As she stood on the podium being crowned Miss America 1999, Nicole Johnson was elated. What most people didn’t know is that only a few years earlier Nicole learned she had type 1 diabetes. Nicole’s diagnosis was devastating and complications from her diabetes forced her to drop out of college. The use of an advanced medical technology called an insulin pump helped her reach the podium.

Type 1 diabetes is a chronic disease in which the body fails to produce enough, or any, insulin to properly regulate blood glucose (sugar) levels.¹ In type 2 diabetes, the more common form, the body does not release insulin normally and is resistant to insulin’s action.

Type 1 and 2 diabetes exact a huge financial toll on the United States healthcare system, and totaled $132.7 billion (U.S.) in 2002.

Type 1 Diabetes Facts

People with type 1 diabetes need to monitor their blood glucose levels several times a day and inject precise amounts of insulin to maintain the proper blood glucose levels in their body. Not doing so can lead to major health problems, including diabetic comas, heart disease, blindness, kidney damage and even death.

Nicole learned the importance of maintaining these levels while competing in the Miss Virginia pageant - she collapsed on stage and fell into a diabetic coma. She knew there had to be a better way to live with this chronic disease. “It was my best and worst day. I knew I had to make a decision about living with type 1 diabetes,” she said.

Huge Financial Toll of Diabetes in the United States

The key to Nicole’s success in managing her disease was an insulin pump. Insulin pumps deliver insulin 24 hours a day through a catheter placed under the skin attached to a pager-sized programmable device that sends precise doses of insulin into the abdomen. The amount of insulin delivered is changed based on what a person eats and their individual body metabolism. Future generations of insulin pumps may be designed to automatically adjust and administer insulin based on the individual’s blood glucose readings. These future pumps may be especially helpful for young children with type 1 diabetes, since they may work automatically without needing to be continually programmed.

Controlling blood glucose levels is both life-saving and cost-saving. A recent study confirmed that insulin pumps are more effective than multiple daily insulin shots at helping people with type 1 diabetes control their blood glucose levels, and can lower the total daily insulin dose they need.⁶ Patients with well-controlled diabetes report higher employment retention rates, greater productive capacity, less absenteeism, and fewer bed or restricted-activity days.⁷

Well-Controlled Diabetes Improves Health and Saves Money

Nicole started using her insulin pump in 1997 at age 23, and she has never looked back. She has not had any complications, and has improved her A1c levels (a measurement of blood glucose levels over time). Nicole achieved her dreams of becoming Miss America and is now married with a four-month-old daughter named Ava. As a diabetes educator, host of a television show about diabetes, motivational speaker and journalist, she strives to inform people about the importance of taking charge of their diabetes.

“I want people to know that diabetes does not have to limit anyone. Thirty years ago, diabetes might have meant that I couldn’t have a healthy baby. The technologies available today have allowed me to achieve my personal and professional dreams,” she said.