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Sarah Cook is a year 10 student with a very busy life. She juggles school work with training and competing as a top athlete.

She also has diabetes.

Picture This

Blood

by Veronika Meduna

Sugar

From

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Sarah is one of about two thousand young people living with type 1 diabetes in New Zealand.

Her family first noticed that something wasn’t right during a camping holiday when Sarah was seven years old. Sarah always felt thirsty – no matter how much she drank. Her mum, Raewyn, is a nurse, and she recognised this as a symptom of diabetes. The family headed straight back home and to the hospital.

When she was diagnosed with diabetes, Sarah was most afraid of the needles. “I actually didn’t know what ‘diabetes’ meant,” she laughs. “But it meant something big when I found out that I would have to give myself so many injections, because the idea of stabbing myself with a needle really scared me.”

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Sarah pricks her finger with a small needle and uses a blood glucose meter to help her check her blood sugar levels

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Diabetes is a disease where a person’s insulin can’t properly control the amount of glucose in the person’s blood.

Glucose is a type of sugar. It’s the body’s main source of energy. Our bodies can’t work properly without glucose.

Insulin is a hormone that occurs naturally in our bodies. It is produced

in the pancreas and moves around in the blood. Insulin helps to move glucose into our cells so that we have energy to move around.

The level of glucose in our blood changes throughout a day. We get glucose from the food we eat. After meals, it goes up. Then when we exercise, our bodies use more energy, and our blood glucose level falls. The glucose level needs to stay within a certain range for us to be healthy.

There are two common types

of diabetes.

What is diabetes?

The stomach helps change food into glucose.

Glucose then enters the bloodstream.

Insulin is produced in the pancreas and enters the bloodstream.

Insulin acts as

a "key" and helps

glucose to enter

cells in our body.

KEY:�

Glucose�

Insulin

Stomach�

Pancreas�

Blood Stream

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Photograph: "Nobel Prize Medal in Chemistry" by Adam Baker from http://goo.gl/Yrmxzr is licensed under CC BY 2.0.

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Type 1 diabetes

occurs most often

in childhood (but it

can occur at any age).�

Type 1 diabetes is an

auto-immune disease. This means that the body’s immune system attacks and destroys the cells

that produce insulin and

the pancreas stops producing it.

Scientists don’t yet fully understand what causes type 1 diabetes. It is NOT caused by eating too much sugar or any other�types of food.

Types of diabetes

feeling very thirsty all the time

�

finding it hard to concentrate

Type 2 diabetes usually happens (but not always)

when people are adults. It develops more slowly than�type 1 diabetes.

Type 2 diabetes is not an auto-immune disease. Nothing attacks or destroys the body’s insulin-making cells. It’s just that the body doesn’t use the insulin the way it should or it doesn’t produce enough insulin for the body's needs.

Type 2 diabetes is linked

to being overweight.

Being overweight is linked

to not exercising enough

and eating foods that have

lots of sugar and fat.

Type 1�diabetes

Type 2 diabetes

Some of the�symptoms of�Diabetes�can be:

feeling tired

�

feeling sick

�

having blurred vision

getting

a lot of skin infections that are slow to �heal

going to the toilet a lot

feeling dizzy

Feeling hungry a lot

Before scientists discovered insulin and how important it is, type 1 diabetes was a killer.

In January 1922, �a fourteen-year-old �boy called Leonard Thompson was rushed to hospital with a serious illness. He was dying of diabetes. Doctors gave him the first-ever injections of insulin. Soon Leonard felt much better. The scientists who discovered insulin were awarded a Nobel Prize in 1923.

Lifesavers

Diabetes can’t be cured. It can only be monitored and managed, and that means having daily blood tests and injections of insulin.

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Sarah has to check her blood glucose level regularly throughout the day – when she gets up, before any meal, and before and after exercise. She pricks her finger with a small needle. She then takes a drop of blood from her finger and measures the amount of glucose in it.

Blood glucose is measured in millimoles per litre of blood (mmol/L). Sarah likes to be within a range of 7 and 12 mmol/L.

Sarah uses a special pump to inject herself with insulin regularly through the day. She keeps track of everything she eats to check that the amount of insulin in her blood can deal with the glucose from her food.

Managing diabetes

If her blood glucose level gets too low, Sarah feels shaky, hungry, and exhausted. She is hypoglycaemic (say hi-po-gly-see-mik) and can become unconscious. She has to eat or drink foods that contain sugar to raise the level.

If her blood glucose level gets too high, Sarah becomes grumpy and thirsty. Her body needs to use insulin to control the blood glucose level.

Sarah’s insulin pump is computerised. It is programmed to deliver insulin into Sarah’s body in small bursts over the day. It also gives larger booster shots of insulin with meals. This means that Sarah doesn’t have to think about measuring out and injecting herself with insulin all the time. Her pump does most of the thinking for her. Sarah just needs to know how to use her pump.

The insulin pump

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Sarah plays lots of different sports but football is her main passion. During the peak season, Sarah plays two games a week and trains up to nine hours each week.

Exercise uses up energy, and Sarah knows that it lowers her blood glucose level. This means that she needs less insulin when she is exercising hard, and Sarah has to change the amount of insulin she injects.

She has to prepare carefully for any big sports event. She has to make sure she eats well and checks her blood glucose level more frequently. “On a normal day, I check my level at breakfast, morning tea, lunch, afternoon tea, dinner, and at night so that I don’t go to bed on a low level. During a sports day, I check it all the time,” she says.

A change of pace

time of testing (finger prick testing)

amount of glucose per 1 litre of blood (mmol/L)

3:30-5pm

Football practice

8:30-9pm

Underwater hockey game

Blood Glucose Levels

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In 2015, Sarah travelled to Sydney to represent Wellington in football. When she travels, Sarah’s bags always include two safety packs. Each safety pack contains a full set of needles, test strips and meters, boxes of juice, glucose tablets, and medication in case she becomes hypoglycaemic.

Low blood glucose levels can happen suddenly, and Sarah always wears a MedicAlert^® bracelet. The bracelet lets people know that Sarah has diabetes in case she can’t tell them herself.

Living with diabetes

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Sarah needs to be prepared when she goes away

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Every three months, Sarah meets with her diabetes nurse, a doctor, and a dietician to talk about how she is feeling and the data she has collected about her blood sugar levels.

Monitoring diabetes

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Sarah and her doctor discuss her results

Managing type 1 diabetes requires a person to take special care of their diet and exercise. Sarah still wishes she didn’t have diabetes, but she also feels it has helped her to push herself and achieve more, particularly in sports.

Both at school and on the sports field, Sarah takes every chance she gets to help people learn about diabetes.

diagnosed – worked out what is making a person sick by observing them carefully and doing tests

hormone – a chemical that is made inside the body and gets different parts of the body to do certain things

immune system – the parts of a body that fight off germs, diseases, and infections – includes white blood cells, which search for and attack bad things that invade the body

millimoles – one thousandth of a mole, where a “mole” is a set number of very small particles

dietician– a person who is trained in and is an expert on healthy food for humans

pancreas (say pan-kree-us) – �a long, flat organ near the stomach that produces insulin, as well as juices that help the body digest food

symptom – a change in the body when something is wrong

Helping others

Glossary