Limerick cyclist Stephen Clancy was on a teaching placement last January when he got the phone call from his mother. "We got your blood tests back and the doctor wants you to go into hospital."
Just a few months earlier, the then 19-year-old member of the U-23 national development squad had ended the 2011 season with a stage win and overall victory in the Charleville 2-Day and, having gone from third category to first category in his first year as a senior rider, was awarded Domestic Cyclist of the Year by Cycling Ireland.
"I was super motivated, training really well and was looking forward to some good results in 2012," Clancy says as he sits at home in Dooradoyle. "I'd been on a training camp with the U-23 squad and (former international) Sean Lacey was there and he was saying 'Jesus, you're going better than me' -- and he'd be aiming for the Lacey Cup in Tralee at the start of the year."
But shortly after, things began to go downhill. Advised to undergo a routine blood test by Cycling Ireland coach Paddy Doran as part of the U-23 set-up, Clancy went to his local GP. When his blood sugars came back high, the doctor advised him to look after his diet -- which was already that of an athlete -- for two weeks before doing another test. When the second set of results came back, the doctor phoned Stephen's mother, told her to drive him to hospital. "It looks pretty much like he has diabetes."
When the diagnosis was confirmed that night in Limerick Hospital, it was a bolt from the blue for the teenager who was used to racing up to 160km on his bike most Sundays.
"That was a shocker," Clancy admits. "I really didn't understand what was going on at the time. When I got my sugar levels tested at the doctors the first time I asked him, out of the blue, if it could be diabetes. He said: 'Well maybe, we don't know yet'. At the time, I thought diabetes was just for lads who ate too much sugary foods. I didn't know that Type 1 isn't self-inflicted. It's an auto-immune condition. It was all confusion. How is this possible? Is this really happening?
"It's not a case where you're diagnosed with something and, over time, you gradually adapt to it. With diabetes, right from the gun, you have to start taking insulin jabs, testing your blood, straight away. That was a complete shock. From that night on, I was a type one diabetic, insulin-dependent for the rest of my life."
One year later, hindsight means he can see the warning signs he missed back then. He was a classic example.
"At first I'd been losing a few kilos bit by bit," he says of the early symptoms. "I was happy, thinking 'I'll be able to get up the hills a bit quicker,' but then I was tired the whole time. I had no energy, my muscles were cramping. I was thirsty, hungry. I was using the toilet a lot during the day, throughout the night and everything."
After his diagnosis, he experienced something all too many diabetics experience. He was immediately told what he couldn't do.
"At that stage I was wondering if this was the end of my cycling," Clancy recalls. "First of all, a nurse came in and the first thing she mentioned to me were the jobs I couldn't do, because I had diabetes.
"You can't be a pilot. You can't be a bus driver."
"That was really negative from the outset and it really upset me to be told 'you can't do this. People don't want you in this job'. You're being pushed away. That was upsetting. Then the consultant came in and, to make matters worse, he'd heard that I was a competitive cyclist. He asked me how much I trained and what was involved."
"I'd recommend... maybe now... just to cycle a mile," he advised.
"You're joking! I'm used to doing 100 miles."
"No. No. These extreme levels of exercise could complicate your condition. Diabetes is difficult enough to manage never mind going out and pushing your body to extreme limits."
For a guy who never took a tablet for a headache and "wasn't too fond of needles," Clancy handled those first glucose monitoring finger pricks and insulin jabs pretty well, but taking away his cycling was a different story.
"I was just in tears," he admits. "Cycling is my sport. I love it and to be told maybe it's not the best idea was devastating."
Allowed out of the hospital for a few hours the next day, however, Clancy defied doctor's orders and mounted his bike on an indoor trainer at home.
"I hopped up on my bike and was checking my blood sugar levels every 10 or 15 minutes. I did an hour's spin while they let me out of the hospital just to see what it did to my body, to my sugar levels, before I went back in for more monitoring.
"There were a couple of hours there where I thought 'my cycling is in danger. It could be over. It's time to move on'. But then I remembered watching this team of diabetics on TV, they were called Team Type1 at the time. I did a little bit more research. I ordered the team founder, Phil Southerland's, autobiography 'Not Dead Yet' and immediately, my attitude completely turned around.
"That was the turning point. That negative feeling didn't last too long. I was focused on getting back cycling. It was 'right, this isn't going to get in the way' sort of thing. If they can do it, I can do it."
After learning how to monitor his blood and use the insulin pen, Clancy set his targets on a return to racing on the domestic scene. But it was going to take time.
"Some people were worried I'd rush back and maybe something would go wrong in a race, so it took a few months," he says. "In that time, all of my training was done alone, because every 15 or 20 minutes I was going to have to stop at the side of the road, take off my glove and prick my little finger to check the blood levels. I couldn't ask someone to go out and train with me and do that.
"I did short spins, half an hour to an hour, and then built it up to two or three hours. At first, I was quite nervous. If I was three hours away from home and something negative happened, diabetes related, what was I going to do? It took a while to get some confidence in managing the condition,
becoming aware of my body."
