You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View
Latest Lantus Articles
This article originally appeared in the February 1, 2004, issue of the Anchorage Daily News. It is reprinted here with permission.
Mindy Mendenhall plays basketball the way a bull browses a china shop. She’s all muscle and emotion under the hoop, and she’s manic enough to launch her body across the court after loose balls.
Lindsay Behrends, a teammate of Mendenhall’s at University of Alaska Anchorage (UAA), got in her way not long ago, and now she wears a Hannibal Lecter face shield during practice to protect a broken nose.
A 6-foot center for the Seawolves, Mendenhall gets as good as she gives. One day this season, she counted 22 bruises on her body.
“That’s just Mindy,” teammate and best friend Kamie Jo Massey said. “I hate it when I have to go against her in practice. She’s so strong. She has tons of bruises from hitting into people, and she bruises other people.”
But if bumps and bruises are the price of Mendenhall’s reckless style of basketball, elsewhere in her life the consequences of unrestrained behavior could be deadly.
She was diagnosed with the disease, which can cause heart and kidney disease, blindness and nerve damage, when she was 10. Ever since, needles, syringes, test strips and monitoring devices have been part of her daily life. Type 1 diabetes demands a constant vigilance that allows no timeouts, not even for basketball.
Over the course of a two-hour practice or game, Mendenhall will dash to the sideline at least three or four times, and sometimes a dozen or more, to prick her finger with a tiny needle to draw blood so she can test her blood glucose level.
If it’s too low, she eats or drinks something.
If it’s too high, she gives herself a shot of insulin, right there in the gymnasium, game or no game. She keeps her supplies at the water cooler; watch closely and you might see her hike up her jersey, pinch her abdomen and inject some insulin.
“You think, ‘Oh, needles, I could never do that,’” Mendenhall said. “But that never bothered me at all.”
What does bother her, on the occasions when she allows herself to think about it, is the long-range impact of her disease.
“I worry about dying when I’m 35,” she said.
Teammate Saved Her Life After a Dream
Diabetes is the sixth-leading cause of death in the United States, according to the American Diabetes Association. The association says more than 18 million Americans have the disease; of those, 5 to 10 percent have type 1.
Besides the long-range complications, a diabetic can go into severe hypoglycemia (low blood glucose) if her blood sugar gets too low. That happened to Mendenhall late one night about a year ago, and though she doesn’t remember much of what happened, Massey recalls it in vivid detail.
Mendenhall and Massey were roommates and slept in bunk beds, with Mendenhall on the top bunk. Massey woke up and heard Mendenhall making noise and moving around in her sleep, and momentarily Massey worried that her friend was in crisis. After all, Mendenhall had told her that her worst low blood glucose reactions usually happen at night while she’s asleep.
“I decided, ‘No, she’ll be OK,’ and I went back to sleep,” Massey said. “I was sleeping and dreaming, and someone in my dream came up to me and said, ‘You better get up and check on Mindy.’”
Massey calls that dream divine intervention. She got up and looked at the top bunk. Mendenhall was unresponsive and shaking, as if having a seizure.
Massey ran to the bedroom where her sister, Tiffany, a nursing student at the time, was sleeping. She woke her and together they ran to the refrigerator, where an emergency shot of glucagon was stored for just this kind of situation. While Kamie Jo frantically read the instructions aloud, Tiffany mixed the medicine and filled the syringe.
By now Mendenhall was thrashing pretty hard, and Kamie Jo had to hold her down while Tiffany administered the shot.
“She was totally out of it,” Kamie Jo said. “It was really scary. Of course, Tiffany and I both started to cry afterwards.”
Star of the Show Thrives on Attention
For Mendenhall, one of the telltale signs that her blood sugar is low is fragile emotions. She’ll cry easily, usually over nothing. That’s one of the signals that she should eat an energy bar or drink some juice.
The tears have nothing to do with feeling sorry for herself. Mendenhall doesn’t walk around as if a dark cloud were following her. If anything, she’s the life of the party.
On road trips, the Seawolves rent two vehicles and divide into two groups when they drive somewhere. Mendenhall rides in the car driven by head coach Jody Hensen and takes complete control of things, whether it’s choosing a radio station or regaling everyone with stories. The other passengers are a captive audience, and Mendenhall is the star of the show.
“She loves people, and she loves attention,” Massey said. “She loves being in a big group and making people laugh. She thrives on that.”
Hensen invited players to a Halloween costume party earlier this season, and Mendenhall showed up looking like a sitcom mother straight out of the 1960s—hair curled into a flip, eyeglasses with big frames, stretch pants and a gaudy pastel blouse.
Hensen asked her what she was. “Yo momma,” Mendenhall said, without missing a beat.
Constantly Monitoring Her Readings
But Mendenhall is serious when it comes to taking care of herself. Diet—what to eat, when to eat—is a huge factor in controlling diabetes, as are the monitoring of blood sugar levels and the intake of insulin.
She meticulously counts carbohydrates, not because she’s on the Atkins diet but because not counting them could have dire results.
She draws blood from calloused fingers several times a day so she can monitor her sugar levels.
She keeps a diary of what and when she eats, how much and when she exercises, her insulin intake and her blood sugar readings. Last week she was eagerly awaiting the arrival of a new testing monitor that can take in all of that information and show trends that may help fine-tune her eating and injection plan.
Diabetic athletes must be particularly watchful of their blood sugar levels while playing or working out, because the body burns sugar at a higher rate during exercise.
Doctors have decided that Mendenhall’s blood sugar must be in a safe zone, neither too low nor too high for her to play or practice safely. If it is not, she takes action—by eating or drinking something with carbohydrates or by injecting insulin. She stays on the bench until she’s back in the accepted range.
