar, and like she did before her diagnosis, eats a whole-foods, plant-based diet, with lots of vegetables and minimal processed foods.
Arzon encourages others with type 1 diabetes to be aware of and trust in their own bodies. "We can become dependent on the technology almost to a fault," she says. "It's important to be aware of what sports do what to your body, and to know what a low feels like or what a high feels like. I think people can surprise themselves every day with how much their body is capable of."