Living life confidently – this is just what all the young people with diabetes are doing whom we meet in this section of diabetes-parents-journal.com. Olympic gold medallist, Matthias Steiner, is no exception. 

Matthias Steiner is 26 years old, Olympic gold medallist in weightlifting, and plumber. He has had type 1 diabetes since he was eight. Originally from Austria, he followed his heart to Saxony. He acquired German citizenship in 2008, and is playing league soccer for AC Chemnitz. Professor Karin Lange, member of our editorial team, spoke with him. 

Even those with no idea of weightlifting clung to their screens as Matthias Steiner battled for Gold in the over 105 kg class at the Beijing Olympics. Again and again, this athlete had to perform with precision, snatching, and cleaning-and-jerking ever increasing weights, whereby not only strength, but also technique, speed and agility were required. 
How does Matthias Steiner manage to maintain this high level of physical and mental strength with diabetes?

Diabetes-Parents-Journal (DPJ): How long does a competition last at the Olympics? What do you do to avoid hypoglycaemia? 
Matthias Steiner: A clean-and-jerk competition consists of three tries. The amount of time one has between each try can vary between two and five minutes. In total, a competition usually lasts around one-and-a-half hours. In order to maintain top performance, I measure my blood sugar each time before going onto the platform, time allowing, as well as afterwards. 

DPJ: Does the stress of competition tend to raise the blood sugar or lower it? 
Matthias Steiner: During a competition, my blood sugar tends to rise because of nerves and stress. However, the level of stress is dependent upon how much and how well I have trained. If I'm in good form, I am more confident in myself, and then I am less nervous when it comes to the crunch. Routine plays an important role in all of this. In general, the degree of nervousness is difficult to calculate. So that my blood sugar levels do not hinder my performance, intensive blood sugar monitoring is especially important. 

DPJ: What do you consume in order to maintain muscle mass? 
Matthias Steiner: I pay much attention to what I eat, preferring mainly wholemeal products, and fresh foods such as fruit and vegetables. I simply like the taste. Of course, I need to eat more than what would be considered normal. In fact, I have to really watch out that I do not lose weight, as I use so much energy during training. It must be noted that no other type of amateur sport requires so much energy. 

DPJ: Which type of insulin do you use for meal times? 
Matthias Steiner: For the bolus, I inject a rapid-acting insulin analogue with the pen. 

DPJ: How much do you train each day? How do you adjust your insulin dosage accordingly?
Matthias Steiner: In general, I can say that training improves the performance of insulin. On the one hand, the training itself sinks the blood sugar and, on the other hand, it is more potent due to higher circulation. Hence, I need much less insulin. 
In preparation for a competition I train, for example, twice a day for two to three hours each session. For this, I lower the basal rate, measure my blood sugar very frequently, and begin training with a slightly elevated blood sugar level at, say, around 200. After half-an-hour's training, it drops back down to 100 or so. 

DPJ: Do you have to inform the doping authorities that you inject insulin, or is it irrelevant? 
Matthias Steiner: For every round at the Olympics, I have to obtain a doctor's certificate to confirm that I have diabetes. This is then forwarded to the International Olympic Committee, so that I do not have to let the authorities know about my diabetes at each doping check. 

DPJ: How old were you when you were diagnosed with diabetes? Do you remember how you felt in the time thereafter? 
Matthias Steiner: I was 18, and it was a shock. I had just started really getting into weightlifting, and I was scared that it would all be over. In the hospital, my metabolism was normalized. Then I did a training course, in which I learnt how to manage the diabetes on my own. I came to the conclusion that I wasn't so sick after all! Eventually, I started getting into training again –  under close medical supervision and with regular blood sugar checks – and that's how I got back on track. As I realized that it was working, I was highly relieved. 

DPJ: Has diabetes influenced your career in sport? 
Matthias Steiner: Yes and no. Yes, because I am more 'aware' when I train, as I always have to keep my metabolic performance in mind. For instance, before commencing a training session or competition, I have to measure my blood sugar and, if necessary, eat a few extra portions of carbohydrate. And no, because I never let the diagnosis stop me from fulfilling my dream of becoming a professional weightlifter. I was always very ambitious, and just kept on going. Besides, although it is true that diabetes is always with me, it does not control me. I do that well enough myself.

DPJ: How did you come to be a weightlifter? What is your advice to young aspiring athletes?  
Matthias Steiner: I was introduced to this sport through my father. He did it as a hobby. I started lifting weights at twelve, and have been doing it ever since because I enjoy it so much. The best thing is, it is not just a matter of strength. A weightlifter must be able to jump and have excellent coordination, etc. 
Whoever wants to do sport should join a sports club and find a qualified trainer. At the beginning, it is especially important to acquire the right mix of exercises – I did a lot of light athletics for a start, such as long jump with weights and shot put. 
All in all, one should start gradually, especially if you are diabetic. Only then should you slowly start to increase the training intensity, to give the body time to get used to it. Muscle will then begin to build up, and as this happens, its effect on the blood sugar must be closely watched.