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Abstract:
In this interview, Nigel Batten, Founder of Round the Isle – Triathlon, CIMSPA Personal Trainer Practitioner, Performance Nutritionist, and Product Support Specialist at GARMIN, shares his unique journey of living, training, and competing with type 2 diabetes. Despite being a lifelong athlete and triathlete, Nigel was diagnosed first with prediabetes and later with type 2 diabetes, challenging the common misconception that the condition only affects those who are overweight or inactive.
In conversation with Dr Michelle de la Vega, PhD, VP of Science Education at The Health Sciences Academy, Nigel reflects on the confusion, frustration, and learning curve that followed his diagnosis, including his experience with medications that disrupted performance, the life-changing insights gained from continuous glucose monitoring, and the process of optimising his nutrition for endurance sport.
Key themes include:
- The myths and realities of type 2 diabetes in athletes
- The limits of standard treatment approaches when applied to highly active individuals
- How CGMs and self-monitoring transformed Nigel’s understanding of his blood glucose responses
- The role of nutrition strategies (carb cycling, gels, hydration) in managing diabetes during training and competition
- The gaps in practitioner support and the urgent need for tailored guidance in type 2 diabetes management for active populations
Nigel’s interview underscores the importance of personalisation, persistence, and proactive communication with healthcare providers, while offering valuable lessons for practitioners, coaches, and individuals navigating diabetes alongside an active lifestyle.
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Below is the full interview transcript for you:
Dr Michelle de la Vega
PhD, Research Scientist, VP of Science Education at The Health Sciences Academy
Nigel Batten
Founder of Round the Isle – Triathlon, CIMSPA Personal Trainer Practitioner, Performance Nutritionist, and Product Support Specialist at GARMIN
Dr Michelle de la Vega:
Hi, Nigel. Michelle de la Vega here from The Health Sciences Academy. And I do have to say that I am truly honoured to have the opportunity to speak with you today. Your story has actually inspired many, myself included. And as I mentioned to you before, I am truly fascinated and in awe of anyone who can do a triathlon. I’m just so impressed.
So I’m really looking forward to hearing more about your story, both your personal and your professional journey. And how you’ve navigated this in your sports and as an athlete and a coach as well with having diabetes. Can you tell me a little bit about yourself? Like, what are you working on, and what is your involvement in sport, and what does a normal week look like to you?
Nigel Batten:
At the moment, I work in a secondary-level school, working with special needs students. So I do a mix of PE, sports leadership, English, maths, and personal development with the students as well. So a lot of coaching is involved in that. Outside of that, I spend a lot of my time training for triathlons, as you mentioned. I do those. I’ve been involved in triathlons since 2020.
I’ve been doing that, and I’ll spend probably three to five days a week training towards the triathlon with a big, specific event in mind.
Michelle:
You’ve done sports since you were young, you’ve gone into rugby and hockey and now on to triathlons. What was your reaction when you were told that you had prediabetes or when you were told that you had type 2 diabetes, despite being an athlete, despite being fit?
Nigel:
Yeah, I was really confused initially. I have diabetes in my family on both sides. I’m the only person in my family who actively does sports, rugby, hockey, the endurance side of things that I’ve been doing. And so to get that prediabetes diagnosis was, I mean, I took it as a moment to reflect. I was like, okay, am I doing something drastically wrong with my diet? Looked at it, okay, there were things that could have been better, but there wasn’t a great deal that stood out for me.
It wasn’t until I got the type 2 diabetes diagnosis that I really sat back. I was like, something’s amiss here because I’m training and I’m training hard, but I’ve still got this. Where has it come from? So, yeah, a lot of confusion, a lot of not anger, but, you know, frustration.
“Certainly, type 2 diabetes is typically associated with people who have an inactive lifestyle. And yet here I am.”
All I can do is just make the best of the situation I’m in. So I’ve just got to manage it properly, manage it effectively. It’s been a learning journey, and it’s been one that I’m happy with what I’ve learned.
“I kind of wish that there was more information available at the right time, if that makes sense. So there’s been a lot of talking with GPs and consultants on the best course of action for me. It’s not been smooth sailing because there’s been a lot of ups and downs, particularly with type 2 diabetes and being active in sport.”
