Meet Kim: Teaching Future Nurses the Truth About Life with Type 1 Diabetes

I was diagnosed in 2011 after returning from vacation where I was intensely thirsty and urinating a lot. I had been experiencing large amounts of hair loss in the shower but had no clue why. I made an appointment and had labs done which showed an elevated A1C, and my provider said, “But you aren’t fat!” I was told to watch what I eat, and my sugars maintained in the 400s no matter what I did or didn’t eat. I love exercise, so I was doing that, too. It wasn’t until I was having breathing issues that I thought were related to asthma that my pulmonologist did an exercise stress test. I was going into acidosis when I exercised and so I was sent to the hospital to start insulin therapy. 

They drew my labs which showed type 1 vs. type 2 diabetes. I am an RN and an assistant professor of nursing, and it was assumed I knew what to do with an insulin pen. I was working in a clinic and had never used one. Now, I want to educate my students not to assume anything about anyone—even healthcare workers don’t know everything about everything. I also want them to have the facts and be able to dispel the myths. We talk about how it isn’t sugar that causes diabetes, that everyone should have a well-balanced diet and not just people with diabetes; no two days are alike with diabetes; how to care for patients with diabetes; and so much more. I also discuss that many people with diabetes are labeled “non-compliant” (that goes for other chronic illness as well), but that doesn’t mean the person isn’t trying or doesn’t care. We have seen our patients trying to decide if they should fill their insulin this month and skip their high blood pressure and heart medications because they cannot afford all of them. We have seen insulin rationing due to cost or access to insulin.

They need to look at how much the healthier foods cost vs. the unhealthy ones. Lots of people have problems with high drug costs, the cost of supplies for diabetes and other illnesses, and even access to getting healthcare. I make sure to impart on them that they need to have those conversations with patients vs. just saying they don’t take care of themselves or they don’t care. No one wants complications from diabetes, no one asked for this disease, but yet they can get put in a category that they don’t take care of themselves. Insulin and the supplies for diabetes are insanely expensive! I share with them the cost of all my supplies and medications with insurance and what it would be without insurance. Their eyes bug out during this part. 

I share all my stories of sick days, frustration over days with highs that won’t go down, lows that won’t go up, and how even when you think you have your body somewhat figured out, it does something different. I share the time I gave myself too much insulin via my pump in the middle of the night and ended up in the ER to keep my blood sugar up, how I was denied an insulin pump at first by insurance because my A1C wasn’t “high enough” so I had to keep a log of all my lows that I eventually didn’t have any symptoms of to prove I had hypoglycemia unawareness—which is dangerous. I tell them about me going out to eat and people I don’t know asking if I should eat that when they see me enter the carbs in my pump. I have had coworkers ask if I should eat that brownie. My response is, “Should you?” Diet in moderation, just like everyone should. 

I was diagnosed two years before my niece was diagnosed at age 9, and so we were pump buddies. I tell the students how people thought she couldn’t go trick or treating anymore or have birthday cake. There is so much misinformation out there. I want my future nurses to know what is factual. They also need to listen to their patients who have diabetes because they know their bodies. What works one time may not the next. An example I give is my love of pizza, but how I end up with hyperglycemia for hours and hours no matter what I do. I split my insulin dose since that helps most of the time, but then one day I do that and I hit lows for hours vs. highs. Active listening to the person with diabetes is a must. We need to make not only insulin affordable, but all medications. I hope I am doing my part to instill this knowledge into my students as they go forth to be the best RNs they can be!