At this moment, about 30 million Americans—nearly 10 percent of the population—are living with diabetes. The Center for Disease Control and Prevention projects that up to one in three Americans will have diabetes by 2050. Scientists are still trying to figure out what exactly is going on (diet and lifestyle certainly play large roles), but one thing is for certain: A lot of people are living with a fairly complex condition, and the situation will worsen.

In a nutshell, diabetes is a human energy crisis condition. Type 1 develops when the body cannot make any insulin, the hormone that controls blood sugar. Type 2 develops when the body cannot produce enough insulin, or the insulin being produced does not work properly. Insulin manages your blood glucose levels by moving sugars from food you eat into your cells; without it, that fuel remains in the bloodstream, where it damages organs and tissues. It’s fatal without treatment.

Fortunately, diabetics can use pharmaceutical insulin to mimic the body’s natural process. But it’s a balancing act: They have to carefully synchronize their insulin injections and blood sugar levels, factoring in the food they’ve eaten and their physical activity.

As one might imagine, that can make daily living—let alone bike riding—a challenge. With the right steps, however, it’s a challenge you can meet. We solicited advice and wisdom from successful cyclists living and competing with diabetes, including pros racing for Team Novo Nordisk, a global all-diabetic sports team of cyclists, triathletes, and runners; Team Skyline Pro Cycling; and Colavita/Bianchi p/b Fine Cooking. Here’s what they told us about riding while diabetic.

Form Your Team and Plan of Attack
The first step in managing diabetes is to work closely with your healthcare professional to figure out a plan that matches your riding and exercise goals. This is a non-negotiable step: Everyone with diabetes is different, and your approach must be personalized to your specific needs. Find a doctor who understands how much you ride and your riding goals.

“In many ways, someone with diabetes is very similar to other athletes in that you need to manage your exercise and nutrition,” says Wil Gibson, 50, of Bartlesville, Oklahoma, a cyclist with Team Novo Nordisk’s Type 2 team. “But we need to be consistent about checking our blood glucose levels and always be prepared with food and medication in order to manage our diabetes.”

Your doctor can help you establish a plan, including best times of day to train and how to go about monitoring, adjusting, and ultimately managing your fluctuating glucose levels. “I’ve gone to the same physician for many years and he is well informed of my intense training routine,” says Gibson. “We’ve worked together to develop diabetes management guidelines specific to me. Whether I am on the bike for one hour or five hours, I am able to make adjustments as needed to maintain peak performance,” he says.

“Once you have your plan, start the program slowly,” says Matt Vogel, vice president of marketing and medical affairs for Team Novo Nordisk. It’s going to take some trial and error to figure out how your body best responds.