Challenges for athletes with type 1 diabetes are numerous. To find the individual balance between energy intake and consumption and adequate insulin treatment without risking severe hypoglycemia or hyperglycemia is a demanding task. Nevertheless, people with type 1 diabetes are active in various sports, both individually and as members of teams (1,2). We report on the first athlete with type 1 diabetes ever to finish solo what is probably the hardest bicycle race worldwide—the Race Across America (RAAM). The U.S. race stretches from Oceanside, CA, to Annapolis, MD, over ∼3,000 miles and 170,000 vertical feet and has to be finished within 12 days.

T.H., a 53-year-old Austrian amateur cyclist working as a nurse in a retirement home, qualified for the 2018 RAAM after regular endurance bike training and competitions, as well as previous participation in marathon runs and triathlons. Diagnosed with type 1 diabetes in 2003,...

You do not currently have access to this content.