FRIDAY, June 17, 2011 (HealthDay News) -- Crystal Bowersox, one of 20 finalists on American Idol last year, almost had her dreams dashed by the disease she's had since the age of 6 -- type 1 diabetes.
Several days before the 10 female finalists were supposed to perform, Crystal started feeling ill. She checked her blood sugar and it was over 400 milligrams per deciliters (mg/dL) -- dangerously high. Target blood sugar levels in people with diabetes vary, but generally should be below 180 mg/dL, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
"I knew I had to go to the hospital, but I thought it would be a quick fix. I ended up staying there two days," said Bowersox.
The singer/songwriter, now 25, had developed diabetic ketoacidosis (DKA), a condition common among people first diagnosed with type 1 diabetes, when they don't know they have the disease. The biggest risk for DKA is not caring for type 1 diabetes -- not checking blood sugar and not getting enough insulin. People with type 1 diabetes have to constantly balance their need for insulin with the foods they eat, their physical activity and their stress levels.
When DKA occurs, the body can't use sugar (glucose) for energy, so it starts breaking down fat for energy. This creates a highly acidic byproduct that can cause severe damage and lead to coma and death if untreated, explained Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City.
Bowersox wasn't the first Idol contestant with diabetes, but she didn't want to broadcast it. "My priorities weren't where they should have been during the Idol process," she said recently. "I wanted to keep my diabetes a secret. I didn't want special treatment, and I didn't want to be viewed as a diva."
Because of pharmaceutical and technological advances, there's almost nothing that people with type 1 diabetes can't do now. But, doing well with type 1 diabetes starts with good medical management.
"There are really great technological tools for patients to manage the disease, but they have to be proactive. Insulin pumps are great, but they're not automatic. Patients have to monitor their blood sugar readings and adjust their pumps based on that information," said Zonszein.
Bowersox thought she could handle her condition on her own. "But, with those crazy intense schedules, you really can't do it alone. You need a team," she said.
The rigors of a show like American Idol can cause dramatic blood sugar fluctuations in someone with type 1 diabetes. "It's different for each person," Zonszein said. "You have to see if you need more or less insulin. Some people are terrific at this, but very often, you see people who neglect the disease."
That's what Bowersox was doing. "I might have checked my blood sugar one or two times a day, if that. There were some days that I would realize I had gone an entire day without testing," the Chicago resident admitted.
Another Idol contestant with type 1 diabetes, Kevin Covais, was 16 when he got his shot on the show's fifth season. He told the producers he had diabetes, and said that they were great about providing whatever he needed.
Being on stage affected his blood sugar, but most of the time he was able to compensate for it. "There was definitely one occurrence when the nerves hit me," he recalled. "I think it was the third live performance. I felt fine throughout the performance, but as the judges were critiquing me, I could feel my blood sugar dropping. I was shaking a bit, and people thought that was nerves, but it's blood sugar dropping." Low blood sugar can be just as dangerous as high blood sugar levels.
Fortunately, Bowersox's story has a happy ending. The producers of Idol rescheduled the females' performance to give her an extra day of recovery, and she finished second overall. She recently released her first album, Farmer's Daughter.
Since then, Bowersox has improved management of her diabetes. She now checks her blood sugar levels 10 or more times a day. "When you know what your reading is, you know what to do. The only way you can live your life is by monitoring your diabetes," she said.
She and Covais are now active in diabetes advocacy, helping the Juvenile Diabetes Research Foundation and the Diabetes Research Institute. And, Bowersox has partnered with the makers of OneTouch blood glucose meters on their LifeFirst campaign to help highlight the importance of blood sugar testing.
"I realized that everything I did was being watched carefully, and to be a good role model, I had to live it. I had to let diabetes become a natural part of my life. Positivity begets positivity. There are no limitations. You can be anything if you maintain good glucose control," she said.
More information
Learn more about diabetic ketoacidosis from the American Diabetes Association.
