By MARK and STACIE OSHIMA
It’s fall, that time of year when Evan and our family raise awareness of type one diabetes (T1D) and prepare for JDRF’s One Walk! This year, the Walk will be held IN PERSON on Dec. 3 at Angels Stadium for the first time since the COVID pandemic hit in 2020. We are so excited to participate in the Walk again and support funding for better treatments and a cure for those living with T1D like Evan.
We invite you to join Evan’s JDRF (Junior Diabetes Research Foundation) team, Evan’s Evangers, come to the One Walk, and consider making a donation to this cause that is so close to our hearts: https://tinyurl.com/EvansEvangersJDRF2022
Anything But Normal
Evan is now 14 years old, a high school freshman. We can’t believe it has been over eight years since Evan was diagnosed with T1D. Living with T1D is his normal, but it’s anything but normal.
It’s frustrating, because it feels like stabilizing blood glucose should just boil down to simple math equations – calculating how many carbs you eat and how much insulin you need for that meal, calculating the offset for how low or high his blood sugar is, and then dosing for whatever amount of insulin is needed.
Complicating all of this, however, are all the factors that affect blood glucose (BG) for someone with T1D: type and combination of food consumed, time of day, level and type of physical activity, puberty and hormones, weather, altitude, illness, stress … not to mention the human error involved with estimating how many carbs are in the food. It feels like it should be just math; but it’s so much more than that.
A Real-Life Episode
A recent 3:3 basketball tournament that Evan participated in at Long Beach State was the perfect example of how complicated managing diabetes can be. Because physical activity lowers his BG, he generally eats extra carbs about one hour before athletic activity to help ensure his BG is sufficiently high so he doesn’t crash, resulting in a hypoglycemic episode.
On this day, something must have been wrong with his insulin pump site, however, as his BG kept rising throughout the games. It soared above 300. It was probably because the cannula (small plastic tube inserted under his skin that delivers insulin from his pump) got hit or bumped (which can happen in a basketball game), which caused the insulin to not be delivered and absorbed properly. This results in ultra-high glucose levels, which can be dangerous if not controlled.
To combat his rising glucose levels, Evan changed his pump site in the public bathrooms of the arena, and we gave him an insulin injection to ensure absorption. He was really disappointed by his performance in the games and said that this was the first time he felt like T1D really affected him athletically. His vision was blurry, and he felt foggy throughout the day. Then after the tournament, we went out for ramen and got soft serve ice cream for dessert with some teammates.
This resulted in the perfect storm. High BG during the day, lots of carbs, lots of guessing how many carbs he consumed, lots of insulin dosed to fight the high BG and carb intake. The good news is, by the time Evan went to bed, the insulin finally started kicking in. The bad news is, his BG started tanking.
As many of you know, Evan also wears a continuous glucose monitor (CGM), which gives us a reading of what his BG is on our iphone app. Unfortunately, there are times when it’s not reading accurately or providing any reading at all, and this was one of those times.
A little after Evan fell asleep, I checked his BG on my app, and it wasn’t picking up any signal, so I decided to manually test his BG with a lancet. It read 35!!! (For some context, 75 is considered low, and if a person goes ultra-low he can lose consciousness, have a seizure, or even die. 35 is an ultra-low number.)
I grabbed two juice boxes and had him drink as quickly as he could. While he drank, I also manually re-tested his BG to double check … this time it was 32. At that time, his CGM started picking up his reading, but his BG was so low, it didn’t even provide the number. It just read “LOW” with two arrows pointing straight down, confirming his plummeting BG.
I grabbed another juice box and noticed that he was drenched in sweat. As he was drinking that juice, I got him a wet cloth to cool him off. I grabbed two emergency life-saving medication devices for severe hypoglycemic episodes in case I needed to administer them. And then I waited and prayed for his BG to rise.
I re-tested his BG multiple times over the course of the night and lay on the floor of his room, because I was too scared to leave him alone. Thankfully, his BG eventually stabilized, but it was a long, scary night.
Turning Type 1 into Type None
In many ways, Evan is a typical teenager, but there is nothing typical about having to manage a disease like T1D. This is why we support JDRF’s efforts to advance treatments of T1D and find a cure. Thank you for your love and support of Evan and the 1.6 millions of Americans living with T1D. Together, we can turn type one into type none! https://tinyurl.com/EvansEvangersJDRF2022