Juan’s Story – Type 1 Diabetes (Puerto Rico)
Our Patient:
Patient: Juan, 15 years old
Location: San Juan, Puerto Rico
Diabetes Type: Diabetes Type 1
Background:
Juan had always been an active teenager, passionate about playing soccer with his friends after school. Born and raised in San Juan, Puerto Rico, his family lived a vibrant and culturally rich life, filled with family gatherings, Puerto Rican cuisine, and a love for the outdoors. At 15, he was in the prime of his adolescence when things suddenly took a drastic turn.
Juan’s family began to notice subtle changes in him. Over a few months, he was constantly thirsty, drinking water all the time, even during meals. He started waking up in the middle of the night to use the bathroom more frequently. Despite eating a lot, Juan lost significant weight and started feeling more tired than usual, even after a full night’s sleep.
Presentation of Symptoms:
One day during soccer practice, Juan collapsed. He felt weak, dizzy, and unable to stand. His parents rushed him to the emergency room, where doctors ran a series of tests, suspecting dehydration or a viral illness. When Juan’s blood sugar levels came back dangerously high, the diagnosis was clear: type 1 diabetes.
– Key Symptoms:
- Excessive thirst (polydipsia)
- Frequent urination (polyuria)
- Unexplained weight loss
- Extreme fatigue
- Blurred vision
- Dizziness and fainting during physical activity
Juan’s family was shocked. They had no history of diabetes, and it took time to understand what the diagnosis meant. The doctors explained that in type 1 diabetes, the body’s immune system mistakenly attacks insulin-producing cells in the pancreas. Without insulin, Juan’s body couldn’t regulate blood sugar levels, leading to dangerous spikes.
Diagnosis & Treatment:
Juan’s initial A1c test showed a reading of 11.5%, indicating that his blood sugar had been uncontrolled for some time. His treatment began with intensive insulin therapy, where he had to learn to administer insulin injections before meals and check his blood sugar multiple times a day. The transition was tough—emotionally and physically.
– Treatment Plan:
- Daily insulin injections (basal and bolus)
- Blood sugar monitoring before meals and bedtime
- Adjusting his diet to avoid foods that cause blood sugar spikes
- Regular check-ups with an endocrinologist to monitor his progress
Complications:
In the first year, Juan experienced several hypoglycemic episodes, where his blood sugar levels dropped too low due to miscalculating his insulin dosage. These episodes left him feeling shaky, confused, and scared. His family helped him adjust his lifestyle, but the journey wasn’t without challenges.
Three years after his diagnosis, Juan began to develop signs of diabetic retinopathy, a complication that affects the blood vessels in the retina. Thankfully, regular eye exams caught the problem early, and with better blood sugar control, his vision stabilized.
- Hypoglycemic episode
- Neuropathy (numbness in hands and feet)
- confusion
- diabetic retinopathy
- Elevated risk of kidney disease
Cultural and Family Support:
Juan’s family played a vital role in helping him manage his diabetes. They adjusted their traditional Puerto Rican meals to be more diabetes-friendly, swapping white rice for quinoa or cauliflower rice and reducing the amount of fried foods and sugary desserts like **tembleque** and **flan**. His mother found ways to make their favorite dishes healthier without losing the essence of their culture.
For example, they began using whole grains and incorporating more vegetables into meals like **mofongo** (a dish made with mashed plantains), ensuring it had less oil and fewer carbs. Juan learned to count his carbohydrates, making sure he balanced his insulin with his meals.
Life Today:
Now 18, Juan has become an advocate for diabetes awareness in his local community. He shares his experience with others, especially teens, helping them understand the importance of blood sugar control and how to live a fulfilling life with diabetes. He’s adjusted to life with insulin pumps, which makes managing his diabetes easier than the constant injections.
Although Juan has to remain vigilant about potential complications like diabetic retinopathy and neuropathy, he’s embraced a proactive approach to his health. His family remains a strong support system, and he continues to enjoy soccer, with some adjustments to his lifestyle.
