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Mandy Marquardt spends her days training and racing furiously around a velodrome. She's a track sprint cyclist, and by age 16, she already was winning medals in junior events when a routine checkup revealed high blood glucose.

Follow-up tests discovered Type 1 diabetes. The diagnosis prompted her doctor to proclaim her cycling future would center on fun and exercise rather than grueling training and competition.

"It was life-changing," said Marquardt, now 30. "You want to be a reckless teenager, but here I was faced with this challenge of learning how to dial in my nutrition, adapt and adjust to find a way to continue to compete and live a normal life."

She has done all that, rising to the top of her sport and demonstrating that diabetes need not put the brakes on a cycling career – or on life.

Type 1 diabetes occurs when the pancreas doesn't produce insulin, a hormone that enables blood glucose to enter the body's cells to be used for energy. Without it, glucose builds up in the bloodstream, with potentially life-threatening complications such as cardiovascular disease.

Unlike Type 2 diabetes, which is the more common form associated with overweight or obesity, insulin resistance and physical inactivity, Type 1 diabetes is caused by the immune system mistakenly attacking and destroying the cells that produce insulin.

For Marquardt, who will compete next week for the USA Cycling National Team at the UCI Track Cycling World Championships in France, managing Type 1 diabetes while contending at the highest level of her sport is a complicated, ever-changing mix of monitoring glucose levels, taking insulin injections and focusing on optimal nutrition.

"There are many variables that can affect my blood sugar, from nutrition to time zone changes, and especially race day nerves," she said. "If my blood sugars are high, it could affect my ability to recover between sprint events, but I never want my condition to be an excuse. It's something I'm constantly monitoring."

She's thankful for personal support from peers and coaches as well as technological help from a continuous glucose monitor. It provides blood glucose readings on her phone in real time through a filament inserted under the skin.

"For athletes with diabetes, the technology has made a huge difference," said Charlotte Hayes, who supports Marquardt on Team Novo Nordisk, a professional cycling team whose athletes all have Type 1 diabetes. "We can use all the information we have to help avoid extreme lows or highs that could be dangerous."

That's true for all people with diabetes, said Hayes, who oversees diabetes, wellness and education for the team. But for Marquardt and other elite athletes, the demands of travel, the intensity of training and the stress of competition ratchet up the stakes.

"It's a challenge for any athlete with Type 1," said Hayes. "You really have to appreciate the amount of focus they have."

Focus hasn't been an issue for Marquardt. She has competed around the world and racked up records and titles. She's also working on her MBA at Penn State, while finding time to mentor kids with diabetes.

"When sharing my journey, I love seeing kids light up, knowing they can do it too," said Marquardt, who lives in Allentown, Pennsylvania. "I'm really grateful to be a role model."

"Inspiration" is the word Hayes uses to describe Marquardt as both an athlete and an individual. "She is showing the world that Type 1 diabetes doesn't have to be a barrier to reaching your dreams," Hayes said.

The year hasn't been without disappointment. As a member of the USA Cycling team, she qualified for a women's sprint spot for the Tokyo Olympics but then was selected as an alternate. She didn't make the trip because the delegation was scaled down due to the pandemic.

"Just like with diabetes, you don't always have control of the outcome. But you do have control of how you respond," she said. "2024 is right around the corner, and I'm totally in."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.

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