So there has been this, I can only best describe it like a tug of war battle with my consultants as to the best course of action. But I’m getting there. I’m getting there. So I think that’s the main thing now.
Michelle:
I want to point out a couple of things, and I have a few follow-up questions about that, too – it is a huge myth that type 2 diabetes used to be considered just for individuals who are obese or overweight, that other individuals couldn’t get it. If you were fit, it had to be type 1 or a different type of diabetes, but that’s no longer the case. It’s a contributing factor. It is a very important contributing factor, but it is not the only factor. So there are other things that influence it besides just what we eat and how much excess body fat, how much visceral fat that someone may have, that actually contribute to the risk for type 2 diabetes and that diagnosis.
So it is a shock for a lot of people, especially those who might be in a similar situation as you were. Did you have symptoms initially, or how did you get that initial prediabetes diagnosis? Were you feeling unwell and you went to the doctor? Because if you’re not overweight or obese, it’s unlikely that a medical doctor would test you for fasting blood sugar levels.
Nigel:
Yeah, so I’d had a couple of periods where after meals I felt a bit sluggish. But I mean, my symptoms were really subtle, really minimal. I’ve had a couple of episodes where I’ve gone to the hospital, where I’d just had no energy and felt like I couldn’t get up. I think it was two situations where I got taken in by the doctor because they said, “Look, you’ve fallen down. Let’s take you in, get you looked at.” And each time was like, “Oh, your blood sugars are a bit high.”
And then obviously later to the type 2 was just a reflective appointment or a scheduled appointment as part of my prediabetes acknowledgement and they said okay you’re in type 2 area now your blood sugars are at that level where we we would diagnose it so I went back for the second lot of blood tests to confirm it and again blood sugars were high and so they confirmed type 2 diabetes at that point and I’m now last week actually I went to genetic testing which was something that eventually got organised by the consultant.
I think for anyone who gets that type 2 diagnosis that I’ve met, there’s this need to sort of get answers. Everything is as wonderful as the NHS is, lots of stuff takes time. And it’s just the way it is now.
If you can’t wait for the answer, I think we’re at that stage where we’ve got to go looking for the answers. And thankfully, I’m one for sticking my nose in a book and finding out. So I’ve been able to manage my symptoms and my progress as I’ve gone along rather than sit and wait for answers.
Michelle:
And what support did you get after your prediabetes diagnosis or after your type 2 diabetes? Was there nutritional or lifestyle behavior support for you or was it just, here’s the medication, try this? What was your experience?
Nigel:
It was a little bit of a mix. So when I got the type 2 diagnosis, I went in for a consultancy with my GP. We sat down, and we looked at the food diary. I did a seven day read called Food Diary. And they looked at it and they were like, well, I can’t see anything wrong. There’s minimal stuff to change. And I was like, yeah, I get that. Me too. At which point I was put straight on to Metformin to manage it after the type 2 diagnosis. I was like, OK.
It turned out not to be the best course of treatment. I think it took about two weeks after I completed a race shortly after starting Metformin. In only a sprint race at the time, I came away very disheartened. I felt like my training had all gone backwards and that I almost didn’t finish my race.
“Within a week, I was in hospital, having almost collapsed at home, zero energy, at which point I consulted the doctor. I was told to come off Metformin.”
I was then put onto Dapagliflozin as the next course of medication. Now, initially, I was wary about this. I’ve done some research into Dapagliflozin, and there was a potential issue of dehydration in endurance sports. Within a few days of starting Dapagliflozin, I felt that it wasn’t going to be the right medication for me. I was already drinking, I must have been on about five litres a day of fluid and still feeling thirsty and constantly urinating.
It wasn’t long before, it was only a few more days after I became wary of how much I was doing that, I was back in hospital again, having virtually collapsed at the dinner table, unable to stay awake. And I came off that again. And I think the most concerning thing about the medication side of things for me was the fact that once I’d sort of gone to the consultant and said, look, these two medications really have not worked.
“I can’t have the risk of crashing during the day, particularly where I work in a Special Educational Needs school as well. It became a high-risk situation for me and I work with students that can be quite aggressive and quite volatile. Now, if I’m unconscious in the classroom, that’s not a good place for me to be, let alone the performance side of things. You know, there was a big personal risk to that happening to me.”
