That's me, frantically stopping at the summit of the Grand Mesa in CO, digging in my bag for some quick-acting glucose.

I get asked the same question every time I talk about my cycling. "How?" For people without diabetes, the inquiry is more broad in scope:

"How do you find the time to workout eight, ten, twelve hours each week?"

"How do you find the motivation to exercise when the lure of a long sleep or an afternoon relaxing with book in hand beckons louder than the call of the bike?"

"How do you keep it up day after day, year after year?"

And for those with diabetes, the question is much more pointed:

"How do you manage your blood sugar while keeping active?"

My answers, of course, don't really matter to anyone but me. The motivation is different for us all, the incentives are going to vary, and the bit about my blood sugar? What works for me probably won't work for anyone else because diabetes is, at its core, a disease both personal and dynamic. Each day, each workout, each moment is different....but my routine is much the same.

I awake every morning at four o'clock, while my husband and kids are still asleep. Before my feet hit the cold of the floor, I check my blood sugar. I start my workouts, generally, with a blood glucose between 155-175 - a little high so I won't drop too fast, but not so high that I bonk. I either eat or administer a shot of rapid-acting insulin (or both), and begin my workout. For the next ninety minutes to two-and-a-half hours, I will run, cycle, lift weights. I will do intervals or resistance train. My heart rate will range from my resting beats per minute of about 50 to, at times, over 210. Throughout it all, a voice in the back of my head will ask, "How is your blood sugar? Too low? Too high? How do you feel?" I will check it at least two more times before I am finished with my morning exercise.

Then, I eat. I've consumed the exact same breakfast every morning for nearly five years, save those days when I travel (in which case it is instant oatmeal mixed with PB packets or apples and almond butter, all of which tucks into my suitcase alongside my other essentials). My standard breakfast is a smoothie designed by Walter Willett, chairman of the Department of Nutrition at Harvard School of Public Health:

Willett uses 2 cups of frozen blackberries, 1 large banana, 1 cup of soy milk, 1/2 cup of apple juice and 1/2 cup of silken, reduced-fat tofu. A 3/4 cup serving provides 185 calories, with 5.9 g of protein, 38 g of carbohydrates, 6.4 g of fiber and 1.8 g of fat, as well as other nutrients from vitamin E to calcium to phosphorus.

...Sometimes, I sneak a little PB in there, too...

And, of course, it's another shot of insulin. I will do this again at lunch (always a big bowl of salad greens accompanied by some raw nuts or seeds, a little cubed tofu or some other lean source of protein) and dinner. In fact, I will check my blood sugar and make an adjustment of one sort or another anywhere from three to ten more times before my last shot of long-acting insulin as I ready myself for sleep and get together my belongings for my next workout early in the morning.

But what of the other, more ambiguous "Hows?" The ones that don't rely on numbers, shots and carb counts? The ones less about "How," perhaps, and more about "Why?" The reasons that I wake in the dark, leave the sanctuary of my sleep so that I can freeze in the fluorescent of the gym or battle the ice and wind on my bike, feel the cold air burn my face and hands as I run in what feels like the middle of the night? These are the things that motivate me:

• This is my time. Like a lot of mothers, my children and their needs are paramount in our home. I find myself often unable to take a shower without two tiny falsettos on the other side of the curtain, clamoring for my attention. These are the hours I earn to re-focus my energies on me. It is selfish time. I am tending only to myself and my own body.
• Cover models. Not because I want to look like them - I don't. But because they remind me that my body, while imperfect with stretch marks earned in pregnancy and bruises on my belly thanks to repeated meetings with a needle, can do a lot more than just take a picture. I have broad, muscular shoulders and thick calves because I put them to good use.
• Stress reduction. The only thing I can think about in mid SufferFest is "survival."
• Living long enough to see my grandkids … and play with them. Because my mother didn't.
• Showing my children the value of being your best self. That means working out, being healthy, being strong and fit and secure. You can't do that sitting on the sofa.
• The dreaded "yuck" of lethargy. Once the habit is ingrained, once you are used to getting your daily dose of cardio, the absence of it is a bit like a fast food binge. You feel lousy.
• A workout partner. My husband is my best competitor, and my most fantastic motivator. And he looks pretty hot in spandex.
• Richard Simmons. Seriously, ever watched "Sweatin' to the Oldies on your bike trainer?" You need to.

• Winning.