by Dwain Hebda
There are a lot of inspiring stories of people overcoming diseases and disorders, but few are more impressive than Dr. Joe Henske of UAMS.
Since being diagnosed with Type 1 diabetes at the age of 15, Henske has run competitively at the high school level and for his undergraduate alma mater, Trinity University in San Antonio. He also runs extensively for fun today, including marathons, and has even turned the eldest of his five children, age 8, onto the activity.
To say Henske, an associate professor in the division of endocrinology and diabetes, doesn’t let his condition define his lifestyle is a gross understatement. And even though he admits his entry into the sport was fueled in part by youthful exuberance, over the long term, he’s gained more than a modicum of self-awareness.
“There are probably a lot of things in college that you do that you don’t really think about the long term, but I think everybody is just trying to do what they’re passionate about and for me running has always been something that I’ve been passionate about,” he says. “I was going to find a way to make it work. Sometimes it did and sometimes it didn’t. Sometimes I dropped out of a race because my blood sugar was too high or too low.”
As anyone who has done one knows – and as anyone who hasn’t can imagine – running a marathon takes an enormous toll on even the fittest of athletes. Henske said every diabetic athlete needs to understand and heed what their body is telling them, balancing competitive drive with common sense.
“As you live with diabetes, you learn some of the effects of exercise and different amounts of exercise on your blood sugars. Then you have to go through that trial and error period,” he says. “I think what’s amazing now is the technology that we have to manage diabetes is so much better.
“When I was a kid and when I was running in high school and college, we didn’t have that. We had the finger stick glucose meters and you might know what your blood sugar was before you ran, but you didn’t know anything about what was happening while you were running and whether it was going up or down and whether you needed to eat something or not. When in doubt I used to eat a banana because that was my sort of solution to everything.”
Today’s wearable glucose meters, transcutaneous devices that include a small thin wire a few millimeters underneath the skin, provide infinitely more information and with much better precision. The devices have not only prolonged and improved Henske’s own running career but makes it possible for athletes with similar conditions compete at the high level.
“These continuous glucose monitors send data directly to a watch or a phone and you can make real time decisions about how you’re going to exercise and how many carbohydrates you need to eat while you’re exercising,” he says. “It’s really facilitated my running career to have that information.
“Look at (former NFL quarterback) Jay Cutler who was at Vanderbilt; he was diagnosed with diabetes as he was going through that process. There’s a U.S. cross country skier, Chris Freeman, who was in four Olympics and was already an elite athlete when he was diagnosed with diabetes. You see that those people never gave up their focus and their mission as they were going through it and they didn’t let diabetes stop them either.”
Henske says science has just tapped the surface of what the high-tech glucose monitors can do.
“Anyone with diabetes, if they have one of these systems, is able to see the cause and effect of what they eat, how much exercise they get and what happens to their blood sugar,” he says. “These are amazingly useful tools to adjust medications, to adjust lifestyle. In fact, we’ve seen some people who believe in bio-hacking or life hacking, basically, people who don’t have diabetes who are wearing sensors because they want to optimize how they feel and how healthy their body is.”
“But for people with diabetes, once you get beyond continuous glucose monitors, we now have insulin pumps that communicate with the continuous glucose monitors and we’re progressing towards closed loop systems where we have a system that’s monitoring your blood glucose levels and delivering insulin based on those levels. I think this is really the here and now in terms of what’s happening, and those systems are going to continue to get better and better.”
“In the future, those systems will possibly deliver other useful hormones besides insulin, including glucagon which can prevent low blood sugars as well.”