And it was at that point where I decided I’m going to come off the medication*. Thankfully, my GP, bless her, she has the most lovely and best intentions in the world, got me onto a CGM, so a Continuous Glucose Monitor.
Michelle:
What were you doing for testing beforehand? Were you testing at home or were you just doing it every once in a while when you went to the medical doctor?
Nigel:
Yeah, I was testing at home with the finger prick glucose test, which, you know, it’s isn’t it’s not drastically painful or anything like that it’s it’s just the daily sort of having to prick your finger sort of thing but having the CGM I learned so much about my glucose patterns in about six weeks that I was using it for.
I learned so much about how my body responded to different foods, to sleep, to stress, all those really important things that affected my blood glucose levels and the patterns when they were high during the day and when was the best time to take things for myself. That has been the best part of my treatment.
But with triathlon, as we found out, continuous glucose monitors do not like being underwater for continuous periods. It’s not been something that I’ve been able to continue doing while I’ve been training for this event, but I did find it incredibly valuable.
Michelle:
But it’s good that you had that opportunity for at least those six weeks where you tried it out, and you noticed the differences in your body, depending on your stress, depending on your sleep, depending on how you were training or how you were eating. And the amount of information that you actually pulled out of that and learned from that was fantastic.
Nigel:
Yes, it was worth its weight in gold. Those six weeks were fantastic. It’s only for the fact that I spend so much time in the water that I’m not using one now. I would quite happily continue using it. But yeah, I definitely learned a lot. And like I said, it was the best part of the whole treatment plan, or the learning journey, where I was able to get the most out of it.
Michelle:
What do you wish your health care professionals, either the dieticians, the consultants that you spoke with, or the medical doctors, the GPs, understood more about diabetes, or your type of diabetes, your specific case of diabetes and sport?
Nigel:
Yeah, type 2 diabetes in sport and type 1 diabetes in sport, there’s two very different levels of research that I’ve been able to find. But there’s a lot more research being done on type 1 diabetes in sport than type 2 that I’ve certainly been able to find.
My perception of that is possibly is that there’s less type 2 diabetics actively playing sport, so therefore the research would be geared towards type 1 diabetes. I’ve read some fantastic pieces on type 1, which have been passed on to me by some lovely people in various different areas. Again, what I’ve really tried to focus on is type 2 so I can learn about how to manage mine. There doesn’t seem to be a lot, and the emphasis seems to be on best practices to go and lose weight first. But the issue that I’ve got is that I don’t have much weight to lose.
There would just seem to be this stumbling block where I’d said, look, I’ve got my endurance sport. I’ve got an event where I need to consume carbohydrates and quite rapidly digesting carbohydrates during sport. Where do I cross the line from being an acceptable rate of consumption or an acceptable level of blood glucose during my race, you know, how do I manage it afterwards, these sorts of things. And I found it frustrating when the dietitian turned around to me saying, Oh, well, you’re involved in sports nutrition, you probably know more than I do on the subject.
And like, well, I don’t have a degree. And I think that was probably one of the most frustrating. It’s definitely one of the most. It’s not the most because there’s one more I’ve come to in a bit. Most frustrating things to sit, especially as a patient going into a doctor saying that I’ve got this genuine issue. Can you help me with it?
It filled me with this overwhelming sense of dread in the consultation.
Michelle:
Type 1 diabetes in athletes are more studied. There is more research about it. And hopefully, there will be more research about type 2 diabetes in athletes as well coming up. But then that also probably means that there are more athletes with type 2 diabetes, which is also like, eh, we really don’t want that either. So it is, like you mentioned, one of those quid pro quos.
Regarding the dietitian that you were speaking with about not knowing much about sports, with your background – you graduated from The Health Sciences Academy a few years ago and took Nutritional Therapy and the Advanced Sports and Exercise Nutritional Advisor certification. So you are going into this with a knowledge of nutrition, health, sports, nutrition for sports. So with that angle, I’m sure that you do know more about the sports angle, or maybe I shouldn’t say that. But there’s a possibility that you know quite a bit about nutrition.
