Being different can be overwhelming, and 10 is a pretty important age for girls not to be overwhelmed by differences.
The bike races across her part of Belgium are all-encompassing affairs. The whole town watches, schools turn the students out to the side of the roads to cheer, shops open sidewalk drink stands, farmers pile hay bales in their fields and string giant painted banners across them in support of local heroes.
On a sunny Wednesday afternoon she stood with her younger brother and grandpa outside of her town and held a banner in a green field. She cheered, her parents took photographs, and when the peloton passed at 42 kilometers an hour it was never certain which rider from the 120 speeding by was her hero.
Kids and adults alike scamper for jettisoned water bottles after the long race caravan speeds away. In the parking lots at the start they collect hero cards of each rider; post-card sized portraits with short biographies and the sponsors’ logos. Autographed originals fetch a higher price in brisk trading.
She has one signed card that she’ll never trade, because that rider, Martijn Verschoor, has diabetes, just like her.
Belgian bike races are full-fledged technical operations, fielding three helicopters, four motorcycles, fixed studio cameras in the final kilometers and a curiously suspended rear-facing lens atop an SUV that allows for long and foreshortened views on the straighter roads, so as to better gauge distances between the chasing groups.
The Belgian TV commentators saw her sign – GO Team Type 1! – in bright red letters, captured from one of the helicopters in the March sunshine.
“Team Type 1-Sanofi has a fan club already in Belgium? The riders have raced here just four days this year. They are very active at the front of this chase. This is an American team, with five riders who are suikersiekte. They have a sprinter here today, the Italian Colli, with some chances in this finale,” the becalmed Belgian commentator said on live on the air.
Colli finished 5th in the final sprint. He came into the last cobblestoned corner with the help of his teammates, who rode at the head of the peloton to keep him in position.
After the race she came with her parents and little brother to the team hotel to give Martijn a stuffed hippopotamus, with green, blue and pink patches stitched into its soft grey fur. The hippo wore a white t-shirt with “I’m too sweet for you” in black letters on the front, and the Team Type 1 logo on the back.
Her mother said the hippo was something she got right after her diagnosis with diabetes.
“The diabetes association uses these stuffed hippos, created by Barbara Flamand whose own daughter was diagnosed at 8-years-old, to teach kids who just got the disease where they can inject themselves with insulin, where it’s safe. Some of the patches are for long-acting, some are for short-acting. She wanted to give this hippo to Martijn ever since we first saw the team at a race in Belgium, back in March,” the girl’s mother said.
“She was very determined to come to the race today to cheer for Team Type 1, and she made the banner herself. We downloaded the Team Type 1 logo from the internet and she made sure everything was ready before the race started on Tuesday,” her mother said.
They took a tour of the team bus, watched the mechanics work through each race bicycle in the parking lot of the Thermae Palace Hotel on the Atlantic sea coast. When the sun fell behind a cloud and the brisk cold air of March began to chill them, her father spoke to the riders she came to meet.
“Her HbA1c most recently was 6.5, because she had a small cold in the last month, and it was hard to keep the diabetes under control,” her father said.
She smiled shyly, unsure exactly what he was saying in English, but certain of the gist.
HbA1c is the measure of glycated hemoglobin in the blood stream, an identifier of average plasma glucose concentration over time. Red blood cells survive two or even three months in the bloodstream before renewal, and by measuring HbA1c, an average blood glucose reading can be determined.
For non-diabetics, the usual reading is 4-5.9%. For people with diabetes, an HbA1c level of 6.5% is considered good control.
“That’s up from 5.9 the last time,” her mother said.
The girl understood the numbers, and beamed proudly. Martijn checked her shoulder and told her Goed zo, Dutch for ‘well done’.
Past the age of 13, the HbA1c in most T1D females rises to unsupportable levels because of social pressure. They don’t want to take care of their diabetes because they think if they get underneath it and defy it, it will just go away. They don’t want to be different.
In a 2004 study by Toronto psychiatrists on metabolic control in adolescent girls with type 1 diabetes, researchers came to the conclusion that “relational aspects of the self and the experience of emotional closeness in relationships are associated with metabolic control in adolescent girls. Efforts to improve metabolic control in girls should include enhancing the self-concept and the experience of relatedness in familial, peer, and patient-caregiver relationships.”
In plain terms, she will take better control of her diabetes as part of an enthusiastic, active and energetic diabetes community.
A community like Team Type 1.
Diabetes is a chronic disease of the pancreas, and means the full cessation of normal insulin production and a potentially dangerous condition that can lead to painful complications and possible death. With the right management, good control of the body’s blood glucose levels, a healthy diet and plenty of exercise, diabetes can be a normal part of an extraordinary life.
“Diabetes will never go away. Never. You will have it forever. You will need to take care of yourself daily and hourly, every day and every hour for the rest of your life,” said Team Type 1-Sanofi CEO and Founder Phil Southerland.
“But that’s just the fun part, because then you get to go do anything you want,” Southerland said.
“All those things you think you’ll never do because you have diabetes? You’ll do them, because you have diabetes. All those places you think you’ll never see because you have diabetes? You’ll see them, because you have diabetes. All those lives you wanted to lead, but thought you couldn’t, because you have diabetes, you’ll go on to lead,” Southerland said.
The family packed themselves back into their car for the 60km drive home. The mechanics resumed washing bikes and adjusting gears. The riders went for a massage and ate a hearty dinner in the hotel dining room.
The sun went down on another day for Team Type 1-Sanofi in Belgium.