TRAILBLAZER

WASILLA — As if battling an obstinate team of sled dogs intent on racing forward, facing freezing temperatures and competing against some of the best mushers in his age group in the Junior Iditarod Sled Dog Race wasn’t hard enough, Jonathan Myers did it stopping every hour to check his blood glucose level.

Myers, 14, battles daily with type 1 diabetes, also known as juvenile diabetes.

Type 1 diabetes results when the body’s pancreas does not produce enough insulin, a hormone that helps convert sugars and starches into usable energy. It is critical type 1 diabetics use insulin to maintain safe levels of sugars in their blood, said Dr. Ross Tanner of the Diabetes and Lipid Clinic of Alaska.

Living with the condition can be hard, said Larisa Myers, Jonathan’s mother. But in talking with the teen, you would not believe it has him down. In fact, he displays an understanding of life’s bigger picture that goes beyond his young age.

“When I found out I had diabetes from the doctor, it just went fine,” he said. “You know it is just another little thing you have to factor in life. You just keep on going.”

His visit to the doctor and subsequent diagnoses of juvenile diabetes was all started by his observant grandmother.

“Last February during a visit to Oregon to see my grandmother, she saw I was eating a lot of sugar and going to the restroom more and more,” he said.

After a medical visit, it was decided Myers should have an insulin pump to help him read his blood levels and control insulin flow. For the average person, reading and moderating blood and insulin levels on a daily basis can be a tedious task. Factor in the physical exertion used in controlling a sled dog team, long hours of enduring cold temperatures, feeding the dogs, stress, and then stopping to check levels repeatedly, and you have an idea what Myers faces when out on the trail.

But all these activities determine how blood and insulin levels fluctuate. As physical activities require more energy from the body to complete a desired task, more insulin is needed to convert starches and sugars into usable energy. And the colder the weather is, the more energy a body needs to keep warm.

It is these conditions that create a high insulin demand, Tanner said.

“Exercising creates a different metabolic state in the body, requiring more energy and therefore more insulin,” he said. “Mushing does the same and it is quite exhausting, using a lot of muscles. Ninety percent of glucose that goes into muscle is converted using the body’s fat, protein and carbs as energy, and insulin is the gatekeeper to this conversion. These hypometabolic states, like mushing, require a whole lot of insulin.”

Tanner has treated a wide variety of diabetics, including professional athletes in the Lower 48 and even one musher competing in this year’s Iditarod. Understanding a body’s needs with these high-performance diabetics is different from an average person’s requirements because of an athlete’s increased physical activity, he said. Although the ailment is better understood today, it can be fatal if not diagnosed or treated.

Once diagnosed with type 1 diabetes, regular blood sugar and insulin moderating are necessary steps to ensure a healthy life, the doctor said. This is done in a variety of ways.

With recent medical advances, diabetics can have both their insulin and glucose levels checked simultaneously through an external insulin pump worn on the body. The pump can monitor the body’s levels through regular updates sent back to the pump’s computer and adjust insulin administration as needed, Tanner said. This can also be done through a hand-held glucometer. This iPhone sized device evaluates both levels, but it is up to the individual to administer insulin through injection. Many patients have both as a sort of fail-safe system in case one malfunctions.

If insulin levels dip too low in, hypoglycemia — or insulin-related shock — can set in, he said. Starting with mild problems such as being a little shaky or sweaty, hypoglycemic shock is a slippery slope. If not treated through insulin administration or raising glucose levels, hypoglycemia can quickly become life threatening as confusion sets in and cognitive abilities diminish, Tanner said.

In addition to increased energy demands and insulin usage during a race, the insulin Myers keeps in vials with him to prevent shock can freeze and become unusable, so Myers had to hold his insulin close to his body to keep it warm.

It was little tips like these that Myers received from Iditarod musher and fellow type 1 diabetes sufferer Bruce Linton.

“Bruce was great, and it was cool to get some help from him,” Myers said. “He gave me a few ideas while doing the junior about the race and how to hold the pump so it doesn’t get in the way and things like that.”

The regular stops to check his blood level placed him last in this year’s Junior Iditarod. But this was by design, as a snowmachiner was assigned to follow him just in case something happened, his mother said.

Backup plans like these were all part of the strategy developed by Myers, his mother, his doctor and Junior Iditarod race officials to ensure his safety on the trail while allowing him to compete.

But even with all the plans in place, his mother’s maternal instincts still kicked in.

“It always worries me when he is out running, and even though we were watching him through and kept him at a slower pace is was still difficult,” she said. “In the end it was a wonderful race, but nerve-wracking for me, his dad and grandmom.”

She found comfort in how well the other junior mushers treated him and constantly checked on him to see if he was OK.

“All the kids knew about it and they were wonderful very supportive,” she said. “They all kept an eye on him.”

Even though he finished in last place, Myers’ effort and determination paid off, as all his fellow mushers voted him as the winner of the race’s Sportsmanship Award.