During a recent game at Seattle University, Mendenhall was out of the target range during warm-ups, and as the starting lineups were announced to the crowd, the Seawolves waited anxiously for the latest monitor reading to see whether their senior center indeed would be able to start. She was.
Mendenhall’s numbers fluctuate the most when her schedule changes. At the beginning of the season, the Seawolves practiced at 7 a.m.—a time of day when Mendenhall isn’t accustomed to eating or exercising. She struggled through some of those practices until finding a routine that worked—waking up a couple of hours before practice so she could eat a meal, take an insulin shot and arrive on the court with her blood sugar level at a plateau.
When afternoon practices replaced morning practices, Mendenhall again adjusted her habits. Road trips complicate things too, because meals come at different times than usual.
“It takes constant management,” Hensen said. “She really does a great job with it.”
A New Fit and a New Diet
Coming to UAA has turned into one of the best things that’s happened to Mendenhall, who is from Springville, Utah. For one thing, she joined a church group and met John Lindquist, a Dimond High grad whom she married on August 15.
For another, people at UAA took an interest in her diabetes. That hadn’t been the case at Snow College in Idaho, where Mendenhall played as a freshman and sophomore.
“My first coach didn’t take any time to understand what was going on. She thought anytime practice got hard, my blood sugar was low.”
At the time, Mendenhall had an older monitoring device that took 45 seconds to give a reading. So her quick trips to the water cooler to test her blood sugar always lasted at least a minute. Now she has a glucose meter that gives a reading in five seconds.
When Mendenhall arrived in Anchorage, UAA trainer Chris Volk set up an appointment for her with a doctor at Providence Alaska Medical Center. One of the first things that happened was Mendenhall’s insulin regimen was changed because the one she had been on was developed for children with diabetes.
Volk introduced her to dietitians at Providence, and they counseled Mendenhall on diet.
“If she had a weak link, it was probably her diet,” Volk said. “They pushed her into being more structured.”
Though many type 1 diabetics do not go far in athletics because of the need to constantly monitor sugar levels while exercising, there is no reason for them to avoid sports, Volk said.
Besides keeping blood glucose levels within the accepted range, the primary goals for a diabetic are healthy blood pressure and lipid levels—both cholesterol and triglycerides, Volk said.
“Her lipid levels are much better than they’d be if she were sedentary. That’s why exercise is good for diabetics, but it’s a challenge. That’s why a lot of them don’t stay with it this far.”
Mendenhall’s husband, who works for the Anchorage School District as a teacher’s aide, is still learning about diabetes. He draws comfort from the way Mendenhall takes care of herself and the knowledge that she’s been dealing with her disease since childhood.
Basketball, he figures, can only be a good thing, because it contributes to her overall health.
“I used to worry a lot, because I love her and that’s what people do. But she isn’t worried about it, so why should I be?” Lindquist said. “A much bigger concern is how many bruises she’s gonna come home with.”
Because diabetics competing at the college level and beyond are fairly rare, Mendenhall is something of a role model for youngsters with the disease. One time last season, UAA gave the local diabetes association tickets to a game so kids with the disease could watch Mendenhall play and then meet and talk with her.
A great idea, but the postgame meeting never happened, because a medical emergency sent Mendenhall to the training room with less than a minute left in the game.
UAA’s bull in a china shop, playing the only way she knows how, slammed onto the hardwood while fighting for a rebound. She had a concussion.
Mindy Mendenhall's Game Day Routine
9 a.m. I wake up. I test using my OneTouch UltraSmart meter. A typical glucose reading is around 140 mg/dl. I eat a bowl of cereal (Team Cheerios or Special K Red Berries). I administer 8 units of Humalog insulin.
Noon I test again. If I am low I have a snack, or if I am high I take a couple units of Humalog insulin. My usual glucose reading is around 160 mg/dl.
1 p.m. Shooting practice! I test right before I start. I am usually around 130 mg/dl. We practice for an hour. I usually test once during practice. If my BG has dropped at all, I eat a granola bar (20 grams of carbs).
2:30 p.m. Pre-game meal. I test before eating. A usual reading is around 200 mg/dl. I take 10 units of Humalog. I usually eat a meal consisting of potatoes, bread, salad, chicken and a juice drink (around 90 to 100 grams of carbs).
5:30 p.m. I arrive at school for the game. I check my BG and try to have it between 140 and 200 mg/dl before I play. My BG is usually high before games (260+). I get so excited sometimes I think I make it go higher than on other days, so I take 4 to 5 units of Humalog before playing. The trainer keeps a bottle of juice for me in case my BG gets low. I keep my meter and my insulin at the end of the bench for constant supervision.
6:40 p.m. Twenty minutes before game time, and still opportunity to get my BG to an ideal level. I test it now and see if it is going up or down from the last time and I react accordingly. If it is still high, I will take more Humalog insulin, only 2 to 3 units. If it is getting too low, I will eat a granola bar or drink half of the juice there (both about 20 to 30 grams of carbs).
Halftime: I test and make sure my BG is still within the target range (80 to 300 mg/dl) that allows me to play in the game according to my doctor’s guidelines. A usual reading is around 180 mg/dl. I usually don’t do anything when I am on target.
After the game: I am usually low from either taking too much insulin or playing too hard. Our trainer provides us with bottles of juice. I will check my BG. If it is low, I can drink a whole bottle of juice and take no insulin.
9:30 p.m. After-game snack or meal: This varies according to how hungry I am. I will usually consume 80 to 100 grams of carbs after a game. I take 8 units of Humalog insulin.
10:22 p.m. I take my 19 units of Lantus insulin to provide my basal insulin needs. I check my BG. A usual reading is around 170 mg/dl. I am then sure my BG will be sustained through the night and I go to sleep.
May 1, 2004