Olivia Smargiasso is the perfect example of living her best life with diabetes. This young lady has achieved so much already and her future is bright.

Olivia Smargiasso (18) lives in Brakpan with her parents and two younger siblings.

Diagnosis

I was diagnosed with Type 1 diabetes at the age of two and a half, in November 2005. My mom had noticed the classic symptoms of thirst and excessive urination. She tested my blood glucose at home, and it was 16,6. By the end of that day, I had seen an endocrinologist and started using insulin.

I think at about five years old, I understood that I had something extra I always had to think about. It was then that I realised I needed to test my glucose and bolus for food (I had gone on to an insulin pump six months after I was diagnosed). This was also the time I became aware that other people in the class did not tell the teacher they were feeling low. A low usually left me feeling sweaty, irritable and very emotional. These mood swings were definitely difficult to regulate.

Aim for a dart board rather than the bullseye

I think because I was diagnosed at such a young age, living with diabetes is all I’ve ever known. Whenever I feel that I don’t want to have to deal with my diabetes anymore, I remind myself that I don’t need to be perfect, only aim for perfection. Living with the challenge of diabetes is more about aiming for a dart board rather than the bullseye, and it’s more than okay to miss here and there.

I’m currently on a Medtronic 670 pump. Before this I used the Medtronic Veo and before that injections. I have used Novorapid short-acting insulin for the last 15 years. My treatment hasn’t changed much in that time, only the carb ratios and other settings on my pumps.

As a child, I saw an endocrinologist, and a diabetes nurse educator, who also has a son (now grown up) with diabetes. Thus, she could empathise with my family, especially my mom. In more recent years, however, my mom, Dr Angela Murphy, has become my doctor; she is a specialist physician

Dr Mom

I always joke that I couldn’t get away with anything because my mom knew when I wasn’t telling the truth. It was definitely challenging at times, having a doctor as a mom, because I knew she expected me to manage my diabetes with accuracy and precision.

I have also been very fortunate, though. My mom will often tell me about the launch of a new diabetic drug, or an advancement in research. She also sees how well I manage the many challenges of diabetes compared to patients or colleagues’ patients. I feel encouraged that perhaps I do manage my diabetes reasonably well.

Achieving in abundance

I was always encouraged not to let diabetes hold me back. I have Protea colours for karate after competing in Zimbabwe, Botswana and at the Commonwealth Karate Games. I’m a keen runner and Running Captain at school. I used to be an avid waterpolo and netball player too.

When I went onto continuous glucose monitoring (CGM), I found that playing sport became much easier as I was always aware of any change in my glucose levels. Before sensors, however, I would aim for a glucose level of 7,5-9 before playing sport in the afternoon and below 6,5 when swimming in the morning. This way I avoided experiencing a high after morning training and a low during netball or waterpolo practices after school.

I also make sure I always have something sugary close by. Game or Powerade have worked best for me; small sips throughout the training or match to replace any energy I’ve used while exercising. I also eat something with slow-releasing energy, like a banana, before training sessions or matches.

I don’t find that my diabetes affects my academic performance too much. If I go low or high in class, my teachers are always happy to let me eat something or bolus to correct my glucose. I am currently 4th in my grade, I was recently awarded the Best All Round Matric trophy and I’m the top senior public speaker too.

Next year, I’m moving to Stellenbosch to study environmental sciences. I’m really looking forward to this.

Diabetes camps

I have attended three diabetes camps; one as a camper and two as a leader. I absolutely love these camps and encourage every child with diabetes I meet to attend at least one. These camps not only equip kids with the practical and medical skills they need to live a full life with diabetes, but also instil a sense of belonging, showing kids that they are not alone in this very difficult journey.

Children get the chance to meet others with similar and different experiences, exchange stories and come up with new ideas and different approaches to the most common obstacles. These camps also show children that they can have a normal life and enjoy normal activities, they do not have to stop eating sweets or give up their favourite sports because of diabetes. I hope post COVID, camps will be able to happen again.

Supportive teachers 

My teachers were always patient, caring, and compassionate when it came to handling my diabetes. My Grade 00 teacher was particularly loving in helping me add up the amount of carbs I was planning on eating at lunchtime. I was always allowed to have a quick snack or go fill up my water bottle. Some teachers went as far as giving me nuts or fruit instead of cupcakes and biscuits when it was a birthday.

My Grade 2 teacher also has a child with diabetes and was involved in the diabetes support group my mom helped establish when I was a child. At the start of every year until I reached Grade 9, my mom met with the new teachers and chatted about my diabetes management. This was never a burden for them and they were always supportive. There have been other girls in my school with diabetes over the years, currently there are four of us in different grades. I’m always happy to chat to them if I can help them in any way.

I have heard stories of children being treated badly at school, by teachers and peers, because of their diabetes. I think more awareness is needed so that phrases like “you can’t eat that” and stigmas of diabetes being a result of an unhealthy lifestyle, are abolished.

Understanding friends

Most of my friends have been with me since preschool and have grown up knowing I have diabetes. When I explain the condition to people I have just met, I often use an analogy: the good soldiers in my body (my immune system) got confused and attacked their own castle (my pancreas) and destroyed it. Now it doesn’t work so I have to get insulin from this pump.

I also explain that it’s a genetic disease and there is nothing I could have done to avoid getting it. Nobody did anything wrong, my parents did not give me too many sweets when I was little. The condition was always in my DNA, it was only a matter of time before it activated.

I also say that I can live a completely normal life and do everyday activities like any other person. All I have do is simply be careful that my insulin covers my carbs, the correct amount and given in time. I need to be aware of the different effects of food and activity on my life.

Love of fruit

I absolutely love fruit, watermelon, pears, and oranges in particular. Whenever I have a sweet craving, I try to go for a fruit rather than a sugary snack. While sticking to a healthy diet is important, treats like KitKats or ice lollies are my go-to when I need something slightly less nutritious.

Good advice

For anyone that has just been diagnosed with diabetes, I would say the most important thing to remember is that life with this condition is a balancing act. It’s impossible to be perfect all the time and constantly have a blood glucose reading of 5,6 but luckily CGM has taught us if most of our readings are in the range of 4 to 10, overall control will be good.

But it’s normal and perfectly okay to miss the target range sometimes. The important thing is that we focus on the positives more than the negatives because that way we will see how well we are doing. Something I live by is, “Today I will do what others won’t do that tomorrow I can do what others can’t”.