SUCCEEDING WITH DIABETES

At just 16 years old, Southlander William Robertson has a string of local and national athletics successes to his name.

William says, ‘I was very shy starting athletics and nervous that I wouldn’t be able to trust my body because of type 1.

‘There’s a lot you don’t know when you go to events, like can I take my bag to the track? Where do they put it? How long between getting called and actually starting a race? What if there’s a delay?’

While these questions don’t matter much to most competitors, for someone with type 1, they can be crucial.

‘I also found out, when I went to do my first big race at the 2019 Colgate South Island Games, that bad nerves feel like a very bad low. I got scared and stumbled in the starting blocks and got disqualified. That was the 200 metres.

‘Even though I was nearly crying, I realised I had to ignore that mishap and try again the next day. I went home to the motel and searched up all the rules so I knew everything I could.’

He was using a pin pricker to test his blood sugar at that time and says, ‘I also knew I had to trust that my last pin-prick test before the race was right. The next day, I won the 100 metres race and also got third in the long jump, which I didn’t expect.’

Since that first big competition, he’s continued to persevere and has had some exciting wins. He came third in the 100 metres at the 2020 NZ Secondary Schools Athletics Championships – the biggest event of the athletics season for under 18s. In 2021, he won the junior 100 metres and long jump at the South Island Secondary Schools Athletics Championships and got second in triple jump.

He’s broken Southland records for his year group in 100 metres, 200 metres, and triple jump and was part of an under 18 relay team that broke the Southland record in 2021. The 200 metres record was 34 years old. There are still challenges. ‘In early 2020, the Southland Secondary Schools Athletics was at the same time as school camp, so I came home from camp a day early. I was so tired.

‘The morning of the competition, I got there and felt sick, like vomiting. I realised that I forgot my insulin injection with breakfast.

‘I just wanted to go home and get in bed. But I tried to keep thinking how I’d feel later when the insulin was working. I just kept that in my mind and had lots of water. It was hard, but I started getting better right at the start of my triple jump.’

To William’s surprise, he won.

‘I learnt so much about double checking things when I’m tired but also that, when something like that happens, I can’t give up. I just have to try and fix it and think past feeling sick.’

His parents have consistently supported him, and one of them always travels with him to competitions.

William says he’s also lucky with his coach. ‘He knows I’ll do my best and trusts that I’m not slacking off if I have to have breaks, or if I do a bit less some days when my blood sugars aren’t behaving.’

Now that William has a Dexcom CGM, his diabetes is a lot more manageable, allowing him to focus even harder on his sport. He can see his blood sugar levels at a glance and is alerted if he’s going high or low.

‘I think that to do well in sports is a very hard thing – but to do that with type 1 diabetes makes it more complicated. But it’s not impossible. I think it’s mind over matter – and just maths if you want it to be.

‘I want to show other young people that type 1 doesn’t mean you can’t do physically challenging things. You can be nervous at the start,and it might go a bit wrong, but if you learn and try again it will work out.’

Over time, William and his family have devised a set of strategies.

‘Mum and I have worked out that, on competition days, I need to avoid insulin for two to three hours before the event warm up. Sometimes it means I have to get up at 5.30 or 6am for a 10am event so I can get food into me.

‘Also, to do all the training, I have to estimate how hard it is on my muscles then work out with Mum and Dad how to adjust my insulin so I’m safe at night. I have quite a few broken sleeps – but it’s definitely worth it.

‘The Dexcom at least now alarms me, as I’m not great at waking to night lows.’

Of course, nothing is ever failsafe. In late 2020, his Dexcom sensor stopped working 90 minutes before a big final.

He was prepared. ‘Luckily, I had a Libre there – and my manual tester.’

He quickly applied a Libre sensor, knowing it would take an hour to calibrate so it could give him his blood sugar readings. That would be just before he had to leave to line up for the race.

‘These types of glitches are annoying, but they show how much extra effort we make to get to where we do as type 1s.’

William and his parents fundraise all year round to help cover not only the costs of competing but his CGM. ‘Nearly every Sunday, I go to our local farmers market with my mum and sell homemade beeswax wraps and cheese, and I look after a local business stall so that I can combine my site with theirs, which saves us a stall fee. We also sell the beeswax wraps online sometimes.’

They took part in Dr Susan Wardell’s study into medical crowdfunding in New Zealand – profiled the autumn 2022 issue of Diabetes Wellness.

William says, ‘As a family, we try and help others. Even though I don’t need to attend junior athletics anymore, I still go once a month and help the younger kids learn how to do long jump or use sprint starting blocks.

‘I was also interviewed about diabetes on our local community radio. I was nervous about this but wanted to do it to talk about how diabetes doesn’t make us that different to other people and how we shouldn’t be limited by diabetes.’

