DULUTH, Minn. — When Kay Henricksen was diagnosed at age 10 with Type 1 diabetes, both she and her parents soon started to encounter the misconceptions.
“It felt like there was a lot of judging,” said her mom, Leah Henricksen of Duluth. “(People would say) this could easily have been avoided if you didn’t feed your kid so much sugar. And when she would have a soda or ice cream, we would get those looks.”
Now 18 and a freshman goalie for the Lindenwood University-Belleville (Ill.) women’s hockey team, Kay still gets confused reactions, the Duluth East graduate said.
“I still get it when I say, ‘Oh, I’m diabetic,’” Kay said in an interview during her winter break from college. “They look at me and say: ‘What do you mean?’ And I’m, like, ‘Do I look like I’m Type 2? I wouldn’t have a body like this if I had Type 2.”
The athletic, 5-foot, 5-inch Henricksen, who was recruited to play lacrosse as well as hockey at Lindenwood-Belleville, exemplifies the confusion in many people’s minds about the two major types of diabetes.
“They’re quite different,” said Norb Knack, diabetes intervention counselor at the Essentia Institute of Rural Health in Duluth.
Knack, 65, also has Type 1 diabetes, but his job is to prevent diabetes from developing in other people, which means his work is about Type 2.
Type 1 is an autoimmune disease that can’t be prevented, Knack said. Although there’s a genetic component in both forms of diabetes, nothing his parents or Kay Henricksen’s parents could have done would have kept them from getting it.
“Type 2, which is not an autoimmune disease, comes on … because the body becomes insulin-resistant,” Knack said. “You overeat and you become overweight, and once you become overweight your body develops insulin resistance.”
Both types are diagnosed when blood sugar becomes sufficiently elevated, Knack said. But Type 2 typically is initially treated with oral medications; insulin might come later. Type 1 can only be treated with insulin therapy.
It’s perhaps not surprising that when diabetes is mentioned, Type 2 is what people probably are thinking about. It’s far more common than Type 1, making up 90 to 95 percent of all cases, Knack said. And the prevalence of Type 2 has grown as Americans have become more obese.
Mysteriously, Type 1 also is growing more common.
“There’s an epidemic in Type 1 as well as in Type 2, and we’re not sure why that is,” Knack said. “With Type 2 it’s because of the obesity epidemic, but with Type 1, we’re not sure what in the world is going on.”
Type 1 used to be known as juvenile onset diabetes, and the typical age for diagnosis is 9 to 11, said Knack, who was 9 when he was diagnosed. But half of Type 1 diabetes cases are diagnosed in people older than 20, including one Knack knows who developed Type 1 at age 70. (When it’s diagnosed after age 20, it’s sometimes known as “latent autoimmune diabetes in adults,” Knack said.)
Type 2 develops slowly over a number of years, but the onset of Type 1 in juveniles often is much more sudden, Knack said.
It was in his case. Knack, who grew up in Milwaukee, was fine one month and deathly ill by the end of the next month, he said.
It wasn’t so dramatic in Kay Henricksen’s case. Diabetes runs in his family, said her dad, Kent Henricksen, so they weren’t taken off guard.
“She had shown some symptoms, so we took her in and had her tested,” he said. “So we were able to catch it before the really bad things happened.”
There was no thought of Kay, who was already in the Duluth Icebreakers all-girls program, quitting hockey. Nor did the independent-minded 10-year-old hesitate about learning to give herself insulin shots.
“I didn’t want my parents touching me anymore,” Kay recalled. “And I said no, I’m going to do it.”
Pump vs. pen
Within six months, she had switched to an insulin pump. The pump delivers a regulated amount of insulin into the fatty tissue on her side from a reservoir in a device that’s about the size of a flip phone. That can be carried in a pocket or attached to a belt.
She takes it off when she plays lacrosse, but not when she plays hockey.
“I’m a goalie, so I wear it on my back side when I play and I don’t get hurt with it,” Kay said. “If it doesn’t get hit and I don’t fall on it, we’re OK.”
And if it’s not OK, the manufacturer overnights a new pump, Leah Henricksen said.
Kay said she’s on her sixth pump.
There may be a generation gap when it comes to pumps. Knack uses an insulin pen to give himself shots; it’s called a pen because that’s what it looks like. He doesn’t entirely trust pumps, Knack said, although he calls them the most sophisticated way to give insulin.
“I know that once I take my basal (baseline) insulin that day, I’m not going to end up with ketoacidosis and in the hospital,” Knack said, referring to the condition that occurs when the blood sugar level is too high. “You don’t know that with a pump. They’ve got alarms, they’re supposed to tell you when it’s not working or the needle has come out of your skin. … But what if you don’t hear the alarm?”
Kay Henricksen has been hospitalized for ketoacidosis once and never for hypoglycemia, the condition of having blood sugar that’s too low. She has learned the signs of when her blood sugar is getting too high or too low, and she knows what to do about it, she said.
‘You’re stuck with me’
Kay isn’t secretive about her diabetes — usually. She didn’t tell the hockey coach in Belleville until he had asked her to play on their team, she said.
“Then I told him I was diabetic,” she related, with an impish chuckle. “He was, like, ‘Are you kidding me?’ I’m like, ‘No. Too bad, you’re stuck with me.’ ”
Given that Henricksen has been alternating with a student athlete from New Zealand as the team’s starting goalie, the coach apparently hasn’t regretted his decision.
Leah and Kent Henricksen said they’ve sometimes had to convince coaches that they had nothing to worry about. Their daughter responded by managing her own condition and by excelling as a player — starting as goalie last year for the Duluth Northern Stars, the combine team from East and Denfeld high schools in Duluth.
It’s a testimony of what the Henricksens want other people to know about Type 1 diabetes.
“It won’t hold you back,” Kent said. “There’s nothing that you can’t do just because you’re diabetic.”
Added Kay: “It just means that you’re more of a trooper to do it.”