While training was one thing, racing was a whole new ball game. How would he monitor his blood sugars in a two or three-hour race, in the middle of a heaving peloton?
"In the beginning, I perfected this technique of dropping to the back of the bunch, pulling out this monitor, riding no-handed for a few hundred metres and pricking my finger. Then I knew if I needed to eat, or needed insulin, or water, or whatever. It wasn't ideal.
"Fellas were looking at me pulling out this monitor, thinking is that a mobile phone? Is he texting his girlfriend or something? It does take time to get used to how your body reacts, but you need to give it the effort it deserves. It's your body you're looking after at the end of the day. Every day you're going to learn something new. You have to learn from your mistakes and don't be afraid of trying new things.
"A lot of diabetics are afraid to exercise for fear of negative things happening, but you won't know until you try. Even if something does go wrong then you can learn from that. You can ask 'why did that happen? What can I do differently with my insulin, my food, my preparation?'"
Just six months after being diagnosed, Clancy was not only back racing in Ireland, but was invited to America to train with the Team Type1 professional squad.
"I came across another cyclist, Darragh Campbell, also a diabetic. He was giving me a few hints and tips and Team Type1 came up in conversation. He'd already been in contact with the team founder, Phil Southerland, and he passed on Phil's email. For me, Phil was this absolute idol.
"What he could do with diabetes was unbelievable in my eyes and every diabetic's eyes. He was this diabetes and exercise god, a person of inspiration. I sent him an email. At the exact same time, Team Type1 was contacting national federations around the world to see if they had any diabetic riders and had emailed Cycling Ireland. The U-23 national coach Paddy Doran knew I was diabetic and we made contact that way. It was strange how it came about."
After three weeks' training with the team in Atlanta, Clancy got another shock, this time a pleasant one. Just six months after being told he would never race again because he had diabetes, he was offered a two-year professional contract with the world's first all-diabetic team for exactly the same reason.
"Unexpected is an absolute understatement," he admits. "To go over and be living with 10 or 12 guys, who all had type one diabetes, was a great experience. We all understood each other, all learned from each other. I thought at the time it was a two or three-week block and that was it. I'd taken time off work in a bike shop and had to be back for a certain day to start back in college. Let's be fair. Let's be honest. If I hadn't been diabetic, I wouldn't have turned pro. It opened up that opportunity for me.
"That's what the team is all about. They've witnessed so many stories of people being diagnosed and then being told 'you can't do this. You can't do that'. People getting depressed, viewing it so negatively. People still ask me if it's fair that we have to race against guys who don't have diabetes. The general attitude and opinion is 'you poor fella, you're restricted in some way'. We're just trying to get the message out there that you're not. Let's show the world you can do this!"
Backed by the world leaders in diabetes control medicine, the squad is now known as Team Novo Nordisk and the multi-national outfit is now eligible for a wildcard entry to the Grand Tours of France, Spain and Italy. To have a team of diabetics ride the Tour de France in 2021, the centenary year of the invention of insulin, is their stated goal.
"It would be a nice way to celebrate the drug that keeps us alive by riding the Tour de France, but that's a bit further down the line," Clancy admits.
"We've a long way to go. We're a young team, a new team, so the start of the Giro d'Italia in Belfast next year is probably not an option either. But the set-up is fantastic, with team buses, trucks, mechanics, equipment, everything.
"When I turned up at training camp, instead of having to prick my finger during the race, we got continuous glucose monitors. I wear a little sensor on my stomach. It's like a little bristle under the skin that transfers wirelessly to a little receiver in my pocket and gives me a graph of my sugar levels. I can see if I'm on the way up or down and it warns you if it's too high or low.
"That, for me, is an absolute game-changer. I won't say I wouldn't be able to race without it, but it certainly improves how you control it during races. You constantly adjust your body's needs, levels of insulin and learning about the food you're eating. For us, it's all about carbohydrates. Slow release, fast release, how much insulin to take and when to take it. My body's needs are completely different to my team-mates' needs. There's no perfect formula to it. For me to be part of a pro continental team is just unbelievable. It's a huge turnaround from heading down to Tralee at the start of the year with my bike in the boot of the car."
As well as riding the world's biggest bike races, the squad takes part in conferences and awareness programs relating to diabetes and their message is imprinted in bold blue letters across their bright white jerseys. They're 'Changing Diabetes'.
"The goal of the team is to spread this message of changing diabetes to as many people as possible and show them what you can achieve with diabetes," says Clancy. "But the sense of satisfaction to be on a team that not only races bikes, but also has a positive impact on peoples lives, a dual purpose... it's more rewarding.
"I get questions from rugby players or footballers who maybe have to control their glucose levels for an hour and a half. If we can complete something like the longest one-day classic, Milan-San Remo, and show the world, 'look I've just ridden 300km and raced for six hours non-stop,' that would have a huge impact.
"You're often at a race and some young type one diabetic will come up to the team bus and they just seem to be inspired. You'd hear kids saying 'look Mom, he has diabetes too,' and they often end up in tears when they see they can do this. They know having diabetes is not the end of the world. It's moments like that when you realise this team is about more than just racing your bike."