He and his parents are committed to raising awareness of diabetes. ‘We sent a PowerPoint presentation about diabetes and its wider impacts to our local Member of Parliament, Liz Craig, who’s on the Health Committee.’ It was then forwarded to the committee in support of Diabetes NZ’s petition for the government to fund CGMs.

William says, ‘It’s sad that Pharmac still aren’t providing CGMs – without them, life is a lot harder. It would be so hard to do well at athletics without my Dexcom. I’m just lucky my grandma and parents manage to pay for it, but I hate how others can’t. It’s totally unfair.’

Covid has impacted on this year’s athletics season. ‘It was sporadic – lots of cancellations again – which was gutting, as I’d trained all year and only got to go to one national meeting.’

But William is nothing if not determined. At that meeting, the National Track & Field, he took third place in the under 18 men’s triple jump.

He says his ultimate goal is to be selected in a New Zealand team to travel to the Australian Championships, and ‘one day I’d like to be selected to go to the Commonwealth Games or Junior Worlds.’

Watch this space.

A desire to work as a paediatric endocrinologist spurred Brooke Marsters to study medicine.

She’s currently studying towards a Bachelor of Medicine and Bachelor of Surgery (MBChB). After completing school with an NCEA scholarship in biology, she enrolled in the Health Science First Year course at Otago University. From 1800 students, she was one of 200 to enter the medical degree. On top of that, Brooke took an extra year to do a BMedSc (Hons), receiving first class honours. Her research led her into a project focusing on the use of the Freestyle Libre among youth, a topic she says she was fortunate to be involved in: ‘Being a teenager is hard, and being a teenager with diabetes is even harder.’

Brooke not only brings lived experience of diabetes to the medical profession but says that ‘as a Pacific Islander, I’m in a position to provide a perspective that is in tune with Pasifika values and is culturally appropriate.’

An initiative she helped organise was a health educator programme aimed at young Pasifika children to promote good physical and oral health for themselves and their whānau.

There have been massive challenges, including financial ones. ‘Taking time out of the medical degree to do research was something I greatly enjoyed. However, this added an extra year to the six-year traditional medical degree.’

She says that, given the large amount of course and study hours her degree requires, it’s not recommended that students also take part-time work. The financial burden is a large one for many students.

Brooke used the money from her McLaren Youth Award to help cover course-related costs – as well as additional accommodation and living costs for hospital placements. For these placements, Brooke has to travel to a new city, and find and pay for accommodation there, all while retaining her usual accommodation in Wellington. She says, ‘For many medical students, finding accommodation for these placements can be challenging, as we’re not financially compensated for them.’

She adds that ‘with type 1 diabetes, I have additional requirements and health-related costs. I need access to a secure fridge to store insulin and a secure place to store my diabetes supplies, reducing some lowercost

accommodation options that may be suitable for other students, such as backpackers.’ Communal refrigerators aren’t ideal for safely storing precious medication. Brooke also faces many expenses related to equipment needed for her medical training – for example, a stethoscope for examining patients’ heart and lungs. ‘In the past, I’ve been able to borrow a stethoscope from a peer, but this isn’t best practice given the current Covid situation and the need to have good hygiene practices.’

With publications in international journals, including Paediatric Diabetes, Brooke has presented her work on national and international stages. In 2019, as one of only two students (and the only undergraduate student) at the conference, she presented to the Australasian Paediatric Endocrine Group Annual Scientific Meeting.

Earlier this year, she was selected to present to the New Zealand Society for the Study of Diabetes Annual Scientific Meeting in Wellington.

Brooke believes that reducing the burden of diabetes not only betters an individual’s quality of life but their family’s as well. This allows them to live their life to the best of their ability and pursue any goals they set for themselves.

‘Being awarded this financial support to complete my degree will enable me to become more visible to others. I hope with this visibility that others might be inspired to pursue any dream they have, irrespective of the additional challenges that living with diabetes may present.’

A high academic achiever during his school years, Sam was Dux of Opunake High School and was then accepted into Otago University Medical School. However, he decided to do a science degree first and is now in his third year of a bachelor of Biomedical Science, majoring in Functional Human Biology.

He put his award money towards his tuition fees and is trying to keep his grades high to keep his options open at the end of his degree.

‘I can see myself researching diabetes in the future. It’s quite a misunderstood disease, in my opinion, and I’d love to contribute to the field somehow.’

He works hard to keep his own diabetes under control for the sake of his future health. ‘I’m always searching for new tricks to help make living with diabetes easier, and I’d love to share them with other people.

‘I joined a closed-loop pump study, and it’s made my life a lot easier.’ He’s passionate in his belief that this technology should be more widely available. ‘It greatly increases quality of life.’

Sam says, ‘I know what it’s like to miss out on different parts of school – sports and social events. Eventually, I want to help make other people’s lives better.’