Nigel:
Yeah, I definitely have. Yeah, I definitely accept the fact that, you know, I’ve been involved in sports since, you know, 2015. As a coach and a practitioner, I’ve been looking at nutrition since then. Graduating with The Health Sciences Academy as well, I accepted the Sports Nutrition Advisor, and then the Nutritional Therapy Certification. They both give me a really good sort of grounding of knowledge towards nutrition in sport. And even since then, I’ve gone on to, to follow on and even keep improving on that.
I have studied it and I’m, I’m exception to the fact that my level isn’t a typical level that you’d find with someone who went in for, that isn’t active, you know, isn’t involved in sport and doesn’t, hasn’t studied those sorts of things. But at the same time, it’s like when you’ve not got, I don’t know, I think it’s a perception more than that. It’s when you go into someone who’s sat in that role, I think you go in thinking that they’ve got all the answers and not everyone has the answers. Yeah, so you go in as the patient, you’re like, oh, I don’t know the answers, I don’t know what’s going on for someone to sit around and say actually I think you probably know more than I do. It makes you sit and pause and yes it was definitely a shock.
Michelle:
So you mentioned that you’ve actually fine -tuned your nutrition a little bit. So on days that you’re training, on days that you’re not training for competition, because what you’re doing each day has to all be a little bit different. On competition day, you’re not going to be eating the same as if you’re on a non-training day or vice versa. So how has your approach changed? Because I’m sure that you were paying attention to these things before your diagnosis as well. Has there been a lot of trial and error, a lot of guesswork, or were you quick to figure out, OK, so I need to have this much protein, I need to have this much carbs, these types of carbs, this quality of GI, and so on?
Nigel:
Yeah, so I looked at it initially. I was like, right, OK, here’s the ideal approach. Here’s how many carbs I need to take, and how much protein I need to take per day. As a typical athlete, I thought, right, okay, my issue is with sugar, with blood glucose. Let’s try bringing my carb intake down slightly when I’m not training and when it comes or when I’m training towards an event. So the idea was that I train low and compete high.
So train on a lower carbohydrate level. Gradually increase towards the point of competition time. And when it comes to competition time, that’s when I’m looking to increase my carbohydrate level back up to what someone would typically take. Prior to an event, I’ll be looking at three grams per kilo of body weight and carbohydrate, just keep it nice and low. For those sessions where I’m training an hour to an hour and a half, if I’m going to train for any longer than an hour and a half, then I’ll consider taking on like a gel for the session just to keep me going.
As we come up to competition time, when the training periods get longer, then I need to really focus on actually, is this reduction in carbohydrates going to benefit me for those longer sessions? I play that one sort of quite by how I’m feeling in need. I’ll take some extra gels out, Extra hydration, things like that, just to keep me going, so that I feel like I’m struggling to get through a session. The main change between microaggressions, when we get to sort of like the later stage of the taper, the carb loading day prior to an event and on the day.
Michelle:
You said you bring gels, do you bring other things to snack on? Do you have like a glucagon emergency pen in case or do you have emergency supplies or anything with you as well?
Nigel:
So for the bike, I’ll have about three liters of water with me for the bike. That in itself will be filled with a hydration mix, so talking like sodium and electrolytes. On the bike as well, on my top bar, I’ll have a series of gels and chews as well. The chew is just to give me something to chew on, feel like I’m eating, just a little bit of a different texture, so you don’t get flavour blindness on the race. They’re both similar carbohydrate intakes. I can pick and choose between the two as I go around.
If I’m feeling particularly bloated or gastric, I can reduce the carb intake down and take on more fluids. If I feel like I’m needing to urinate, you know, just hold back on the fluids a little bit and do everything I can to get me through to the transition point where I can sort of reassess really as to what my next stage is going to need from my nutrition. And again, it’s all going to be dependent on the day and on that weather. So the hydration strategy is going to be key. And yeah, just test and adjust. And I think that’s all it’s going to be.
And so I’ve got that side of things nailed.
Michelle:
So good luck. You’ve done a lot of your prep work and a lot of what you’re doing right now is a lot of trial and error, it seems. So what do you feel like are the key things that are the key tools that you wish that you knew a year ago when you were first diagnosed with type 2 diabetes or 3 years ago when you were first diagnosed with prediabetes?
