Miss Idaho Will Wear Her Insulin Pump During Miss America Competition

Miss Idaho Sierra Sandison never expected to become a diabetes advocate. The 20-year-old had been diagnosed two years earlier with Type 1 Diabetes, and uses an insulin pump to control her blood sugar levels.

However, a chance meeting with Miss Idaho’s Outstanding Preteen, 12-year-old McCall Salinas at the Miss Idaho competition changed all that.  When Sandison stepped out of her dressing room, Salinas asked “Oh my gosh, is that an insulin pump?”

Sierra’s first thought was “Oh no, people are going to notice, I was hoping that it was little enough that no one would notice.” But when she learned that McCall also had Type 1 diabetes and did not use a pump because she was afraid of what her friends would think, Sierra knew she what she had to do:

“I have to do this for McCall. It was really scary (to walk out on stage) but thinking about McCall gave me a whole new confidence.”

Sandison went on to win the Miss Idaho title.  Besides winning the crown, she won an outpouring of support, as pictures of her in a bikini with insulin hit social media.  She told People magazine, “I’ve gotten personal messages from people in over 35 different countries!”

Tonight Sandison will compete in the Miss America pageant, and her trusty insulin pump will be literally right there at her side as she takes to the runway.

“I try to show other diabetics it’s possible to live a normal lifestyle. And now I’ve been able to take advocacy to a whole new level.”

Good luck tonight Sierra, we’ll be rooting for you!

What is Type 1 Diabetes?

Type 1 diabetes Diabetes, generally speaking, is a condition in which the body’s cells do not receive adequate supply of sugar, in particular, a sugar called glucose. When our food is digested,  glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. But glucose cannot enter our cells without insulin. It is insulin which enables our cells to take in glucose. Without insulin, the sugar levels in the bloodstream rise.

Type 1 may more accurately be termed “insulin-dependent” diabetes. This is because people with the condition require daily, subcutaneous injections of insulin for the rest of their lives. In type 1, the body’s immune system attacks cells in the pancreas that make insulin.

Type 2 diabetes occurs when the pancreas does not make enough insulin, suffers from “insulin resistance”, or both.  Insulin resistance means that the cells no longer respond properly to the insulin present.  An unhealthy weight is a major risk factor.

Despite the differences between type 1 and 2, the complications are often the same. The higher the blood sugars over an extended period of time, the greater the risk for complications such as blindness, stroke, nerve damage,  limb amputation, kidney failure, and premature death.

How is Insulin given to those with Type 1 Diabetes?

NeedleMany people with diabetes must take insulin to manage their disease. Most people who take insulin use a needle and syringe to inject insulin just under the skin. Several other devices for taking insulin are available and new approaches are under development. No matter which approach a person uses for taking insulin, consistent monitoring of blood glucose levels is important. Good blood glucose control can prevent complications of diabetes.

What alternative devices for taking insulin are available?

Insulin_PensInsulin pens provide a convenient, easy-to-use way of injecting insulin and may be less painful than a standard needle and syringe. An insulin pen looks like a pen with a cartridge. Some of these devices use replaceable cartridges of insulin. Other pens are prefilled with insulin and are totally disposable after the insulin is injected. Insulin pen users screw a short, fine, disposable needle on the tip of the pen before an injection. Then users turn a dial to select the desired dose of insulin, inject the needle, and press a plunger on the end to deliver the insulin just under the skin. Insulin pens are less widely used in the United States than in many other countries.

Insulin_PumpExternal insulin pumps are typically about the size of a deck of cards or cell phone, weigh about 3 ounces, and can be worn on a belt or carried in a pocket. Most pumps use a disposable plastic cartridge as an insulin reservoir. A needle and plunger are temporarily attached to the cartridge to allow the user to fill the cartridge with insulin from a vial. The user then removes the needle and plunger and loads the filled cartridge into the pump.

Disposable infusion sets are used with insulin pumps to deliver insulin to an infusion site on the body, such as the abdomen. Infusion sets include a cannula—a needle or a small, soft tube—that the user inserts into the tissue beneath the skin. Devices are available to help insert the cannula. Narrow, flexible plastic tubing carries insulin from the pump to the infusion site. On the skin’s surface, an adhesive patch or dressing holds the infusion set in place until the user replaces it after a few days.

Users set the pumps to give a steady trickle or “basal” amount of insulin continuously throughout the day. Pumps can also give “bolus” doses—one-time larger doses—of insulin at meals and at times when blood glucose is too high based on the programming set by the user. Frequent blood glucose monitoring is essential to determine insulin dosages and to ensure that insulin is delivered.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


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