Rising above with Type 1 diabetes
Fit and active
Markus ‘Mauzi’ Sauer proves that type 1 diabetes is no obstacle - he continues to conquer marathons with determination. The condition spurred on the Graz native (Austria), driving him forward through life and across various marathon distances and endurances. This year, he trained for the Transalpine Run (TAR).
Read further to find out how he prepared for this extraordinary race across the Alps, what his strategy was for keeping his glucose levels balanced, and how myLoop, powered by CamAPS FX supported him with crossing the finish line.
During seven days from Lech am Arlberg (Austria) to Lake Reschen in South Tyrol (Italy) – on a course that is 90 per cent new, with three new stage locations. A total of 243 kilometres and 15,135 metres of elevation was conquered: The Transalpine Run (6–12 September 2025) has been held for 20 years. This time, right in the middle of it: Markus Sauer took on this adventure with his running partner, Peter.
Markus. His marathons. His motivation.
Markus, born in Graz in 1991, was diagnosed with Type 1 diabetes in 2015. “I’ve only become sweeter since then,” he jokes. He has been playing sports since the age of 16 and has been running marathons since 2014. During his second marathon, he suddenly felt unwell, had to pull out at the 32 km mark, and subsequently received his diagnosis. Giving up is not an option for Markus, also known by the nickname "Mauzi", in sport or work. Markus works as an account manager for mechatronics, electronics and energy technology.
Why did running become so important for Markus?
The diagnosis changed his life in unexpected ways, but he decided to train hard and run marathon after marathon and learned how to regulate his glucose levels along the way.
‘‘Running has improved my quality of life,’’
He once told a local newspaper. His myLoop powered by CamAPS FX, supports him through every kilometre. He is proud of this achievement, but he wants to break through the three-hour marathon barrier soon and is training hard to achieve this goal.
‘‘Diabetes is no obstacle. Limits only exist in the mind and are a matter of personal attitude.’’
Through his running, he aims to promote a positive attitude towards diabetes and encourage people to exercise mindfully.
«Listen to your body, then everything is possible! » He sees diabetes as a source of motivation rather than an obstacle.
‘‘It drives me on. I know I need to think and plan more. I get to take better care of myself and my body. I don’t see that as a disadvantage. In my opinion, it’s an advantage.’’
«Good preparation and technology – that’s how you can do anything with diabetes.»
mylife Diabetes Care: "Markus, you’re taking on what’s probably your biggest challenge!"
Markus: (laughs) "Yes. Together with my running partner Peter, I am tackling the Transalpine Run (TAR), a seven-day stage race over 243 kilometres with extreme elevation gains."
mylife Diabetes Care: "What motivates you to do this?"
Markus: "We want to test our limits, meet new people and enjoy beautiful landscapes. We also want to show the world, when it comes to diabetes, the only limits are the ones you set for yourself. Two years ago, I already completed nine marathons in nine days. This time, we have another 15,000-plus metres of elevation to add.""
mylife Diabetes Care: "What kind of kit do you take with you for such a race?"
Markus: "I use the myLoop AID (Automated Insulin Delivery) system or hybrid closed-loop system: the YpsoPump insulin pump, linked to my CGM (Continuous Glucose Monitoring) sensor and the CamAPS FX app on my smartphone. It works very reliably. However, I always carry an insulin pen with me in case of an emergency. I carry protein bars and invert sugar syrup with me as a source of energy or to raise my glucose levels. This allows me to react quickly. In case my glucose levels drop sharply or I have a hypo, I carry glucagon with me – one in the form of a traditional injection and one as a nasal spray."
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Smartphone-based therapy management is the future of diabetes treatment. Combine the YpsoPump insulin pump, the CamAPS FX mobile application and the Dexcom G6, FreeStyle Libre 3 or FreeStyle Libre 3 Plus sensor for continuous glucose monitoring (CGM) to create an automated insulin delivery system that is controlled directly via your smartphone.
mylife Diabetes Care: "How about food – how do you equip yourself?"
Markus: "For a quick source of energy, I carry LipoSnacks, which are tubes of sugar containing 36 grams of pure glucose. I also take protein bars: either 100 g bars containing roughly 50% protein and 50% carbohydrates, or smaller 50 g bars containing about 55% protein and 45% carbohydrates. I mainly drink water as this works best for me. At the refreshment stations, I also make sure to consume enough salt, especially when I sweat a lot. The organiser traditionally serves beer at the finish – I don’t yet know whether it will be with or without alcohol, but I’ll probably stick to alcohol-free isotonic drinks."
mylife Diabetes Care: "You’re running with your friend, Peter."
Markus: "Yes, for more than eleven years. Having a running partner by your side is reassuring, both for mental support and for safety reasons. Peter doesn’t have diabetes himself, but he knows enough to take the right measures if necessary. With the Companion mode*, I can even share my glucose level data with him."