Nigel:
Yeah, you know, I think what I would have liked to know sooner rather than more recently is, as I say, it was a conversation that I actually had during a consultancy. It was trying to work out, you know, what was an acceptable level of blood glucose during a race. And I still don’t have a definitive answer for that. Anything sort of we’re looking at 15 millimoles plus, then I’ve got to be careful. I’m up into some potentially dangerous ground. But if I’m consuming carbs at a slower rate or a lower rate and spacing them out rather than big bites of carbs, so 60 to 80 grams per hour, if I took all that on at once, my blood sugars are going to go through the roof.
So I’ve got to space them out rather than taking them on. That’s kept my blood sugars lower. They still go up, but they’re not creeping above that. That’s more of a personal limit that I’ve set myself, is to try and keep it under 15.
After a race, I’m looking at bringing those blood sugars back down. For a few days, my carb intake is much lower. I’m acutely aware that being type 2 diabetic and having high blood sugars for extended periods, it’s not going to be good for me. And so on race day, I’ve taken it as sort of an acceptance that it’s going to be high temporarily. If I can bring it back down post-race, then that’s great. But I do need to bring it back down, certainly over the next few days, and get it back onto a more maintainable level.
So that’s what I’ve done. been the thing that I would have liked to have known earlier on, so that I could have felt less apprehensive about taking sugars around an event. Because initially, when you get the type 2 diabetes diagnosis, there’s an immediate fear around sugar. And you’re like, oh, I can’t touch that. I can’t touch that. And sometimes you really can’t. So the more I stress about this, the more likely it’s going to have a negative effect. and not just on the race but on myself as well.
It’s increased stress that you don’t need in life and especially in racing as well. Your body’s under enough stress as it is, you don’t need to cause it more mental stress. I set myself a benchmark of not taking my blood sugars above 15 in a race, not letting them drop to a dangerous level because the other side of that is you’re not going to finish the race because you’re on the side of the road if they drop too low.
Michelle:
A colleague came to you and said that they were just diagnosed with type 2 diabetes. What would you want them to know from day one, and they’re a practitioner, to really understand from the get-go that’s really going to put them in the right direction?
Nigel:
Yeah, I think the really important thing about from the moment you get the diagnosis, is to be reflective. If you can sit there and go, okay, I’ve got the diagnosis, how can I work with this? Rather than just sitting there and either fighting against it or just accepting it and sitting to the side and taking the medication. If you’re already involved in sport and you get the diagnosis, it’s not the end of the day. There are things you can do.
“Don’t stop training. Keep yourself active. And I think that’s the main thing. It’s not that you’ve got type 2. That’s the end of your story. I’ve improved my fitness since the diagnosis.”
It’s not a stop. Don’t stop. Communicate with your consultancy team. Make sure they understand where you’re coming from. And if they don’t, it’s going to involve several conversations. And I’m now, after over a year, only just getting around to having the genetic testing.
It might not be as straightforward as you think, but there’s no reason to panic, especially if you’re currently active. Work out what works for you and yeah, you’ll get, you know, take it easy. I think the more you stress about it, the more difficult your journey is going to be. Be aware of how much sugar you’re taking on. I think very early on, I did stress about it quite a lot. And yeah, I think now my approach to it is a lot more relaxed, a lot more understanding because I’ve taken time to have a look at what’s actually happening with me and understand it and what does work and what doesn’t work.
So yeah, don’t stress, take your time and yeah, talk to people about it, do your research, talk with a consultant. You know, yes, you might end up being on medication, whether it’s the right one for you or not. But I think that’s something between an individual and their consultant.
Michelle:
That’s actually absolutely perfect. I really like that as a conclusion that you know what you have to do. You have to take a little bit of initiative for yourself and put yourself forward that sports is something I’m passionate about, and no, I’m not going to quit doing sport because of this diagnosis. We’re going to work together with the consultant team. We’re going to have these conversations, and we’re going to figure out going forward what medication might work for me, what changes might work for me. And this might be a long road, and it most likely is a long road, but like you got there, they’ll get there as well.
It’s a marathon, not a sprint, as they say.
Or an ultra in your case, almost. Well, thank you so much.
Nigel:
Thank you, Michelle.
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*Disclaimer: The views and experiences shared in this interview are personal to Nigel Batten. They are not intended as medical or nutrition advice. Always seek professional guidance for individual health concerns.
