Jessica Johnson, 17, half rolls her eyes as she recalls the tedious and mortifying scene in class every morning: A few minutes before the bell, she quietly gathers her books and attempts to subtly slip out the door as her teacher and classmates try not to watch her.
It’s a ritual they all get accustomed to, sooner or later. Because she has type 1 diabetes, Jessica needs to test her blood sugar just before lunch, one of at least four times each day. That requires a trip to the school nurse to quickly stick her finger for a blood drop, which goes into a meter inside her purse that will instantly read her blood sugar levels, giving her an idea what she can and shouldn’t have at lunch.
“What I eat — or don’t eat or drink — depends to some extent on that number,” Jessica, a junior at Forest Lake High School, said. “It’s the same with other meals during the day, and in between. I know what I need to do and what activities I should or shouldn’t do that day to keep the numbers in a good range. But sometimes the number gets a little out of whack no matter what you do.”
Type 1 diabetes is a 24/7/365 companion for kids like Jessica and her family. The 10 percent of people with diabetes who have type 1 make no insulin, meaning they have an everyday battle to balance their food intake, exercise and medicines with a precision most of us would find unthinkable.
If they forget or get out of range for whatever reason, they pay a price. Sugar too low? You get lightheaded and dizzy, weak in the legs, arms and hands. Sugar too high? You’re extremely thirsty, gulping down drinks followed by multiple trips to the bathroom. You also get a terrible headache and nausea.
But her disease doesn’t begin to define Jessica. She leads a busy life with friends and lots of activities through church and school. But she also takes care of herself. She has had some scares when her “number” was seriously off, including one time when she was in the hospital for several days with diabetic ketoacidosis. Ketoacidosis is a life-threatening issue when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.
That’s why she was so willing to be in a research trial headed by Laura Gandrud, MD, through Children’s Minnesota’s McNeely Pediatric Diabetes Center in St. Paul. The trial used cell phones to test the use of wireless technology to help parents and medical providers keep real-time tabs on diabetes patients and head off problems. The small trial, which shut off Jessica’s phone if she didn’t test, was successful, and the subjects, including Jessica, reported feeling a lot better after several weeks of tightly controlling their blood sugar.
Jessica’s ability to control her blood sugar is an important step in gaining even more independence over her disease. In fact, she recently marked a teenage rite of passage — getting her learner’s driving permit. And like many 17 year olds, she can’t wait to take the wheel on her own.