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With the Companion remote monitoring mode of the CamAPS FX app, users can share their data with up to 10 "companions". Both the user and the “companion” use the CamAPS FX app for remote monitoring, which is integrated into the app. CGM, insulin and other data, as well as alerts, are mirrored in the companion's CamAPS FX app.
mylife Diabetes Care: "To get to the starting line you’ve had to train a lot. How did you fit that around your work?"
Markus: "I did strength training twice a week, starting at 5 a.m. in the gym with targeted exercises for mountain running. I also went on training runs involving a lot of elevation gain and trained with my manager - a tradition we’ve had for over two years. In addition, I took up cycling and bouldering. Overall, I trained for 10–15 hours per week."
Markus’s diabetes management with myLoop powered by CamAPS FX
mylife Diabetes Care: "Markus, the CamAPS FX app allows you to set your own personal glucose target. How do you plan to use this feature?"
Markus: "I’ll set the personal glucose target higher than normal. I’ll test this out over the first few days. In addition, I’ll use the “Ease-Off” mode to reduce or the “Boost” mode to increase insulin delivery, depending on what’s needed. I may adjust the target day by day depending on the situation."
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myLoop, powered by CamAPS FX, is the only AID system to provide highly customisable personal glucose targets from 4.4-11 mmol/L (80-198 mg/dL) in 30-minute segments over 24 hours. You can manually adjust your personal glucose target (PGT) to keep glucose levels at your desired target before, during and after exercise. In addition, the CamAPS FX app predicts glucose trends over the next 2.5-4 hours and adjusting the insulin delivery according to that prediction every 8-12 minutes.
mylife Diabetes Care: "The "Ease-off" mode is a feature of the CamAPS FX app. What situations will you use it for?"
Markus: "I mainly use the "Ease-off" mode on climbs, as my blood sugar often drops then. I activate it before the climb because uphill runs are significantly more strenuous than flat routes. After the race, I activate it depending on the afterburn effect: if I continue to burn a lot of carbohydrates, I leave it active for one or two hours; otherwise, I switch it off."
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temporarily raises the personal glucose target (PGT), softens the algorithm’s insulin calculations and will suspend insulin delivery earlier than normal, if glucose levels are predicted to fall below target. This will reduce the active insulin in the body to reduce the risk of hypoglycaemia when active.
mylife Diabetes Care: "How does a seven-day race differ from a one-day marathon? And what do you expect from the CamAPS FX algorithm?"
Markus: "The algorithm works perfectly on flat terrain. But that should also be the case in the mountains. I want to avoid hypoglycaemia, both at night and during the race."
Eating and Bolusing
Four hours before a marathon, Markus gets up early to enjoy a proper breakfast. His goal: to get through every stage in good shape. He eats granola, which provides him with a mixture of fast and slow-release carbohydrates, and sees what else the hotel buffet has to offer in terms of wholemeal products, butter, honey, jam, sausage and cheese.
‘‘My body will tell me what it feels like eating and what it needs.’’
During the run, he drinks between half a litre and a litre of water per hour. At the refreshment stations, he avoids electrolyte drinks because he cannot estimate the amount of sugar or carbohydrates they contain. Instead, he takes extra salt dissolved in water, and sometimes a banana or a salty soup. He also makes sure to carry enough energy bars and gels with him.
He tailors his bolus strategy to his individual needs. On the first day, he plans to make very few changes. He will only reduce the bolus if the start time is very close to breakfast. From the second day onwards, he will adjust his strategy based on his experiences. He expects to reduce the normal bolus for breakfast. For the rest of the day, he plans to use 50-75% of the usual amount based on the information provided by the CamAPS FX app.
He considers this adjustment reasonable, although he will probably have to reduce the insulin amount further as the Transalpine Run week progresses. Markus is supported by his myLoop powered by CamAPS FX, to avoid hypoglycaemia during the recovery phase. This strategy has proven successful in previous competitions, allowing him to wake up rested in the morning, eat breakfast with a good appetite and then run.
A friend of his once aptly remarked that the worst thing about a marathon is not being able to eat anything sensible for five hours – a statement Markus agrees with. With balanced, easily digestible meals for breakfast and dinner, he is confident that everything will go smoothly.
Fatigue and stress
‘‘Stress won’t be much of an issue during the run, unless we’re too slow. Fatigue is a different matter. It’s a mental thing. I’m already visualising the race - the thrill of the start, day after day, and the finish on the 12th of September at Lake Reschensee – receiving the finisher’s medal and putting on the finisher’s T-shirt. Then the strain of the past seven days will fall away from us. But how do you eat an elephant? Bite by bite!’’
On a final note, discover Markus’s final thoughts just before the race:
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Important disclaimer:
Please note that Markus's management of his type 1 diabetes during the 2025 Transalpine Run is unique to him. All content reflects his own experience exclusively and does not constitute medical advice. Remember that exercising triggers individual physiological responses that can significantly impact glucose levels. You should always consult your doctor before making any decisions about your treatment.