Kurt Lockhart, who has Type 1 diabetes, and his wife, Francesca, walk their dog, Ballot, near their home in Austin.
Jay Janner/Austin American-Statesman
Big things are happening for Kurt and Francesca Lockhart this Valentine’s Day. The Austin couple is expecting their first child, a boy, any day now. Their dog Ballot has no idea how her life is about to change.
Like many couples, they are partners in everything on the home front, but for the Lockharts that includes managing Kurt Lockhart’s Type 1 diabetes.
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Just months before the Lockharts met, Kurt noticed some changes in his body. In the summer of 2019, at age 26, Lockhart was feeling tired and sluggish, he said. He was thirsty all the time and needed to urinate frequently. Those are all classic symptoms of diabetes, but as an active young adult, who didn’t have a weight problem, diabetes never occurred to Lockhart.
He did have family members who had Type 1 diabetes, but they had all been diagnosed at a much younger age. He thought that at 26, he had escaped the disease.
“It was very shocking to me,” he said of when he was diagnosed.
Doctors made the diagnosis using blood testing, including antibody testing, and got him on insulin. That antibody testing confirmed that Lockhart’s diabetes was Type 1 and not Type 2.
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Kurt Lockhart, who has Type 1 diabetes, and his wife Francesca at their home in Austin. They have both become healthier by focusing on his blood sugar levels.
Jay Janner/Austin American-Statesman
What is the difference between Type 1 and Type 2 diabetes?
Type 1 diabetes means the pancreas no longer produces any insulin. Type 2 diabetes means the pancreas is producing some insulin, but the cells are not responding as well to that insulin, a condition known as insulin resistance.
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What is the treatment for Type 1 and Type 2 diabetes?
Type 1 diabetics have to be on insulin, said Dr. Thomas Blevins, an endocrinologist at Texas Diabetes and Endocrinology. Think of people with Type 1 diabetes as needing hormone replacement.
People with Type 2 diabetes might need insulin, but sometimes they can improve the way their body handles the amount of insulin it produces by losing weight and other healthy lifestyle changes.
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Kurt Lockhart, who has Type 1 diabetes, holds an Altoids mints tin containing inhaled insulin cartridges. He can fit them in his pocket and bring them with him anywhere.
Jay Janner/Austin American-Statesman
Is Type 1 diabetes the kind you get in childhood?
About 60% of the people newly diagnosed with Type 1 diabetes are 20 years old or older. While many are diagnosed in their 20s, he has seen plenty of adults newly diagnosed in their 30s, 40s and 50s.
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It is true that children tend to have Type 1 instead of Type 2, but that’s not always true.
Adults are often misdiagnosed with Type 2 because Type 1 is not as common and even doctors don’t think about Type 1 once someone is an adult. In children, Type 1 develops quickly, but in adults it can be a slow progression of the pancreas shutting down its insulin production.
Type 1 also has a genetics component. Blevins recommends that any adult who has a family history be tested for the antibodies, and their children should also be tested. The antibodies can appear years before the person has symptoms or a diagnosis.
“A lot of diagnosis happens in the hospital,” Blevins said. “They find they have very high sugar, but the antibodies have been there for a long time. That’s sneaky.”
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People who have one autoimmune disease also are more at risk for getting a second, including diabetes.
Kurt Lockhart, who has Type 1 diabetes, holds his insulin that he keeps in the refrigerator at his home in Austin.
Jay Janner/Austin American-Statesman
Are people with diabetes always overweight?
No. While weight can be an issue with people with Type 2, people who have Type 1 also can be overweight, or they can have no weight problem at all. Making healthier lifestyle changes cannot rid a person of Type 1 diabetes, but they can make a person who has Type 2 no longer need medication and establish a more normal blood sugar pattern.
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What happens if your blood sugar is too high?
Having a blood sugar that is consistently too high — 180 milligrams per deciliter hours after eating — can damage the kidneys, the nerves and the eyes over time.
What happens if your blood sugar is too low?
Blood sugar below 70 milligrams per deciliter is dangerous right away, Blevins said. Think of the body without glucose as the car without gas. People can become unconscious, have organ failure, heart problems and even die.
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What’s new in diabetes treatments?
Technology innovations such as continuous glucose monitors have allowed people to avoid having to do finger pricks to test their blood sugar multiple times a day. Doctors can prescribe a variety of insulins, including long-acting and short-acting in shots, pills, inhalers and pumps. They also have GLP-1s for Type 2 diabetes that help people lose weight as well as increase the insulin the body does make. Researchers are also trying to figure out if they could implant cells for the body to be producing insulin again, Blevins said.
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Kurt Lockhart, who has Type 1 diabetes, checks his Dexcom app at his home in Austin.
Jay Janner/Austin American-Statesman
Living with diabetes
“It can be a roller coaster sometimes, making sure your blood sugar is not too high or too low,” Kurt Lockhart said. He carries his short-acting insulin with him at all times to bring down his blood sugar, as well as fruit snacks to bring up his blood sugar quickly.
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He tracks his blood sugar on his continuous glucose monitor app, and Francesca also tracks her husband’s blood sugar through sharing the app.
“She has been such a rock helping me manage those highs and lows,” Kurt Lockhart said of his wife. “It’s peace of mind to have a second person to see those ratings.”
Sometimes she’ll even text him or call him to make sure he’s checked his blood sugar or done the intervention if it’s too high or low.
In addition to the medications, the couple also focus on healthy eating and managing the amount of carbohydrates they consume. They also make sure to exercise. “It makes me healthier,” Francesca Lockhart said.
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They also reach out to learn from other adults with Type 1 diabetes through the support and research group Breakthrough TD1.
This Valentine’s Day, if their son hasn’t arrived yet, they’ll share a meal, maybe with a glass of wine and dessert.
“I do like chocolate and cheesecake,” Kurt Lockhart said.
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And they’ll check what his continuous glucose monitor says and adjust his insulin to account for a special meal.